If this is really accurate, how big of a deal is this to you?

First off, I will indeed stipulate that any instance of workplace violence, whatever causative factors might be in play, is at least one too many instances of workplace violence. We deal with what appears to be an increasing potential for angry (and I’m using that as a catch-all—there are so many shades in the spectrum of rage) feelings to be acted upon, sometimes at the most minute of stimulations (I was going to use provocation, but I have certainly witnessed instances of acting out in response to so little, it boggles my mind). In response, it appears that our friends in Chicago are pushing towards a more demonstrative focus on issues related to workplace violence through the establishment of some new standards in the EC chapter.

From a practical standpoint, I don’t know that there’s anything so “new” here that folks are going to have to reconfigure their programs. In all likelihood, the elements being promulgated are among the things that you’ve been looking at for more than a little while (I did remember a time when workplace violence wasn’t quite so prevalent in healthcare and there were some places for whom this was not a topic of great consideration). So, the things that will clearly be a focus in the coming survey cycle include: an annual analysis of workplace violence prevention considerations, which would in turn result in mitigation of risk elements that cannot be resolved; monitoring of workplace violence occurrences, including reporting and investigation of said occurrences; providing education and training appropriate to the risks of workplace violence in the organization; and the participation of organizational leadership in these efforts, through establishment, and ongoing implementation, of a workplace violence prevention program. I am paraphrasing a wee bit here (you can find the verbiage here) but I guess the question I keep coming back to is: who isn’t doing this? I cannot imagine that there is a healthcare organization in the United States that is not struggling with this to some degree; the effective management of the risks associated with workplace violence.

The other interesting note from the above-referenced materials is the characterization of workplace violence occurrences being underreported, which may very well be the case, but it begs the question of what that actually means? There are certainly many points in the occurrence “chain” in which something might go unreported—and I suspect we have room for improvement there, if only in getting folks to the point where they’ll speak up. But underreporting beyond someone choosing not to speak up seems fraught with peril; the occurrences that come to the attention(s) of committees, services, etc. are not easily dismissed, etc., particularly as a function of regulatory reporting. I suppose this is one way to “leverage” an existing program by playing the compliance card (XYZ agency requires us to do this, etc.), but given the difficulties associated with the retention of staff, etc., how is it not in everyone’s best interests to have an effective process? I do not believe that we are in the habit of knowingly placing folks at risk without some level of preparation, but I also know that, for a fair number of safety professionals, the competing priorities that tend to reduce the opportunities for providing direct education to frontline workers are more bountiful than ever. I think we need to try and use the numbers to advance the cause of education and preparation for staff to deal with these ever-more-likely-to-happen events.

About the Author: Steve MacArthur is a safety consultant with The Greeley Company in Danvers, Mass. He brings more than 30 years of healthcare management and consulting experience to his work with hospitals, physician offices, and ambulatory care facilities across the country. He is the author of HCPro's Hospital Safety Director's Handbook and is contributing editor for Healthcare Safety Leader. Contact Steve at stevemacsafetyspace@gmail.com.