Combating Workplace Violence in Children’s Hospitals: Insights From an Expert-Hosted Webinar

Workplace violence is a troubling epidemic affecting all healthcare organizations — including pediatric hospitals — with detrimental effects on staff well-being, patient outcomes, and organizational health.

In a recent webinar hosted by Commure Strongline, Jeanne Venella, DNP, RN, CEN, CPEN, with over 25 years experience as a certified adult and pediatric ED nurse at the Children’s Hospital of Philadelphia (CHOP), Dr. Howard Grant, former CEO of Lahey Health System, CMO at Geisinger, and Medical Director and staff pediatrician at CHOP, and Justin Green, founder of Strongline, gathered to discuss the pervasive nature of pediatric workplace violence and its implications for staff engagement, patient experience, and overall care outcomes.

3 Reasons Violence in Children’s Hospitals is Increasing

73% of all non-fatal workplace injuries occur in the healthcare sector — making it the least safe industry in terms of on-the-job safety –– with pediatric units ranked third in terms of danger, trailing closely behind psychiatric units and adult emergency departments. Below are 3 main factors contributing to this sharp rise in the levels of workplace violence occurring in pediatric care settings.

1. Emotional Toll on Parents

It’s every family’s worst nightmare to see a child hospitalized. Parents often experience elevated levels of stress and helplessness when a child falls ill. One study found that half of parents of young children with RSV (respiratory syncytial virus) experienced extreme stress at the time of hospitalization, leading to potential frustrations being redirected towards healthcare providers.

2. Emotional and Behavioral Challenges of Patients

Patients, especially those struggling with mental health concerns, face emotional and behavioral challenges that can manifest as increased anxiety and depression.

Recent data from the CDC showed a significant rise in teens experiencing persistent hopelessness, with 30% reporting thoughts of suicide. Additionally, behavioral health patients are no longer typically confined to a single unit but are scattered throughout hospitals, further increasing the complexity of locationally managing care delivery and maintaining staff safety.

Doctor talking with pediatric patient | Commure Strongline to help prevent violence in children's hospitals

3. Political Tensions and Growing Divisiveness

“The threat of violence can come from outside the hospital, where digital fuel and political divisiveness can threaten Children’s Hospitals,” Venella explained, noting that children’s hospitals are uniquely exposed to outside threats of violence versus other units and departments — an unprecedented phenomenon that has taken a particularly sharp rise in recent months and years. “One of our customers has been repeatedly threatened for providing gender-affirming care.”

Gender-affirming care has faced backlash, with hospitals receiving threats and demands for different doctors due to offensive remarks targeting personal characteristics. “59% of U.S. physicians have heard offensive remarks targeting personal characteristics such as their race, age, gender, weight, or sexual orientation, and nearly half had a patient request a different doctor,” Venella continued. “This external pressure adds to the already challenging environment faced by healthcare professionals.”

How Violence in Children’s Hospitals Impacts Pediatric Staff

Research conducted over the past few years has revealed alarming statistics regarding the effects of workplace violence on healthcare professionals, including pediatricians. The following key findings highlight the importance of addressing this issue:

  1. Increased risk of psychological distress: Staff exposed to workplace violence are two to four times more likely to experience conditions such as post-traumatic stress disorder (PTSD), anxiety, depression, and burnout.
  2. Negative impact on work efficiency and engagement: Staff members who experience workplace violence often report decreased job satisfaction, motivation, and enthusiasm. For critical care staff, violent episodes can result in a 48% decrease in motivation and job satisfaction.
  3. Link between workplace safety and patient safety: Units with a strong focus on workplace safety exhibit a 52% lower rate of RN-perceived missed care. When staff feel safe, performance metrics across the organization — including patient experience scores, patient outcomes, and staff engagement — improve significantly.

The Financial Burden of Pediatric Workplace Violence

In addition to the negative impact on staff and patient care, panelists discussed how workplace violence can escalate labor costs and exacerbate staffing turnover in pediatric healthcare settings, emphasizing the following factors:

High staff turnover: Workplace violence contributes to staff turnover, with 25% of critical care staff expressing willingness to quit their jobs due to such incidents. A recent McKinsey study found a safe environment to be the number one factor impacting nurses decisions to stay or leave their current patient-facing roles.

Increased costs of recruiting and replacing staff: Recruiting and replacing healthcare professionals is particularly costly in pediatric hospitals. Temporary staffing to fill gaps — which often arises due to workplace violence — incurs a significant financial burden. Children’s hospitals have experienced a threefold increase in contract labor costs since the pandemic, and healthcare workers saw a 50% increase in days away from work — associated with intentional injuries in the workplace — between 2018 and 2020. On average, the cost of replacing a single RN can cost over $50,000, but anecdotally, the costs can add up to over double that, with an onboarding process of six to eight months.

Underreporting and Lack of Tracking

Webinar panelist, Dr. Grant, highlighted the issue of underreporting workplace violence incidents. “No matter how bad a hospital thinks its workplace violence is, it’s probably worse because 70% of all healthcare workplace violence incidents go unreported.”

Venella continued, “The main barriers to reporting include a lack of tracking and reporting infrastructure, difficulties in accessing reporting systems, and the time-consuming nature of the reporting process.”

Worse yet –– many healthcare staff today feel that workplace violence comes as part of the job. How can we expect pediatric staff to provide exceptional care to patients and families if faced with threats and potential harm?

Combating Pediatric Workplace Violence: The Need for Effective Solutions

To address workplace violence effectively, it is crucial to implement comprehensive solutions that prioritize staff safety while considering the unique challenges facing pediatric hospitals.

While many healthcare organizations have implemented much-needed foundational strategies including risk identification and de-escalation training, these approaches come with limitations, such as retrospective risk identification, inadequate access to help when staff members are alone with patients, and the inability of fixed panic buttons to consistently work and be in the right place.

Of those attending the webinar, 78% reported that their hospital’s current solution is not adequate when it comes to ensuring that all staff feels safe from workplace violence.

Introducing Commure Strongline

Commure Strongline offers an innovative and flexible duress alerting technology designed to provide discreet and immediate support to healthcare staff in the event of workplace violence. It allows caregivers to press a button on a badge they carry, which transmits their real-time location and name to relevant parties who can initiate a response.

As the only wearable duress alerting device purpose built for healthcare, Commure Strongline was created and developed at Jefferson Health System by frontline caregivers to overcome obstacles and limitations of other solutions. “From the beginning, reliability and functionality have been top priorities for the Strongline system. Every aspect is monitored and controlled to guarantee alerts are delivered promptly and accurately. The system’s performance is continuously assessed, and any potential issues are quickly identified and resolved,” Green explained.

“Dynamic location tracking is an important feature of the system,” he continued. “It allows for real-time tracking of the person in distress, ensuring responders can locate them accurately, even if they move during the incident. This feature eliminates potential confusion and delays that can occur with traditional panic buttons.”

Green discussed how Commure Strongline addresses gaps identified in other existing systems, such as wearable panic buttons with limited coverage of certain staff or facilities, and clinical communication devices that may not always be within reach. “Children’s hospitals have the most sophisticated early intervention and de-escalation protocols and tools — all the pieces of the puzzle in place except for one: the ability for caregivers to discreetly call for help before a situation escalates into violence,” Green explained. “Strongline, for many pediatric hospitals, is the missing link.”

Pediatric Workplace Violence Ends with Commure Strongline

Children’s hospitals have been at the forefront of implementing workplace violence prevention programs. However, the need for discreet and immediate support for staff members has been identified as a crucial missing link.

Commure Strongline’s duress alerting technology has proven to be effective in meeting the unique needs of pediatric healthcare settings, ensuring the safety of all staff members across various locations within the organization. By investing in solutions like Commure Strongline, children’s hospitals can improve financial performance, enhance staff retention rates, and create a safer working environment for all.

The message is clear: Protecting staff is not only the right thing to do for the safety and wellbeing of staff, patients, and families alike — it’s a strategic imperative that can positively impact every facet of an organization’s operations.

Watch the Webinar

Related Read: The Playbook on Workplace Safety: 4 Steps to Preventing Violence in Healthcare