Combating the rise of workplace violence in healthcare

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Incidents of workplace violence in healthcare settings are on the rise. According to the Bureau of Labor Statistics, healthcare workers are five times as likely to experience workplace violence than employees across all other industries, and these occurrences comprise an alarming 73% of all nonlethal workplace injuries and ailments stemming from violence. The World Health Organization (WHO) estimates that between 8%-38% of healthcare employees encounter some form of physical violence during their employment, with countless others experiencing verbal abuse.

Workplace violence — which includes physical violence, verbal threats, intimidation, and other forms of harassment — can be instigated by patients or coworkers, and has been linked to psychological distress, low employee engagement, high turnover, lower quality of care, and increased liability . In an industry where employees already face countless challenges — so much so that, by some estimates, nearly half of healthcare workers may leave the profession in the next year — violence in the workplace must be addressed and prevented. The nationwide demand for physicians is already growing faster than the current supply: the Association of American Medical Colleges has projected a potential shortage of over 100,000 physicians by 2033.

Healthcare organizations should prioritize both physical and psychological safety for their healthcare teams. It becomes imperative for healthcare leaders to scrutinize their current workplace violence prevention processes and establish policies that ensure safe and supportive employment environments. Beyond zero-tolerance policies and encouraging communication about workplace violence, the most effective strategy for preventing harmful occurrences is to predict future instances using data-driven insights. Below are three steps healthcare organizations should take to ensure they are doing all they can to protect their staff and that providers are adequately prepared to diffuse threats in the workplace.

1. Perform Routine Risk Assessments
   Although there are many different catalysts for violent events in the workplace, early detection of risk can often be achieved. One example would be conducting mental health screenings for patients. By identifying historical incidents and prior violent tendencies, this approach helps to be proactive in addressing problems before they arise.
   Research reveals that in 2022, 48% of hospital nurses reported an overall rise in workplace violence, up from 30.6% in September 2021. To diminish these numbers, hospitals have increased implementation of risk assessment tools such as the Brøset Violence Checklist (BVC). The BVC is a violence prediction screening tool that evaluates imminent violent behavior by identifying behavioral patterns and has the highest efficacy for anticipating workplace violence. Such tools comprise a set of industry-wide standards that healthcare professionals can use to identify warning signs, determine the risk of violence, and take subsequent steps to reduce it.
   Healthcare organizations can also proactively identify risks that may exist by performing an organizational analysis and evaluation of existing structures, processes, and policies. As part of any continuous process improvement, an annual program evaluation should be conducted, and updates should be integrated into future policies and education.
2. Provide Safe Environment for Training
   While violence can occur in any healthcare setting, data from the National Institute for Occupational Safety and Health (NIOSH) reveals that these incidents habitually occur in psychiatric settings, emergency departments, reception areas, and elderly/long-term care settings. It’s important to equip all clinicians with skills and training to handle threats, but specialized training for professionals working in these higher-risk settings should be considered.
   Offering practical, adaptable simulations can help employees learn initial recognition, de-escalation, and crisis prevention techniques in a safe learning environment, and can be administered via multi-modal delivery models including virtual reality (VR) technology. In addition to enhancing educational accessibility and repeatability for providers with heavy workloads, VR simulations can be personalized to include sensitivity trainings for specific patient or provider populations. VR is has also been shown to have a 75% learning material retention rate and a 52% reduction in skill fade.
3. Invest in Security and Reporting Technologies
   Healthcare workers who operate in solitary settings may be at increased risk for workplace violence. In these situations, organizations can support their staff by tightening surveillance measures and implementing rapid reporting systems that include mechanisms to ensure employees receive instantaneous help from additional staff members. Accessible, quick methods for constant communication with other providers and security can help mitigate violent episodes and instill a sense of safety for clinicians.Healthcare workers want to feel supported by their employers — and they should never need to confront a violent situation alone.

Healthcare organizations recognize there are many different types of workplace violence. It is essential to provide support, integrate mitigation strategies and necessary resources to detect and prevent future occurrences. Workplace violence is unacceptable in any context and can have damaging short and long-term effects. We can no longer shrug it off as “part of the job.” With healthcare settings experiencing the majority of workplace violence incidents, physician shortages expected to worsen, and a growing patient population due to the aging Baby Boomer population, healthcare leaders must prioritize efforts to improve the experiences of their staff and patients.

Felicia Sadler, MJ, BSN, RN, CPHQ, LSSBB is Vice President of Quality at Relias.