Policy Playbook: Workplace Violence and You

Author: Summer Chavez, DO, MPH, MPM (Health Policy Fellow, Georgetown University/Medstar) // Reviewed by: Alex Koyfman, MD (@EMHighAK) and Brit Long, MD (@long_brit)

emDocs is proud to release a new series, Policy Playbook, led by Dr. Summer Chavez! This first post in the series looks at workplace violence.

What is the issue?

On November 21, 2019, the House of Representatives passed the “Workplace Violence Prevention for Health Care and Social Service Workers Act” (H.R. 1309). ¹ If signed into law, this bill would require the Department of Labor to promote a safety standard in specific areas of health care and social services delivery.¹ Employers must draft and implement a plan to prevent and protect employees from workplace violence, deliver workplace violence training to employees, and maintain records.¹ The law mandates the employer to investigate potential dangers or events related to workplace violence in an expedited timeframe. In addition, the law would provide protection from retaliation and discrimination for employees for reporting.¹

Why does this matter?

Although the Occupational Safety and Health Administration (OSHA) can issue a citation to employers for not creating a safe workplace, employers are not required to implement a workplace violence prevention program. ² However, OSHA has publicly issued guidelines and recommendations to address workplace violence in the healthcare setting. ³ Eight states currently have laws requiring workplace violence prevention programs and the majority of states have some form of law related to assaulting workers in the healthcare setting. ² Other variations exist, such as those related to specific settings or signage. ²

Workplace violence, particularly in the healthcare and social services setting, is thought to be underreported, with some estimates as high as 50%. ^3,4 Compared to other industries, the number of serious workplace violent incidents, defined as those severe enough to require time off from work, was four times higher in healthcare from 2002-2013. ⁴ 80% of violent incidents are committed by patients. ⁴ A 2018 survey of emergency medicine physicians found 47% of respondents had been physically assaulted while at work, and almost 50% of those surveyed thought hospitals should do more to reduce workplace violence. ⁵

What can I do about it?

• Get in touch with your legislators—write or call!
• Meet with your department and hospital leadership.
• Develop your own workplace violence prevention program.
• Encourage reporting of workplace violence incidents.
• Help change your workplace culture.

Helpful Resources & Links:

• ACEP Policy Statement on Protection from Violence in the Emergency Department
• No Silence on ED Violence Campaign
• Active Shooter Planning and Response Guide
• OSHA Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers
• Suggested Actions from the Joint Commission
• Workplace Violence and Relationship to Regulatory Compliance

References:

1. Courtney J. Text – H.R.1309 – 116th Congress (2019-2020): Workplace Violence Prevention for Health Care and Social Service Workers Act. https://www.congress.gov/bill/116th-congress/house-bill/1309/text. Published November 21, 2019. Accessed February 4, 2020.
2. Workplace Violence. ANA. https://www.nursingworld.org/practice-policy/advocacy/state/workplace-violence2/. Accessed February 4, 2020.
3. Occupational Safety and Health Administration. Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers. https://www.osha.gov/Publications/osha3148.pdf.
4. Occupational Safety and Health Administration. Workplace Violence in Healthcare. https://www.osha.gov/Publications/OSHA3826.pdf. Accessed February 4, 2020.
5. Violence in the Emergency Department: Resources for a Safer Workplace. American College of Emergency Physicians. http://www.acep.org/administration/violence-in-the-emergency-department-resources-for-a-safer-workplace/. Accessed February 4, 2020.