Hospitals making progress on combating workplace violence

Photo: Dean Mitchell/Getty Images

Hospitals and health systems are making headway when it comes to preventing infections, combating workplace violence and protecting the safety of patients, but according to a new American Hospital Association report, there's still work to be done.

The AHA gleaned its insights from the Quality Collective (QC), a collaborative platform facilitating engagement among leaders in healthcare quality improvement. In response to the impact of the COVID-19 pandemic, the QC embarked on a three-month initiative to address evolving challenges in quality improvement, and to collectively strategize on pressing healthcare quality-related issues.

Curbing workplace violence was a top priority for QC members. According to the AHA, hospitals and health systems use independent surveys and culture of safety surveys to better understand staff experiences and gather improvement suggestions regarding workplace violence. Some members indicated workplace violence is underreported by front-line staff, which has prompted awareness campaigns and interviews with staff, followed by additional surveys to assess the impact.

Forming subcommittees focused on workplace violence prevention within hospital teams has enabled hospitals and health systems to complete risk assessments, address staff concerns and present top recommendations to executive leaders, the report found. It added tat establishing a code of respect as part of organizational policy provides staff with clear procedures for responding to violent incidents.

The AHA recommended using technology support for mitigating workplace violence. To enhance prevention efforts, hospitals and health systems can employ electronic medical record safety screening tools and use QR code systems for reporting violence, bullying and incivility.

Trainings, meanwhile, can help by providing strategies to de-escalate a situation through practiced scripting and role modeling as well as empowering staff to speak up about any discomfort – emphasizing the importance of reporting workplace violence. Frequent workplace violence training and drills can be organized into "safety weeks" to provide an engaging way to bring awareness and educate staff on workplace violence, the AHA said.

Additional strategies include collaborating closely with local police to share strategies for emergency preparedness, defining roles during an emergency event, prioritizing de-escalation tactics before police involvement and installing panic buttons that contact the police directly and immediately.

WHAT'S THE IMPACT

In clinical domains, QC members reported that their organizations excel in patient safety, infection prevention and emergency preparedness. Opportunities for improvement were identified in population health management, behavioral health and health equity.

Culture, executive leadership commitment and performance improvement infrastructure were identified as strengths, while community engagement, technology and board involvement emerged as areas that still need work.

QC members identified a number of priorities when it came to organizational quality. Among them are a reduction in readmissions; reduction in harm events; improved stewardship of antibiotics; high reliability; an improved patient experience; health equity; and workplace violence prevention.

In terms of clinical quality, respondents cited patient safety, infection prevention and emergency preparedness and response as areas where there has been success. Less successful are population health management, behavioral health and health equity, according to members.

When assessing cultural quality, areas of success included commitment from executive leadership, accreditation and building performance improvement capacity. Areas ripe for improvement include community engagement, board engagement and technology.

THE LARGER TREND

A 2023 Premier survey found that 40% of healthcare workers have experienced at least one incident of workplace violence within the past two years, with the violence occurring most frequently among nursing staff at the hands of men between 35 and 65.

More than half of all reported incidents were at the hands of combative patients.

Those who have experienced such violence indicated that the events most frequently happened while explaining or enforcing an organizational policy, or while providing an update on a patient's condition to the patient or to the patient's family members.

Data compiled by the Cleveland Clinic in 2021 showed that, while workplace violence can occur in any organization in any industry, it's about four times more prevalent in healthcare than it is in other industries.

A National Nurses United survey done in November 2020 showed that, of 15,000 registered nurses nationwide who responded, 20% reported they were facing increased workplace violence.

Jeff Lagasse is editor of Healthcare Finance News.
Email: jlagasse@himss.org
Healthcare Finance News is a HIMSS Media publication.