Articles

Combating Healthcare Workplace Violence

Violence against healthcare workers has been a steadily growing concern. The industry is working towards addressing these dangers.

While prior legislation did not pass in 2019 and 2021, hospitals and health systems started to see changes in January 2022 with the Joint Commission's new workplace violence prevention standards. As the Joint Commission pointed out in its R3 Report to implement the workplace violence prevention requirements, the U.S. Bureau of Labor and Statistics has seen steady increases in violence-related healthcare worker injuries for the last decade.  

The new accreditation requirements include the following[1]:
 

•  Hospital Manages Safety and Security Risk.
  • The hospital conducts an annual worksite analysis related to its workplace violence prevention program. The hospital takes actions to mitigate or resolve workplace violence safety and security risks based upon findings from analysis.
• Hospital Collects Information to Monitor Conditions in the Environment.
  • The hospital establishes a process for continually monitoring, internally reporting, and investigating the following: safety and security incidents involving patients, staff, or others within its facilities, including those related to workplace violence.
• Staff Participates in Ongoing Education and Training.
  • As part of its workplace violence prevention program, the hospital provides training, education, and resources (at the time of hire, annually, and whenever changes occur regarding the program), to leadership, staff, and licensed practitioners. The hospital determines what aspects of training are appropriate for individuals based on recognition, response, and reporting of workplace violence as follows:
    • What constitutes workplace violence;
    • Educate the roles and responsibilities of leadership, clinical staff, security personnel, and external law enforcement;
    • Training in de-escalation, nonphysical intervention skills, physical intervention techniques, and response to emergency incidents; and
    • The reporting process for workplace violence incidents.
       
• Leaders Create and Maintain a Culture of Safety and Quality Throughout the Hospital.
  • The hospital has a workplace violence prevention program led by a designated individual and developed by a multidisciplinary team that includes the following:
    • Policies and procedures to prevent and respond to workplace violence;
    • A process to report incidents to analyze incidents and trends;
    • A process for follow-up and support to victims and witnesses affected by workplace violence, including trauma and psychological counseling, if necessary; and
    • Reporting of workplace violence incidents to the governing body.
       

Because not all hospitals and health systems subscribe to the Joint Commission standards, there have still been large gaps in healthcare employers looking to address workplace violence.  The opportunity to close these gaps was established on April 18, 2023, when both the Senate and the House reintroduced the Workplace Violence Prevention for Health Care and Social Service Workers Act (HR 2663 and S 1176) currently in committee review.

If passed, the legislation would require the Secretary of Labor to issue a standard for healthcare providers to write and implement a workplace violence prevention plan, and the legislation would apply to several different healthcare settings. The prevention plan would need to include the following:

• Unit-specific risk assessments and prevention measures, such as environmental and physical modifications;
• Adjusting staffing to prevent violence;
• Training regarding workplace violence prevention;
• Enhanced record-keeping requirements; and
• Employee protections for those who report workplace violence to their employer and law enforcement.

There also has been legislation introduced (Safety from Violence for Healthcare Employees (“SAVE”) Act) that would make assaulting healthcare workers in hospitals a federal crime with enhanced penalties for assaults resulting in serious bodily injury. The legislation has been pending in the House committee since November 1, 2023.

States have passed legislation to combat workplace violence in healthcare. In 2019, the Virginia General Assembly passed legislation making it a Class 1 misdemeanor to threaten to injure or kill healthcare workers. On October 1, 2021, Maryland’s Workplace Violence Act took effect permitting an employer to seek a peace order on behalf of an employee facing threats or acts of violence in the workplace. Now, all employers, not just healthcare, can petition for peace orders for their employees for any of the following acts:

• An act that causes one serious bodily harm;
• An act that places one in fear of serious imminent bodily harm;
• Assault in any degree;
• False imprisonment;
• Harassment;
• Stalking;
• Trespassing;
• Malicious destruction of property;
• Misuse of telephone facilities;
• Misuse of electronic communication or interactive computer service;
• Revenge porn; or
• Criminal visual surveillance.

 
Whiteford’s team has experience building out and revising compliant policies and procedures to meet regulatory and accreditation standards and providing immediate advice and counsel to respond to workplace violence concerns.