How to Measure the True Scale of Workplace Violence in the Healthcare Industry

Attempts to make healthcare facilities safer working environments may be ineffective due to the underreporting of workplace violence in the healthcare industry. Anonymous tip texting can help ensure efforts made to address workplace violence in the healthcare industry are not undermined.

In recent years, multiple states have passed legislation to address workplace violence in the healthcare industry and make healthcare facilities safer working environments. Although the majority have only established or increased penalties for assaults on employees, nine states require employers to run workplace violence prevention programs based on OSHA´s Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers (PDF).

OSHA´s Guidelines are also the foundation of The Workplace Violence for Health Care and Social Service Workers Act (HR 1309) which was passed by the House of Representatives in November 2019, but which failed to pass the Senate due to the COVID-19 pandemic. If the Act is passed in a subsequent Congressional session, organizations in all areas of the healthcare industry will be required to implement workplace violence programs which include:

  • A system for recording all serious occupational injuries and illnesses – including those sustained by an assault (including sexual assault).
  • A system for recording different types of assault, circumstances of each assault, and the nature of injuries sustained.
  • A system for recording employee-on-employee assaults – including verbal assaults and aggressive behavior.
  • A system for alerting healthcare and social service workers to a patient with a history of past violence, drug abuse, or criminal activity.

The objective of these systems is for safety managers to identify trends in workplace violence and implement measures to make working environments safer. However, the success of these objectives is reliant on employees reporting workplace violence in the healthcare industry – something that, in the past, healthcare workers have been reluctant to do. Consequently, there is no baseline against which to benchmark the success of workplace violence prevention programs.

Why Workplace Violence in the Healthcare Industry is Underreported

There are many different theories relating to why workplace violence in the healthcare industry is underreported. In 2015, OSHA attributed underreporting to the lack of a reporting policy and/or a fear of retaliation; while it was also been suggested a culture exists in which workplace violence is “part of the job”. However, in 2019, Edith Brous – a New York healthcare attorney – offered a different theory that management focus on patient satisfaction can deter reporting.

In an interview for Oncology Nursing News, Brous suggested that healthcare organizations who are reluctant to hold patients responsible for inappropriate behavior result in healthcare workers believing that reporting workplace violence is not worthwhile because nothing will be done to prevent it. This theory was also voiced by the American Nursing Association among a list of “Barriers to Reporting” (PDF), which included:

  • A health care culture that considers workplace violence part of the job.
  • A perception that violent incidents are routine.
  • A lack of agreement on definitions of violence; e.g., does it include verbal harassment?
  • Fear of being accused of inadequate performance or of being blamed for the incident.
  • A fear of retaliation by the offender and or employer.
  • Lack of awareness of the reporting system.
  • A belief that the incident was not serious enough to report.
  • Lack of manager and employer support.
  • Lack of training related to reporting and managing workplace violence.
  • A fear of reporting supervisory workplace violence.

The American Nursing Association makes several recommendations about how to address the issue of underreporting workplace violence in the healthcare industry consisting of employee and employer strategies based on OSHA´s Guidelines. However, the same issue exists as with the previously-mentioned workplace violence prevention programs – there is no baseline against which to benchmark the success of these strategies.

How Anonymous Tip Texting Services Can Address the Issue of Underreporting

Anonymous tip texting services have been helping law enforcement agencies fight crime for decades; and although many Crime Stopper schemes are reward-driven, their success is attributable to caller anonymity. A similar service in a healthcare facility should have a similar level of success considering that “informers” would receive rewards in the form of safer working environments.

Unlike the Crime Stoppers schemes, reports of workplace violence would be texted to a central platform configured to record the type of violence, the circumstances preceding it, and any injuries sustained. The data minus the sender´s mobile phone number is recorded on the platform for investigation – which increases the accountability of healthcare organizations to address the causes of violence, identify trends, and implement measures to make working environments safer.

Anonymous tip texting would overcome many of the theoretical reasons for underreporting workplace violence in the healthcare industry and the barriers to reporting listed by the American Nursing Association. In addition, although it would initially generate a spike in the volume of incidents reported by healthcare workers, an anonymous tip texting service would give the industry benchmarks against which to compare the success – or otherwise – of workplace violence prevention programs.