Let's Raise Public Awareness of Hospital Violence

Hospitals have a lot to fret over right now. Amid staffing shortages, enhanced competition, aggressive whistleblower suits, new infections cropping up, and abrupt cuts in reimbursements, it's small wonder that hospital violence has not gotten the attention it deserves.

Thankfully, this appears to be changing. The Joint Commission last week issued a well-timed Sentinel Event Alert on violence in the healthcare setting and noted that a "significant increases in reports of assault, rape, and homicide had occurred, with the greatest number of reports in the last three years."

My colleague at HealthLeaders Media, Cheryl Clark, wrote a comprehensive review of the report. For the sake of time I'll refer you to her story.

The opening paragraph of the JC report, however, is worth repeating. It states: "Once considered safe havens, healthcare institutions today are confronting steadily increasing rates of crime, including violent crimes such as assault, rape and homicide. As criminal activity spills over from the streets onto the campuses and through the doors, providing for the safety and security of all patients, visitors and staff within the walls of a healthcare institution, as well as on the grounds, requires increasing vigilant attention and action by safety and security personnel as well as all healthcare staff and providers."

Hospital violence is a theme that I have touched upon recently, both in this HR column and in our flagship HealthLeaders magazine, because I've been reading and hearing with alarming regularity about the problem. It's unnerving to read the words "assault, rape and homicide" used to describe events inside a "hospital."

As I wrote in an earlier column, Bureau of Labor Statistics data show that for every 10,000 hospital workers, eight workplace assaults resulted in missed work days. By comparison, in the overall private sector, only 1.7 workplace assaults resulted in missed work for every 10,000 workers.

Don't despair—regardless of the grim statistics. The cause is not hopeless, and I believe this disturbing trend can be reversed starting with a combination of employee training and public awareness. The good news is you don't need a national, top-down mandate, or a special report–however timely and welcomed–from The Joint Commission to determine the potential for violence in your hospital.

It starts with a workplace assessment to identify acts of violence and threats of violence at your hospital. One critical component of that assessment includes asking for–and listening to–the concerns of your clinical staff. These are smart, veteran professionals who–though they may not be experts in security--more than likely have a very realistic sense of the potential for violence in their workplace. They can help identify the real threats, and avoid the rabbit holes that waste time, energy, and morale. Your assessment might include observing first-hand nights and weekend shifts in the ED. To my knowledge, hospital violence rarely occurs in the C-Suite.

When you've assessed the threat, fashion the response. This could likely vary greatly depending upon the healthcare setting. Metal detectors; scenario training; armed security; heightened video surveillance–these are calls that each hospital has to make on its own.

Regardless of the setting, your hospital should have a prescribed approach to workplace violence, where every employee knows how to respond, where to go, where to direct patients and visitors to safety. Your employees will embrace response training, where staff are not working at cross purposes in times of great stress.

Another critical component is raising public awareness about the threat. First, your hospital should very publicly adopt a zero tolerance policy for violence. Hold a media conference and invite your newspaper, local TV, and radio. You don't need to have had a violent incident at your hospital to take a proactive stand. Explain the growing trend and your local concerns.

Of course, "zero tolerance" is largely symbolic. Words alone will not stop the violence. However, stating the case against violence puts the issue in the public consciousness. In effect, you are making your concerns the public's concerns. And you are inviting–if not obligating–local media to join your cause.

The public has been largely mute on the issue of hospital violence because the public does not understand the extent of the issue. It is your job to educate them. They will respond, because there is something particularly heinous about violence against healers. It strikes a chord.

With public support and media awareness, you can take your concerns to your local and state elected officials. If needed, laws can be enhanced or enacted. Perhaps additional funding for security can be had.

The data show that hospital violence is on the rise, even as crime in the overall society is hitting record lows. I hate to say this, but let's not wait for a potential Columbine-like mass shooting at a hospital before we take up the cause. Let's act now!

I would like to hear from readers about how they've tackled violence in the healthcare setting. How severe is the problem in your workplace? What has worked for you? What hasn't? What have been the toughest hurdles? Is your hospital C-Suite listening to your concerns?

Let me know. I'm concerned. I'm listening.

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