Workplace violence in health care remains rampant as preventive efforts continue

This article was first published on our sister site health economics.

Violence against health workers has become almost routine, albeit horrifying.

The North Carolina Research Triangle expert experienced this situation regularly as an emergency medical technician. After taking a job as a nurse at one of her local hospitals, she realized that the violence was occurring at least weekly and was getting worse.inside worst thing he remembers, the patient went wild, throwing an elderly woman across the room and injuring 10 other people. The perpetrator was taped twice by security guards, but to no avail.

Since the pandemic, the problem has only gotten worse. In a national survey of 2,500 registered nurses conducted last summer by National Nurses United (NNU), nearly half of respondents said: Violence in the workplace was on the rise than the previous year. This is a 57% increase from September and an astonishing 115% increase from March 2021.

But even before the pandemic, violence against health workers was escalating. According to industry experts, the injury rate suffered increased by 63% between 2011 and 2018. Bureau of Labor Statistics data.

A costly emergency with no single solution

This situation is exacerbating the medical emergency on all fronts, not least the availability of qualified professionals such as nurses, doctors, assistants and service support staff.

It also has a significant economic impact on the health care system.a 2019 Report by Kaiser Permanente There were concerns about the burden of violence on the system. In 2017, out-of-system violence in the United States resulted in 2.3 million emergency department visits and 376,500 hospitalizations, costing an estimated $8.7 billion. Add in the $429 million in costs of violence, and the scope of the problem becomes even larger. And it’s only gotten worse in the meantime.

Many stakeholders are trying to take action on this issue.

• Groups such as the American Hospital Association continue to press Congress to pass similar legislation for health care workers that criminalizes assault and intimidation and protects airline employees.
• Community-based social welfare organizations partner with medical institutions. Better Tomorrow, a hospital-based violence prevention program in Springfield, Massachusetts, aims to connect victims with community services and devise prevention strategies. It is a Roca Springfield and Baystate Medical Center project focused on violence intervention in high-risk urban communities, and is funded by a $1 million grant from the U.S. Department of Justice.
• Kaiser Permanente is taking a focused approach, allocating an additional $25 million this year to expand its operations. Gun Violence Research and Education Center.
• The Joint Commission’s Speak Up program is aligned with patient safety and advocacy, but it also helps address sources of grievances (discrimination, care, facts about antibiotics) that can lead to violence. Masu.

OSHA intervenes

The frequency of violent incidents in medical settings is also high, prompting the Occupational Safety and Health Administration (OSHA) to respond. Convened a working committee to lay the foundations for a new regulatory framework for the prevention of violence in the health sector.

The panel is charged with Explore different topics This is a fundamental concern, especially what a “programmatic” approach to workplace violence prevention standards requires. However, other topics include risk assessment, violence control measures, prevention training, research and documentation, and more. One concern is to avoid biasing patients or clients.

of standard It will cover approximately 14 million workers and 300,000 health facilities, including hospitals, nursing homes, and various types of social services. The cost to employers of compliance is estimated by OSHA to be $1.2 billion annually.

Violence risk management requires a company-wide perspective

The risk of violence in health care settings only increases in a turbulent environment, but its impact is influenced by the cost of violence insurance, namely general liability (and to some extent management liability) and the availability of workers. This has not yet been reflected in the cost. compensation.

This does not preclude the need for management to increase preventive training and precautions and follow safety best practices.

The development of a company-wide, multidisciplinary violence program manages risk and promotes a culture of safety and quality.

joint committee new and revised standards for workplace violence prevention; Effective January 1, 2022, it provides a blueprint for best practices. Requirements include a violence prevention program managed by a multidisciplinary team, regular education and training on intervention and de-escalation. The focus is on prevention, awareness, response and reporting.

At a fundamental level, any violence prevention program must be built on a better understanding of risk. This means identifying all possible triggers (violence from a patient is very different from violence from an outside intruder) and ensuring appropriate safety measures are in place (e.g. entry/exit points and well-lit This means ensuring strict parking lot security, etc.).

It is difficult to effectively prepare proactive mitigation plans for unpredictable situations such as violence against nurses, doctors, and hospital aides. Most healthcare organizations have probably never included a pandemic, or even a global pandemic, on their top 10 list of crises to worry about. There is no time like the present to reconsider this.

Peter Reilly is the Operations Leader and Chief Commercial Officer of Hub International’s North American Healthcare practice, a global insurance brokerage firm. He leads and coordinates HUB’s healthcare planning, growth, and strategic initiatives. He also collaborates with other leaders and experts within the HUB to develop and introduce unique products that support healthcare institutions and providers across the healthcare delivery spectrum.