Health care workers are increasingly becoming victims of violence-related injuries on the job.
The National Institute for Occupational Safety and Health reported that the violence injury incidence rate among Occupational Health Safety Network–participating facilities rose 65 percent for all health care personnel from 2012 to 2014. Workplace violence injuries increased by 55 percent among nurses during this time period.
Bonnie Michelman, executive director of police, security and outside services at Massachusetts General Hospital in Boston and the security consultant for Partners Healthcare Inc., says violence in the health care workplace remains a frequent challenge.
“It is critically important that we are all united in combating and minimizing the threat of violence,” Michelman told fellow hospital security leaders, nurses and others during an American Organization of Nurse Executives webinar on this subject last week. The program, led by Michelman and Christina Stone, R.N., nursing director of inpatient psychiatry at Massachusetts General, covered strategies and tactics that can be employed to better manage patients who exhibit signs of aggressive behavior, ways to collaborate to optimize response protocols when violence occurs and the need to develop proactive approaches to crime prevention.
With an average of more than 60,000 people coming through its facility every day, Massachusetts General has developed many sophisticated approaches to continuously improve its security measures. During the webinar the organization touched on several initiatives it has implemented, including:
- Analytics: The hospital deploys a computerized incident and activity reporting system that enables security leaders to quickly spot trends and identify things like the most volatile areas of the hospital so that resources can best be deployed or augmented.
- Addiction conflict and substance use disorder teams: The teams consult with med-surg staff about how to best manage these types of patients should they exhibit aggressive behavior. Stone notes that getting the addiction conflict team onto these units quickly along with a psychiatric physician to make medication recommendations has helped nurses and residents de-escalate these situations.
- Health care-specific training on management of aggressive behavior: All incoming nurses receive this education as part of their orientation. Police and security staff are also certified in behavioral recognition training and offer a two-hour class to staff on how to recognize people who may become aggressive or violent.
- Strategic Management Assessment Response Team: This multidisciplinary team, led by police and security, also includes clinical staff and leaders from the employee assistance program, risk management and psychiatry. The SMART Team discusses volatile situations that may be going on and provides customized consultations with departments on difficult situations they’re dealing with.
- Specialized services: The hospital offers assistance to employees who have been the victim of a crime in the line of duty. “We’ll go to their home to do a risk assessment, we’ll go to court with them if they decide to seek a restraining order or to press charges. We will not let them navigate that situation system alone,” Michelman says.
Stone says the organization also places a strong emphasis on training, education and providing tools to help clinical and nonclinical staff to recognize escalating situations and respond appropriately. Senior leadership has also been strongly supportive of these programs and others designed to reduce the threat of violence, she adds.
- The American Hospital Association’s Hospitals Against Violence website provides a variety of articles and multimedia resources that can help organizations respond to the threat of violence in their facilities and communities. Click here to access the HAV website.
- AONE webinar: Reducing Health Care Violence by Innovative Training and Valuable Partnerships.
- "Occupational Traumatic Injuries Among Workers in Health Care Facilities — United States, 2012–2014," Morbidity and Mortality Weekly Report.
- Occupational Health Safety Network: "Data and Injury Trends Among OHSN-Participating Facilities."