Independence Health System Tackles Workplace Violence

Workplace violence, often perpetrated by patients, is a top safety concern for staff at healthcare facilities across the country.

Independence Health System is taking a multi-faceted approach to addressing workplace violence.

"We have a three-pronged strategy for workplace violence," says Michael Fiorina, DO, CMO for the Pennsylvania-based health system. "First, we have leadership and administrative support for addressing workplace violence. Second, we have a focus on physical implementation of workplace violence interventions. Third, we put an emphasis on staff training."

Fiorina was a participant in the recent HealthLeaders CMO Exchange in Deer Valley, Utah, where workplace violence was a hot topic of conversation.

A study of outpatient physician clinics found that as many as 59.3% of physicians, 62.1% of nurses, 68.4% of receptionists, and 40.0% of technicians had experienced workplace violence. In 2023, the financial cost of workplace violence for hospitals was estimated at $18.27 billion, according to a study conducted by the American Hospital Association.

At Independence Health System, a workplace violence committee meets monthly to discuss leadership and administrative support for clinicians and staff. Members of the committee include two CMOs, three CNOs, the head of quality and safety for the health system, emergency department directors, and a representative from the department of medicine.

"For our five-hospital health system, this committee takes a broad view of workplace violence," Fiorina says. "It takes on governance and ownership of what we are doing as a health system to address workplace violence."

This includes discussing workplace violence during routine safety meetings at each hospital.

"At these meetings, staff members are encouraged to share ideas about reducing workplace violence," Fiorina says. "There are things that are seen at the frontlines that may be missed by the health system's workplace violence committee. By including workplace violence in the safety meetings at the hospitals, our employees feel we are taking the issue seriously."

For physical interventions, the health system has installed metal detectors at hospital entrances. Metal detector wands are used to screen patients who come to emergency rooms by ambulance. Over a three-month span at one hospital, the metal detector found 150 contraband items, which were mostly pocket knives.

Independence Health System is also posting signs at healthcare facilities to alert patients and family members about expectations for behavior when interacting with healthcare workers.

"Our signs that target workplace violence say that patients and family members should expect to be treated with the utmost respect and our staff expects to be treated with respect," Fiorina says. "The signs say we will not tolerate abusive language, threatening behavior, or aggressive physical contact."

Staff training for workplace violence includes techniques to de-escalate potentially violent situations involving patients and family members, as well as self-defense training.

"We want to head off workplace violence incidents involving patients before they happen," Fiorina says. "We have also provided training in personal protection such as what a staff member can do if they are caught in a chokehold."

Michael Fiorina, DO, is CMO of Independence Health System. Photo courtesy of Independence Health System.

How to Respond After Workplace Violence Incidents

When an incident does occur, health system leadership is quick to respond.

"If the victim feels they need to press charges, we support them in contacting local authorities and filing a police report," Fiorina says. "In addition, we have a robust employee assistance program. The EAP gets a referral after a workplace violence incident and reaches out to the affected employee to offer them the opportunity to discuss the incident and get counseling."

If a healthcare worker is injured during a workplace violence incident, they are immediately taken to a hospital emergency room for care.

"There is no charge for a staff member to get those services," Fiorina says. "If there is a need for further care, it is provided through our workmen's compensation office. We provide not only physical care but also emotional and psychological care."

The health system has a process to assess how and why those incidents occurred.

"The health system's workplace violence committee tracks incidents, and if there are trends, root cause analyses are conducted," Fiorina says. "The charge for the workplace violence committee includes getting suggestions from the frontlines and coming up with solutions."

The HealthLeaders Exchange is an exclusive, executive community for sharing ideas, solutions, and insights.

To find out more about the HealthLeaders Exchange program, visit the program’s webpage or the program’s LinkedIn page. To inquire about attending a HealthLeaders Exchange event and becoming a member, email us at exchange@healthleadersmedia.com.