Workplace violence: It could happen to you

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You may think workplace violence would never happen in your office, but the same can be said for flooding, wind damage and other natural disasters. Workplace violence is possible anytime, anywhere.

The Society for Human Resource Management (SHRM) defines workplace violence “as a spectrum of behavior…that generates reasonable concern for safety…physical and mental…for patients and employees.” Given this broad definition, workplace violence is not just limited to an active shooter situation. Bullying, harassment, physical abuse and verbal abuse can all be considered workplace violence.

Perpetrators of workplace violence can include employees who are dominant in words and actions, get upset easily, have issues at home and bring their attitude to work and act from a position of authority. They can also vendors, patients, patients’ family and employees’ family.

There are warning signs for possible workplace violence to watch for, including difficulty getting along with others; negative and non-supportive attitudes; odd behaviors such as being childish, pouting and generally non-supportive of the practice mission a physician or even fellow employees; recent layoffs; and controlling behaviors. Staff may be attacked, patients may be threatened, patients (or a family member) may come back and threaten and someone may lose control or turn violent at any time.

News of a shooting instills both shock and fear when it occurs in the workplace, nearly always with devastating results. But a shooting doesn’t have to result in casualties. Don’t wait for tragedy to strike to start preparing. Your medical practice needs to have a workplace violence prevention and response program in place.

Here are some key steps you can take to protect your patients and staff:

• establish a zero-tolerance policy for violent behavior by adapting a clear code of conduct;

• form a prevention program through effective communication;

• train staff to be aware of the potential during onboarding and include in your annual training along with OSHA, HIPAA - it’s that important;

• review your insurance coverage, including liability, physical damage and business interruption; and

• take ALL incidents seriously.

Take an in-depth tour of your facility to assess lighting, access control, badges, keys, alarm systems and review security video, especially if you are part of a medical office building. Encourage employees to report to their supervisor or to the compliance officer, who should log incidents; identify trends; report incidents to local police if necessary; and offer intervention including medical evaluation as needed.

The Department of Homeland Security has an active shooter program that is well worth reviewing in detail. Impart to your staff that if confronted by an active shooter, they should:

• run – have an escape route in mind,

• hide – move so you are out of the shooter’s view and

• fight – confront the active shooter as a last resort.

The Department of Labor, Occupational Safety and Health Administration, and Department of Health and Human Services also have a great deal of material available to help you plan for a number of possible workplace violence scenarios.

What is done after the incident is critical. You should offer psychological support for those involved, both directly and indirectly. Your compliance officer, practice leadership and board of directors should review all incident(s) in detail to determine what happened and how to prevent similar incidents from happening again. Prepare for how the issue will be communicated to internal staff, patients and the general public. Ask external resources for assistance dealing with the after-incident event, such as the local police department and counseling services.

Workplace violence can - and does - cause stress, turnover and create an uncomfortable workplace for staff that can impact patients. Do not think that your practice has not or does not have incidents of workplace violence. These situations do occur and are often swept under the rug or ignored and thus tolerated. There are likely signs that need to be addressed honestly and thoroughly to ensure you have a safe, secure and comfortable workplace for both your staff and patients.

Owen Dahl, LFACHE, CHBC is a consultant, author, speaker and professor with more than 50 years of experience in healthcare administration. He is an independent consultant based in The Woodlands, Texas.