Between a Rock and a Hard Place The Dilemma of Workplace Violence in Healthcare

1. Between a Rock and a Hard PlaceThe Dilemma of Workplace Violence in Healthcare

2. Dilemma a situation in which you have to make a difficult choice an usually undesirable or unpleasant choice a problem involving a difficult choice

3. College Station Medical Center

5. What We’ll Cover What defines Workplace Violence? What are our obligations in addressing Workplace Violence? Common concerns with Workplace Violence Training What methods can be utilized to train our staff? What are the benefits of addressing Workplace Violence?

6. Defining Workplace Violence

7. Workplace Violence Defined FBI Report, “Workplace Violence - Issues in Response” • Workplace Violence was a term that surfaced in the Summer of 1989. • While there is no precise measure of the full extent and cost of violence in the workplace, it clearly represents a major challenge, affecting an estimated 1.7 million employees directly and millions more indirectly every year. (Source: U.S. Dept. of Justice)

8. Workplace Violence Defined ASIS International: Workplace violence refers to a broad range of behaviors falling along a spectrum that, due to their nature and/or severity, significantly affect the workplace, generate a concern for personal safety, or result in physical injury or death.

9. Workplace Violence Defined Four types of WPV Type I - Criminal acts. Those events where there is no relationship between the business and the actor. For example, a robbery with or without associated homicide or assault.

10. Workplace Violence Defined Four types of WPV Type II - Customer/client/patient violenceThose events in which the actor is not an employee, but has a relationship with the business or organization as a customer, client, or patient, and becomes violent while receiving services, etc. For example, a patient assaults a healthcare worker.

11. Workplace Violence Defined Four types of WPV Type III - Co-worker on Co-worker violence. Those events which occur during or after an employment relationship. An example would include current or former co-workers who harm or threaten to harm another employee. This would also include contractors and vendors.

12. Workplace Violence Defined Four types of WPV Type IV—Violence stemming from a personal relationship. Those events which occur in the workplace and stem from a personal, or intimate, relationship with at least one employee. These “domestic” events can include threats, harassment or physical harm.

13. Workplace Violence Defined Total of Private Industry Assaults Red = Healthcare U.S. Bureau of Labor Statistics

14. Workplace Violence Defined The National Institute for Occupational Safety & Health : • Acknowledges the high rate of assault in healthcare and tells us they occur most often during: • When setting limits such as: • Eating or drinking • Tobacco use • Alcohol use • Times of high activity w/patients • Meals • Patient transportation Or during involuntary admittance

15. Workplace Violence Defined Source: OSHA “Facts About Hospital Worker Safety” Hospital Worker Injuries Resulting in Days Away from Work, by Event or Exposure

16. Workplace Violence Defined Causes of Fatal Workplace Injuries in Hospitals, 2003–2011

17. Workplace Violence Defined Causes of Injuries Resulting in Days Away from Work for Selected Healthcare Occupations - 2011

18. Workplace Violence Defined National Council on Compensation Insurance Companies paid out $126 million in workers' compensation claims for workplace violence in 1995. In 2003, NCCI updated and extended its earlier analysis on this violence in the workplace. The following are among the key findings:

19. Workplace Violence Defined National Council on Compensation Insurance Workers compensation claims involving a criminal act are 10 times more likely than nonviolence claims to involve a fatality Among high-risk-of-violence occupations, incident rates remain high, particularly in health care, the retail trade, and other customer facing industries

20. Employer Obligations in Addressing Workplace Violence

21. Employer Obligations The General Duty Clause OSH Act of 1970 29 U.S. Code § 654 (a) Each employer— (1) shall furnish to each of his employees employment and a place of employment which are free from recognized hazards that are causing or are likely to cause death or serious physical harm to his employees; (2) shall comply with occupational safety and health standards promulgated under this chapter.

22. Employer Obligations “What gets measured gets managed.” - Peter Drucker

23. Employer Obligations 2013 Data 44,529 total calls ---------- 3315 High Risk

24. Brookdale Hospital Medical Center

26. Common Concerns with Workplace Violence Training

27. Common Concerns • Is it really necessary? • How do we convince others of the need? • Costs • In hiring a firm or organization • In lost productivity to training time • According to the Institute of Finance and Management the average healthcare organization spends $5.50/employee on WPV prevention • Fear that staff may mishandle the training

28. Common Concerns People (internal/external) may think we’re admitting to a problem It’s too negative - we promote a positive atmosphere There is too much liability incurred

29. Training Methods Utilized

30. Training Methods • In-house trainers • Select an employee (or group) to develop a program • Train the Trainer programs • External organizations • Often have expertise coupled with knowledgeable trainers

31. Training Methods Pitfalls… • Don’t just “check the box” • Inadequate instruction/instructors • Allowing the program to be watered down or letting instructors “pick and choose” what will be taught • Choosing an inadequate program/vendor • Lack of support at the administrative level

32. Benefits of Addressing Workplace Violence

33. Benefits of Addressing Workplace Violence • Reduced exposure to liability • “If we would have had this program, we wouldn’t have paid out a penny” • Increased employee satisfaction • “This is the first time I have ever had training where I felt like…actually cared about me” • Reduced injury and time off of staff – not dealing with: • Lost wages • Replacement worker • Lower moral

34. Benefits of Addressing Workplace Violence • Zero tolerance for inappropriate incidents • With the right program, staff members can be trained in: • Recognizing and Diffusing Conflict and Aggression • Safety awareness • Legal issues • Restraining violent individuals

35. Renown Regional Medical Center - Center for Advanced Medicine

37. QUESTIONS? Mike Owen | Program Manager Watch House International (o) 888.225.9569 | (m) 417.818.2319 www.WatchHouseInt.com | www.TheSafeApproach.com