To quantify the prevalence of workplace violence incidents occurring within Missouri hospitals, MHA relaunched a data collection initiative to inform advocacy efforts and member technical assistance. Designated hospital safety and security leaders have received an Excel-based collection tool, along with a request to submit standardized measures three times annually, to wpvdata@mhanet.com.
Worker Safety
Health care providers — especially front-line staff within hospital emergency departments — increasingly are faced with violent encounters by patients and visitors.
The U.S. Bureau of Labor Statistics found that 52% of all workplace violence incidents recorded are in health care. MHA has developed resources to assist member hospitals with mitigating workplace violence through advocacy, reducing regulatory burden, strengthening partnerships and implementing evidence-based strategies through policy development and staff skill building.
Workplace Violence in Health Care Settings Definition
MHA facilitated the review and adoption of a definition of workplace violence with the intent of providing clarity and scope, and establishing parameters for future data collection.
Purpose
To provide scope and direction to statewide program development and data collection initiatives.
Definition
“An act or threat occurring at the workplace that can include any of the following: verbal, written or physical aggression; threatening, intimidating, harassing or humiliating words or actions; bullying; sabotage; harassment; physical assaults or other behaviors of concern involving staff, licensed practitioners, patients, visitors or others on-site or off-site when related to the health care facility.” — International Association for Healthcare Security and Safety
IAHSS Resources
Priorities
MHA has prioritized the following actions to assist Missouri hospitals with reducing the incidence of workplace violence.
- Advocating for urgent awareness and reasonable regulatory interpretation from the Centers for Medicare & Medicaid Services — formal communication to Health and Human Services leadership to include CMS, the Assistant Secretary of Preparedness and Response and the Assistant Secretary for Mental Health and Substance Abuse was sent by MHA on behalf of member hospitals.
- MHA sent a letter to each Missouri county prosecutor informing them that hospital personnel were added to the definition of “special victim” in Section 565.002, RSMo., thereby enhancing the penalties for assault of hospital staff. The new provision broadens the scope of protected health care workers from the emergency department to the entire hospital facility.
To develop long-term actions, MHA staff conducted a listening tour of members in fall 2017 to better understand first hand experiences of workplace violence in member hospitals. Look for additional information in the following areas as developed:
-
- identification and dissemination of “best-practice” policies related to:
- warrantless blood-draws
- use of security/law enforcement worn body cameras
- appropriate and permissible use of TASERs (Thomas A. Swift’s Electric Rifle)
- reporting violent incidents to law enforcement
- identification and dissemination of “best-practice” policies related to:
- development of education and training related to:
-
- de-escalation for different patient and visitor profiles
- management of substance-related encounters with patients and their visitor
- prevention of sexual violence against health care employees
- incorporating security personnel into the care team
- development of criteria to evaluate different de-escalation training programs
- data to monitor trends and evaluate initiatives
- Workplace violence issues and identified solutions will require partnerships to effectively reduce occurrences within health care facilities.
- MHA staff, in partnership with the Missouri Department of Public Safety, hosted regional meetings in spring 2018 to provide joint education and policy development around HIPAA, EMTALA and Chain of Custody.
Resources
Workplace Violence Prevention Toolkit
With expressed permission, MHA adopted the Oregon Association of Hospitals and Health Systems’ Workplace Violence Prevention Toolkit as our framework to guide improvement efforts.
ASHRM Healthcare Facility Workplace Violence Risk Assessment Tool
The American Society for Healthcare Risk Management has developed a toolkit with resources, policies, checklists and training aids that helps health care organizations work with their staff to identify, mitigate and respond to workplace violence.
OSHA Guidelines for Preventing Workplace Violence
Healthcare and social service workers face significant risks of job-related violence and it is OSHA’s mission to help employers address these serious hazards. These guidelines reflect the variations that exist in different settings and incorporate the latest and most effective ways to reduce the risk of violence in the workplace.
TJC Workplace Violence Prevention Resources
The TJC Workplace Violence Prevention Resources for Health Care Portal provides a valuable source of information from TJC and other organizations related to the topic of workplace violence in health care.
CDC Workplace Violence Prevention Course
The National Institute for Occupational Safety and Health offers a free, interactive course designed to help health care workers better understand the scope and nature of violence in the workplace.
Contact An Expert
Policy Repository
To provide programmatic assistance to support the mitigation of workplace violence within hospitals, MHA sought policies from Missouri hospitals and other health care providers across the U.S. active in these efforts. The following information has been redacted by MHA and reviewed by Healthcare Services Group. This resource is for MHA members.
Regulatory Update
An update on workplace violence regulatory considerations is available.
Media Library