It’s every healthcare practice and facility administrator's worst nightmare—a situation where someone has entered your office or building with the intent to harm patients and staff.
Unless you’ve been under a rock in recent weeks, stories of violence at healthcare facilities have filled news headlines and jarred us awake to that ongoing reality. Consider these events:
- June 1, 2022: Five people were killed and several injured in a mass shooting in a medical office building on the campus of Saint Francis Health System in Tulsa, Oklahoma.
- June 3, 2022: Two staff nurses and an emergency department physician were stabbed inside Encino Hospital Medical Center in California.
- June 5, 2022: A visitor was shot at Wayne UNC Health Care in Goldsboro, North Carolina, prompting a one-hour lockdown at the hospital.
These awful tragedies have also reminded us about the critical role we can play in protecting patients and staff during a potential violent or active shooter situation. Whether you run a large medical facility or a small- to -medium sized practice, some refreshers on steps you can take to increase the physical security of patients and staff is a timely one.
Has Violence in Healthcare Settings Increased?
If it seems like there’s been more incidences of violence in healthcare recent years, you’re not alone. Federal data shows that healthcare workers faced 73 percent of all nonfatal injuries from workplace violence in the U.S. in 2018.
Even prior to the pandemic, healthcare workers suffered more workplace injuries as a result of violence than any other profession. Approximately 654,000 healthcare practitioners are harmed each year by attackers, according to the American Hospital Association.
And it’s just gotten worse since COVID. Since then, AHA studies say 44 percent of nurses witnessed or were victims of physical violence and 68 percent reported an increase in verbal abuse. In worse-case scenarios, 44 workplace homicides took place among private healthcare employees on average each year from 2016-2020, according to the Bureau of Labor Statistics.
And though most of this data refers to violence against healthcare practitioners, your patients are equally at risk when there’s violence in your office, clinic, or hospital.
What Legislation Is There to Protect Healthcare Employees From Violence?
In November 2019, the U.S. House of Representatives passed the Workplace Violence Prevention for Health Care and Social Service Workers Act (HR 1309). Though the bill still needs Senate approval, if enacted into law the Department of Labor to create an occupational safety and health standard requiring certain healthcare employers to develop and implement a plan to protect staff members from workplace violence. It would be similar to legislation passed to safeguard airline employees from occupational violence on commercial flights.
On June 7, 2020, a separate bill was introduced in Congress aimed at protecting healthcare workers from workplace violence that is modeled after existing protections for airline and airport employees. The Safety From Violence for Healthcare Employees Act would criminalize assault or intimidation of hospital employees and provide legal penalties for individuals who knowingly and intentionally do so.
How Does Workplace Violence Affect Patients and Staff?
For starters, there has to be a zero-tolerance policy for any type of violence or verbal abuse in the healthcare setting for everyone. In addition to the possibility for significant physical harm and legal liabilities, there’s a slew of reasons it’s vital to train and educate your staff about workplace violence. Some of these include:
- Ineffective patient care
- Psychological distress
- Job dissatisfaction
- High turnover
- Higher costs
Make sure you create greater awareness of and train your staff about the dangers of workplace violence, how to identify it, and what to do about it. For example, you can emphasize:
- What constitutes workplace violence
- Roles and responsibilities
- De-escalation methods
- Non-physical intervention skills
- Physical intervention techniques
- Response to emergency incidents
Reporting process for workplace violence incidents
In a nutshell, be prepared and have a plan. You’re likely already short-staffed and want to avert potential flashpoints before they happen. This will help you retain valuable staff members and let them know that you care about their physical, emotional, and psychological well-being.
What Can I Do to Protect My Patients and Staff From Violence?
Though physical violence rates are higher in hospitals and long-term care facilities, attacks against patients and staff can happen anywhere and at any time. Though statistically unlikely, healthcare organizations can be targets for violent individuals and even an active shooter scenario. Ensure you have clear policies and guidelines in place so staff know what to do in the event of any type of violence in your office.
A great resource is the U.S. Department of Homeland Security’s action guide for hospitals and healthcare facilities. It outlines that active shooter or assailant events can happen with little to no warning and suggests warning signs to look for that might escalate to violence. They include:
- Individual presents erratic, unsafe, or aggressive behaviors
- Individual threatens harm to themselves or others
- Claims of marginalization or distancing from friends and colleagues
- Changes in performance at work by staff member
- Sudden and dramatic changes in home life or personality
- Appearing out of place in staff-only, restricted locations
- Stalking/harassing of staff/patients
- Observable grievances and making statements of retribution
- Auditory indicators and menacing, antagonistic behavior
- Staff, volunteers, contractors not displaying proper ID badges
But what if a scenario is imminent or in progress? What can I do to protect myself and my patients in case of an active shooter or violent person?
- Avoid the assailant.
- Evacuate patients and staff from your office.
- Call or text 9-1-1 when it’s safe to do so.
- Secure patients and staff and lockdown critical areas if possible.
- Run to designated safe location if escape is not immediately possible.
- If running isn’t an option, preserve the safety of patients and staff.
- Try to hide in a room with thick walls and limited windows.
- Silence electronics.
- Secure entryways or doors by locking and securing with available furniture/equipment.
- Defend yourself, your patients, and your staff.
- As a last resort, try to disrupt or subdue the attacker using available items, such as a fire extinguisher.
What Preventive Measures Can I Take to Avert or Mitigate an Attack?
Again, advanced planning is critical to minimize the physical risk to patients and staff from an active assailant.
- Create an emergency action and notification plan. Train and educate staff on potential warning signs, how to report suspicious behavior, and assign staff various roles to help protect patients during an incidence of violence.
- Implement a facility wide notification capability, such as using a group messaging tool to alert scheduled patients and staff during an emergency. You can send a single group text message to a large number of people quickly and easily and prevent scheduled patients from arriving at your office or facility.
- Develop lockdown procedures for situations where an assailant may be outside your office.
- Designate a “safe” location at your office.
- Limit facility access, especially at night, with monitored entrances.
- Post signage relating to emergency exit and entry and first-aid locations.
- Coordinate your emergency planning with local law enforcement authorities.
Your options will be limited if and when a violent situation or active assailant scenario develops at your practice, hospital, or health system. Plan ahead to have procedures and policies in place to protect patients and staff and minimize harm in an emergency. Remember:
- Create an emergency action and notification plan.
- Train and educate staff about how to handle violence in your office.
- Communication will be key during a chaotic situation.
- Don’t forget: Run, Hide, Fight
- Call 9-1-1 as soon as it’s safe to do so.
- Your advanced preparation can be critical to protecting your patients and staff.
To learn more about how group texting can be a critical tool to quickly contact patients during an emergency or other contingencies, download the guide, “Best Practices for Solutionreach Group Messaging.”