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Surveying Hospitals’ Workplace Violence Preparation


By James Kendig, Field Director

Late last month, a man identified as 45-year-old physician Henry Michael Bello walked into Bronx-Lebanon Hospital Center in New York—his former workplace—and opened fire with a rifle. He killed a fellow doctor and wounding six other people. 

The shooting was but one extreme example of the numerous workplace violence threats that workers in healthcare facilities across the country face every day.

Surge of Health Professional Injuries

According to the Occupational Safety and Health Administration (OSHA), from 2002 to 2013, the rate of serious workplace violence incidents, which are defined as those requiring days off for an injured worker to recover, were more than four times greater in healthcare than private industry on average. 

The “2017 Healthcare Crime Survey,”which analyzed the responses of security professionals at 222 U.S. hospitals, found that "Workplace Violence Type 2" assaults, which are acts of violence committed against hospital staff by patients and visitors, accounted for 89 percent of all assaults and aggravated assaults at hospitals from 2012 to 2016. 

By their very nature, hospitals and other healthcare facilities inherently contain many of the combustible elements that can result in outbursts of violence. The vast majority of people seeking treatment at a hospital and/or families and visitors are under a great amount of stress. When other elements—mental health conditions, narcotics addiction, and so forth—factor with someone’s propensity for violent behavior arise, so does the perfect storm.

De-Stigmatized Reporting

Nearly everyone agrees that workplace violence in the healthcare environment is not a new phenomenon, but doctors, nurses and other staff are now more likely to report it.

The Joint Commission, the American Hospital Association, the American Nurses Association, the American Medical Association, and other major health care organizations such as the Veterans Administration have all developed new violence-prevention resources, highlighting health systems with notable programs and solutions.

All these organizations understand that if health care providers do not feel safe in their practices, sub-optimal care and even increased risk of errors in treating patients are entirely possible.

In my work overseeing The Joint Commission’s Life Safety Code surveyors, I’m increasingly answering questions about workplace violence prevention in surveys. Though The Joint Commission doesn’t have a specific standard for “workplace violence prevention”, the topic is covered pretty extensively in some of our existing standards. Much of this falls under the security umbrella. For example, we ask that organizations:

  • complete a risk assessment

  • determine security sensitive areas

  • controlling access into and out of these areas 

  • addressing security for all persons entering the hospital

The preface information in the standards notes that safety incidents are most often accidental. On the other hand, security incidents are often intentional, caused by individuals from either outside or inside the hospital. While security issues may only scratch the surface for a problem as complex as workplace violence, keeping the wrong people out of the building could mitigate a lot of harmful incidents, including incidents like the tragic hospital shooting in New York.

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