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Addressing Workplace Violence in Healthcare

The scale of workplace violence in healthcare is unknown due to significant under-reporting; however, data from the Bureau of Labor Statistics indicates healthcare employees are four times more likely to be victims of workplace violence than in any other sector of private industry. Both these issues can be addressed with mobile technology.

In 2013, the Wayne State University School of Medicine conducted a survey to examine the difference between reported workplace violence in healthcare and documented workplace violence in healthcare. More than two thousand healthcare professionals from the hospital system responded to the survey – 45% of whom claimed to have reported an incident informally to a supervisor or manager.

However, when researchers compared the results of the survey to actual events entered on the hospital system´s database for documenting workplace violence incidents, they found a significant difference. Despite there being a human resource policy mandating the documentation of reported incidents of workplace violence, only 12% of informally-reported incidents were documented.

The discrepancy was consistent with previous research into the underreporting of workplace violence in healthcare; and while researchers acknowledged some of the discrepancy was likely attributable to non-physical violence, they noted that the underreporting of workplace violence in healthcare creates a critical barrier to the appropriate allocation of resources in order to prevent it.

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OSHA Finds Understanding Workplace Violence in Healthcare a Challenge

Two years later, the Occupational Safety and Health Administration (OSHA) used the research referenced in the Wayne State University study and Bureau of Labor Statistics data to support the view that workplace violence in healthcare is vastly underreported in an “Understanding the Challenge” report. The report attributed the level of underreporting to a wide variety of issues, including:

  • The perception that violence is “part of the job”.
  • The fear of retaliation (when reporting a co-worker).
  • A lack of training in violence prevention.
  • The lack of a reporting system – or lack of faith in the reporting system.
  • The lack of effective means of emergency communication.

In the conclusion to the report, OSHA suggests workplace violence in healthcare is preventable if management and employees participate in a comprehensive workplace violence prevention program in which the risks of violence are identified and addressed, safety and health training is implemented, and accurate records of workplace violence in healthcare are maintained.

The agency´s recommendations were subsequently included in a 2016 report – Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers (PDF) – which later became the backbone for the proposed Workplace Violence for Health Care and Social Service Workers Act (HR 1309). Despite passing in the House, the bill´s passage through the Senate was prevented by the COVID-19 pandemic.

Potential Issues with the Healthcare Violence Prevention Act

Had the Act been passed by the Senate, several potential issues existed. The first was that programs to prevent workplace violence in healthcare organizations should be designed around “past violence incidents”. As the past violence incidents in question were underreported and under-documented, the programs may have been inadequate to address the scale of actual violence.

The second issue is that the language of the Act does not fully address the five reasons given above for the underreporting of workplace violence in healthcare. While the Act states systems should be implemented for employees to report workplace risks, hazards, and incidents, there is nothing to address the culture of underreporting, the fear of retribution, or the lack of emergency communications.

A third potential issue is that the Act stipulates any national workplace standard that results from the Act´s passage should provide no less protection for employees than any state workplace standard. This implies that the Secretary of Labor would have to produce a workplace standard that is at least as comprehensive as the standard adopted in California – along with its incident reporting requirements.

Author: Steve Alder is the editor-in-chief of HIPAA Journal. Steve is responsible for editorial policy regarding the topics covered in The HIPAA Journal. He is a specialist on healthcare industry legal and regulatory affairs, and has 10 years of experience writing about HIPAA and other related legal topics. Steve has developed a deep understanding of regulatory issues surrounding the use of information technology in the healthcare industry and has written hundreds of articles on HIPAA-related topics. Steve shapes the editorial policy of The HIPAA Journal, ensuring its comprehensive coverage of critical topics. Steve Alder is considered an authority in the healthcare industry on HIPAA. The HIPAA Journal has evolved into the leading independent authority on HIPAA under Steve’s editorial leadership. Steve manages a team of writers and is responsible for the factual and legal accuracy of all content published on The HIPAA Journal. Steve holds a Bachelor’s of Science degree from the University of Liverpool. You can connect with Steve via LinkedIn or email via stevealder(at)hipaajournal.com

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