July 1, 2018
Workplace violence affects many industries, and health care is no exception. In 2015, a Boston surgeon was shot to death at the hospital where he practiced by a family member of a patient who the surgeon had treated.1 In November 2017, a cardiologist in Ohio was shot and killed in the hospital parking lot by a man who “shared a mutual love interest,” according to the story in USA Today.2 As these tragic incidents illustrate, physicians and surgeons can become targets.
According to the Occupational Safety and Health Administration (OSHA), about 75 percent of the nearly 25,000 workplace assaults reported annually occur in health care and social service settings.3 OSHA also reported that workers in a health care setting are four times more likely to be victimized than workers in private industry.4 Furthermore, the National Crime Victimization Survey shows that workers in a health care setting have a 20 percent higher risk of experiencing workplace violence than workers in other settings.5
With this in mind, The Joint Commission recently released Sentinel Event Alert, Issue 59: Physical and verbal violence against health care workers. The focus of the alert is to help health care organizations better understand these violent acts toward health care workers from patients and visitors.
The Centers for Disease Control and Prevention National Institute for Occupational Safety and Health defines workplace violence as “violent acts (including physical assaults and threats of assaults) directed toward persons at work or on duty.”
The Joint Commission’s Sentinel Event Policy states that rape, assault, or homicide of a patient, staff member, licensed independent practitioner, visitor, or vendor while on site at a health care facility is a sentinel event that warrants a comprehensive systematic analysis. Sentinel event data received by The Joint Commission includes 68 incidents of homicide, rape, or assault of hospital staff members over an eight-year period.
The alert states that most incidents of workplace violence in the health care industry are verbal; however, other violent acts include assault, battery, domestic violence, stalking, and sexual harassment.6
Typically, the most common perpetrators of these violent acts are patients or visitors,7 with a 2014 survey attributing about 75 percent of aggravated assaults and 93 percent of all assaults against health care workers to patients or customers.8
The alert states that each instance of workplace violence against health care workers should be communicated to leadership, internal security, and possibly law enforcement, although studies show that these incidents sometimes go unreported. One study showed that the reporting rate for emergency department (ED) physicians was just 26 percent.9 One possible reason is that health care workers believe that violence directed against them is “part of the job.”10
While workplace violence occurs in all care settings, most recorded incidents are in the ED and inpatient psychiatric settings.4
The alert lists many factors associated with workplace violence, including the following:
Read more—including seven actions that organizations can take to better handle or prevent workplace violence—by accessing the alert on The Joint Commission website.
The thoughts and opinions expressed in this column are solely those of Dr. Pellegrini and do not necessarily reflect those of The Joint Commission or the American College of Surgeons.
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