Out of all nonfatal workplace violence occurrences, 73% involve healthcare workers, states the 2018 data from the U.S. Bureau of Labor Statistics.

Workplace violence against healthcare workers is embedded in our history. For decades, healthcare professionals have been a victim of workplace violence in cases of fatal and nonfatal incidents. Out of the 73% reported in 2018, an average of 20 constituted fatal cases. The data only covers workplace violence cases that healthcare workers report. In reality, more unreported cases go unnoticed by organizations or the healthcare industry in general.

The impact of this affair has led to an increase in the number of workplace violence cases. The safety risk of healthcare workers became a priority for the healthcare industry as the cases got traction worldwide. The escalation in these cases has many reasons, but the most prominent one is the lack of effectiveness in current workplace violence strategies. That’s why the U.S. House of Representatives passed H.R. 1195, Workplace Violence Prevention for Health Care and Social Service Workers Act, on April 16th, 2021.

It is the next step toward strengthening workplace violence prevention and ensuring the safety of healthcare workers. There have been many attempts by various bodies in the government and private sector to standardize a law that would prioritize workplace violence prevention.

However, they were all failed attempts until H.R. 1195, a bill that covers all the rights of a healthcare professional to stand against workplace violence and prevent future incidents.

What Is the Workplace Violence Prevention for Health Care and Social Service Workers Act?

It is legislation that regularizes a prevention plan for workplace violence, requiring the help of the federal Occupational Safety and Health Administration (OSHA). The legislation would mandate healthcare employers to implement a plan that protects their workers from workplace violence in accordance with the national standard provided by OSHA.

Workplaces that house a healthcare professional would have to follow H.R. 1195 and implement a plan for the safety of their workers. These workplaces include hospitals, social services, residential treatment centers, detention facilities, and the Veterans Administration, among many others.

The legislation requires these workplaces to provide workplace violence prevention training to their staff, investigate violent occurrences, and implement risk assessment and a workplace violence prevention plan. The workplaces would have to maintain a record of five years, as per the terms dictated in H.R. 1195.

The OSHA 2015 Guidelines for Workplace Violence Prevention would be the standard for implementing an effective prevention policy for the healthcare industry. The policy requires analysis of workplaces, hazard prevention and control, safety training, recordkeeping, and management’s commitment to employee participation. Once H.R. 1195 takes place, the prevention would be regularized.

However, the bill must be passed by the Senate before the healthcare industry can benefit from this proactive strategy for preventing workplace violence against healthcare professionals. Although the U.S. House of Representatives passed the legislation with 254-166 votes, the Senate approval is still pending.

Once the Senate approves the Workplace Violence Prevention for Health Care and Social Service Workers Act, it will need the U.S. President’s signature to turn it into law.

Objection or Support from the Healthcare Industry

Nurse and doctor safety is a priority for all healthcare industry employers. Still, they do not entirely support the proposed legislation. There is an organization within the healthcare industry that supports the bill, while another opposes it for a set of reasons.

American Public Health Association (APHA) supports the legislation after acknowledging the increase in workplace violence incidents in the U.S. APHA states that preventable measures are necessary to protect healthcare workers from assaults and violent crimes. They urge other healthcare industry professionals and workplaces to support the legislation so that healthcare workers can benefit from a standardized workplace violence prevention plan. Following APHA’s strong support for the safety of healthcare workers, American Psychiatric Nurses Association, American Nurses Association, National Nurses United, and other nursing unions have registered their support for the Workplace Violence Prevention for Health Care and Social Service Workers Act.

On the other hand, the American Hospital Association (AHA) opposes the legislation stating “prohibitive costs” as the main reason. Their objection is based on the decline of hospital revenues after dealing with COVID-19. They further state the current strategies that implement a workplace violence prevention policy to address such cases. However, it has already been established that the current policies are ineffective due to the lack of standardization of an executive plan for workplace violence prevention.

AHA also states, “We do not believe that the OSHA standards required by H.R. 1195 are warranted, nor do we support an expedited approach that would deny the public the opportunity to review and comment on proposed regulations.“

The difference in the opinions of healthcare industry organizations and associations sheds light on the failure of workplace violence prevention legislation before H.R. 1195. It also demonstrates the determination of healthcare employers to improve the workplace environment for the betterment of their workers. In light of that, it is only a matter of time before legislation like Workplace Violence Prevention for Health Care and Social Service Workers Act becomes law.

Why Should the Healthcare Industry Adopt H.R. 1195 before It Becomes Law?

Healthcare has a strict hierarchical system like many others in the industry. The role of leadership is crucial in establishing an effective workplace violence prevention policy.

Studies have shown how proactive actions by employers or leaders prevent workplace violence. It improves employee morale and productivity, leading to lower employee turnover and fewer sick days. Moreover, the use of H.R. 1195 aids in reducing employee mistakes that are often the product of burnout or distraction after a violent incident. Employers’ participation in improving workplace violence prevention policies helps improve organizations’ bottom line (workplace violence costs $1.1 billion across all U.S. hospitals per year).

With the implementation of an improved policy, the industry will witness:

• Reduced compensation claims due to workplace violence incidents.
• Minimized losses after readmissions and under-compensated care.
• Controlled premiums and reduced insurance loss run.
• Lowered costs due to absenteeism and employee turnover.
• Lowered costs related to patient injuries, accidents, and errors.

Given the benefits of an improved workplace violence prevention policy, healthcare organizations are bound to reduce budget issues. It will provide an opportunity to adjust H.R. 1195 requirements within the organization’s budget.

Actions Healthcare Organizations Can Take Now

Until such legislation is passed, certain strategies can help mitigate workplace violence and implement a prevention strategy that strengthens the workforce from within. Healthcare organizations can take on this challenge by taking action to decrease the number of potential threats to their workers.

Review Existing Policies on Workplace Violence

Healthcare organizations must review existing workplace violence policies to conduct research and identify loopholes in the existing strategies that plague the industry.

This research can provide insight into the industry’s actions to ensure their workers’ safety. The benefits of such measures do not end with eliminating inconsistencies in outdated strategies. Such actions would also:

• Assure the safety of healthcare workers.
• Improve morale during challenging times.
• Decrease potential damage cost.
• Educate healthcare professionals about dangerous situations.

Once the healthcare industry recognizes the need for change in workplace violence policies, they’ll be inclined to make the following changes to policy:

• Include a clear definition of workplace violence and procedure to report incidents.
• Explain the precise plan to respond to and investigate all reported fatal and nonfatal incidents.
• Establish training standards and frequency.
• Document record-keeping and post-incident reviews.

Provide Training to Healthcare Workers

As soon as the healthcare industry accepts the need to change workplace violence prevention policy, the training of healthcare workers to deal with incidents will become imminent.

It’s a proactive approach to ensure workers know their rights to stay safe within their organization.

1. De-Escalation Techniques

Training to assess and de-escalate a potentially violent workplace situation can prevent many cases. Going against human nature during a frightful situation and staying calm requires proper understanding and practice of de-escalation techniques.

2. Situational Awareness

This training would prepare healthcare workers to identify workplace violence.

If it has been normalized in a particular workplace, the training will enlighten the workers to identify unsafe situations as harmful or dangerous.

3. Stress Management

Violence against healthcare employees is unavoidable, given the volatility of the environment. Workers must be trained to manage stress during a potentially dangerous occurrence. It will keep them level-headed without losing control of their emotions or the situation at hand.

4. Security Procedures

Awareness about the in-house security procedures can help healthcare workers to establish authority during a violent incident. A training program helps them learn all the necessary procedures to follow when someone threatens their safety.

5. Threat Assessment

Differentiating between fatal and nonfatal workplace violence situations is essential for the safety of healthcare professionals. Not only in terms of workers, but employers also need to assess a threat and determine how dangerous it is. 

This is where the Workplace Violence Prevention for Health Care and Social Service Workers Act would help with its standard approach. Threat assessment would identify vulnerabilities and correct them using the appropriate security measure such as alarms, panic buttons, access control, monitoring systems, and lighting.

Ensuring a proper signage system is established within a healthcare organization also improves workplace violence prevention. The signage will mark exits, restricted areas, and evacuation routes. 

Final Words

Standardization of a workplace violence prevention policy is imminent in ensuring the safety of healthcare workers across the industry. The Workplace Violence Prevention for Health Care and Social Service Workers Act (H.R. 1195) can make it possible.

The government can play a vital role in helping the healthcare industry grow in the right direction with policies that support healthcare workers. However, a lack of support from the industry is the proverbial elephant in the room.

Although the approval of many healthcare associations for H.R. 1195 is appreciated, the points highlighted by AHA cannot be ignored. Healthcare has been an evolving industry with regulated administration and rules. Decades pass, but the industry standards remain unchanged, creating an air of cautiousness for new regulations like a workplace violence protection act.

It’s true that healthcare employers have policies to tackle workplace violence, but they are ineffective and do not cover all aspects of workplace policies. While fatal cases are the ideal worst situation that healthcare professionals have to face, it is essential to note that nonfatal occurrences are just as dangerous.

Nonfatal incidents do not leave marks on a victim’s body; they injure a healthcare professional’s mental health. PTSD, anxiety, depression, lack of emotional control in professional situations, burnout, and poor self-esteem are some of the problems a healthcare worker would face if they were a victim of workplace violence. This clearly shows the flaw in the existing strategies that are inadequate.

Implementing a new regulation or legislation will ensure a unified approach to a global problem affecting the healthcare industry. Ignoring the need for a standardized policy would be fatal for the industry. Healthcare workers deserve a safe workplace and to be heard. A violence prevention law can ensure this transpires in the healthcare industry.

If the industry regularizes H.R. 1195 before it becomes law, it will prepare healthcare workers to tackle workplace violence without facing injuries or embarrassment. The industry can strengthen its workforce by training individuals to contain and altogether avoid violence in the workplace.

No matter the danger, an active workplace violence prevention policy, like H.R. 1195, is equipped to help mitigate violence incidents, including active shooter situations.

This article originally ran in Security, a twice-monthly security-focused eNewsletter for security end users, brought to you by Security Magazine. Subscribe here.