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The Playbook on Workplace Safety: Four Steps to Preventing Violence in Healthcare

Clinicians, staff, and organization leaders designing a playbook on workplace safety

As we begin to leave the pandemic era of the past two years, we are facing a new epidemic in healthcare settings across the country: Workplace violence — including physical and verbal abuse, harassment, and intimidation — against clinicians and staff has reached crisis levels.

In certain sectors, such as law enforcement, the risk of violence seems to inherently come with the territory. Healthcare isn’t often thought of as one of them — yet, prior to the pandemic, nurses and nurses’ aides were assaulted more than police officers and prison guards. And a study conducted earlier this year revealed that 9 in 10 healthcare workers had witnessed or experienced workplace violence in the last month alone.

It’s clear, now more than ever before, that a reactive approach to workplace violence is no longer a feasible option — and during National Safety Month and beyond, it’s critical that health organizations take swift and proactive action. By following a proven four-step playbook, health organizations can codify a proactive and cross-functional workplace safety program that mitigates workplace violence, protects their people, and, in turn, improves healthcare for us all.

Step One: Assess

In the fight to stop workplace violence, measurable progress can only be achieved through collaborative buy-in from across the organization. Health organizations should start by identifying and supporting internal champions across all relevant departments; this includes nurses, physicians, direct clinical care staff, IT personnel, security and safety officers, and administrative staff.

By bringing together a cross-functional team of interdisciplinary experts, health organizations can better assess the current state of workplace violence across specific units and facilities. It’s also critical to involve executives and senior leaders in these early stages. Without input, investment, and expertise from the top down, any workplace violence program is likely to fall short of institutional goals.

Step Two: Aim

One of the biggest challenges in addressing workplace violence is separating the reported and unreported incidents — and then fully understanding the scope of each. Once the team has been assembled, obtaining a clear baseline of both reported and unreported incidents of violence is the first step to developing a data-driven workplace violence prevention program.

This baseline study or assessment should evaluate the current state of workplace violence over a predetermined period of time, tracking the number and frequency of total events as well as variations by day and time, patient cohort, and rooms, units, and departments. The workplace violence prevention team can then use this evidence-backed assessment to aim at and prioritize initial targets for reduction.

Step Three: Solve

With the baseline established and key targets identified, organizations can begin developing strategies for solving the problem of workplace violence. Teams should first catalog an uncensored list of strategies — considering both tried-and-truth methods as well as out-of-the-box thinking — then narrow the list and select one or several solutions to start with that are attainable and sustainable.

It’s important to keep in mind the tradeoffs of these decisions in order to maintain a multipronged approach. For example, organizations should ensure that they have the human and technical resources required to back the support strategies, and that these strategies include a balance of physical (e.g., mobile security system), emotional (e.g., safety-specific huddles), and organizational (e.g., safety-related benefits) components. When in doubt, refer back to the original idea list to explore and iterate on additional strategies.

Step Four: Execute

With the right team, the right metrics, and the right strategies in place, health organizations can begin to execute on their workforce violence prevention program. In addition to the above steps, key components of the action plan should include:

  • Finalizing and implementing an agreed-upon phased approach
  • Reviewing the reporting process to measure and adjust goals over time
  • Evaluating appropriate interventions, policies, and standards

Finally, consider the people involved and their unique roles. Set up team members for success by providing clarity on who does what, how, by when, and — most importantly — why. The greatest outcomes occur when all stakeholders understand the reason for their actions and the broader impact they have on their colleagues, their patients, and the organization as a whole.

There may be no single solution to end workplace violence for good — but, through actions both big and small, we can still enact meaningful change. By establishing comprehensive safety strategies, health organizations can operate as a united front to combat workplace violence and restore “care” into the healthcare environment for all clinicians, staff, and caregivers.

Jeanne Venella, DNP, MS, CEN, CPEN

Jeanne Venella, DNP, MS, CEN, CPEN

Chief Nursing Executive Commure Strongline Advisor

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