Workplace violence has become a hot topic in today’s discourse; however, workplace violence is not just headline fodder for media outlets. The trend is well-documented and especially felt by the healthcare industry which continues to experience the brunt after the onslaught of COVID-19. In 2018, 73% of all nonfatal workplace violence incidents involved healthcare workers. A late 2020 survey reported that 20% of nurses reported they were facing an increase in workplace violence after the COVID-19 pandemic began. Another study reported a 14.6% increase in workplace violence at New Jersey hospitals over the prior three years.

The issue of workplace violence is not purely academic but carries legal consequences for an employer’s nonprevention. In January, the Occupational Health and Safety Administration (OSHA) hit Montefiore Medical Center in New York City with over $13,000 in fines for failing to protect employees from workplace violence from patients, which resulted in broken bones and bite injuries. OSHA determined that Montefiore’s workplace violence prevention program was inadequate and lacked employee training. Further, while the healthcare industry has seen the highest incidence of violence, other industries are not immune. In late July, OSHA proposed more than $330,000 in fines against Family Dollar Stores Inc. for failure to implement effective workplace violence prevention programs, after one incident left an employee dead.

The first step in mitigating workplace violence is developing effective policy. An effective workplace violence prevention program should have clear goals, be suitable for the size and complexity of operations, and adaptable to specific situations. The first step in developing such a program is identifying risks through records review, hazard analysis of job tasks, employee surveys, and patient/customer surveys. The second step is to implement appropriate controls based on the identified risks. Some common controls in the hospital setting are providing two exits to every room, adding accessible silent panic buttons, ensuring workers are not alone with patients prone to violence, and periodically surveying and moving unneeded items out of reach of patients. Lastly, the program should be constantly reassessed and adjusted (preferably after every incident or near-miss) to ensure it is best-tailored to meet the program’s goals.

Of course, simply developing a policy is not enough. An employer must ensure that their workers are well-trained on the policy and their role in its implementation. Workplace violence can happen to anyone, and anyone can commit workplace violence. Therefore, it is imperative that all workers, including contract workers, supervisors, and managers, are trained on the policy. While training should include general instruction on developing a respectful workplace culture as a form of violence prevention, there should also be individualized training on job-specific hazards and the appropriate responses that have been developed for various positions. For example, emergency room workers should be informed that nighttime has been identified as a particularly high-risk time for violence and in turn workers should always be accompanied by or in the line of sight of another individual. After this initial training, workers should be given periodic refresher trainings on program expectations.

Merely ignoring the rising trend of workplace violence and thinking “it won’t happen to me” is not an option for employers, especially in the healthcare realm. The key to mitigating workplace violence is effective policy and training guided by experienced professionals in the labor and employment field.

The Healthcare team wishes to gratefully acknowledge the significant contribution of Eric Locker, a summer associate.