Workplace violence: Key considerations for healthcare entities

By Marti Arvin

Marti Arvin (marti.arvin@cynergistek.com) is Executive Advisor at CynergisTek Inc., which is headquartered in Mission Viejo, CA.

Working in healthcare can be difficult during an ordinary day. Add additional environmental stressors such as a hurricane, flooding, or a global pandemic, and it becomes even more so. These stressors not only affect the healthcare worker but patients and their families as well. Dealing with an aggressive or violent patient or visitor is not that uncommon but might be even more of an issue when these types of additional stressors are layered on top of the situation.

Being prepared will make it easier for the organization to deal with an aggressive or violent situation. Healthcare entities need to consider how to deal with aggressive or violent patients or visitors. This might include drafting a policy and procedure, providing training, and conducting drills on how to respond.

Healthcare workers can be subject to increased workplace violence risk

Healthcare has some interesting crime rate stats. In a 2020 survey by the International Association for Healthcare Security and Safety, for every 100 beds, there were 28 instances of disorderly conduct and almost 11 instances of assault.[1] While significantly less, there were still 1.4 instances of violent crimes per 100 beds, which include murder, rape, robbery, and aggravated assault. According to a 2015 report published by the Occupational Safety and Health Administration on preventing workplace violence, healthcare has almost as many instances of workplace violence–related injuries as all other industries combined.[2] Between 2011 and 2013, healthcare serious workplace injuries from assault constituted 11% while it was 3% among the private sector as a whole.

According to a 2017 report by the International Association for Healthcare Security and Safety Foundation,[3] some of the top stressors that can be potential triggers for an aggressive or violent outburst are things like:

  • Increased wait time in the emergency department,

  • Behavioral health patients in the emergency department with little or no information, and

  • Police using the healthcare facility to treat disturbed individuals rather than placing them in jail.

Other things that can increase the risk of such behavior in a healthcare organization are:

  • Unrestricted movement of visitors,

  • Increased prevalence of firearms and other weapons entering the building,

  • Decrease in security staff because of budget constraints,

  • Lack of or inconsistently followed security protocols, and

  • Staff not being trained to identify the warning signs of potentially violent behavior.

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