Addressing the rising risk of violence in healthcare facilities

May 17, 2022 – While not widely talked about, the healthcare industry has long been considered one of the most dangerous occupations due to the perceived dangers of workplace violence that many healthcare providers face in the performance of their duties. With violence against health care workers looming and causing serious harm, many health care workers have responded by calling for federal protections.

According to research reported by the American Hospital Association (“AHA”), prior to the onset of the current pandemic, healthcare workers suffered more workplace injuries due to violence than any other occupation, with approximately 654,000 injuries each year. However, violence against hospital staff alone has increased significantly since the beginning of the pandemic. For example, research from the American Heart Association showed that 44% of nurses reported an increase in physical violence and 68% reported an increase in verbal abuse.

When violence occurs in a healthcare facility, there are many unpredictable consequences, including potential injury or death to building occupants, property damage, lawsuits, and an increased likelihood of adverse medical events. Healthcare employers have long developed strong guidelines to detect and deter such violence against their employees. Still, given the recent push by industry employees to provide additional federal protections, healthcare employers must ensure they review employment policies to prevent potential claims for alleged failures to protect their employees.

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Healthcare Hazards: Defining Workplace Violence

The National Institute for Occupational Safety and Health (NIOSH), a research agency branch of the Centers for Disease Control (CDC), defines workplace violence as “an act or threat of violence, regardless of intent, that occurs within a protected premises, facilities, or when covered employees perform covered services.”

According to NIOSH, there are four types of violence that can occur in the healthcare workplace. The first category is perpetrators unrelated to the workplace or its employees. In the second type, the attacker is a customer or patient of the workplace or employee. The third is when the attacker is a current or former employee of the workplace. Finally, the fourth category occurs when the abuser has a personal relationship with the employee but not the workplace.

According to the American Nurses Association (ANA), Types II and III workplace violence are the most common categories of healthcare workplace violence. In fact, an ANA survey of more than 5,000 nurses showed that 59% of nurses were verbally assaulted by patients in 2019. That number rose to 70 percent in 2021, according to a report by emergency room nurses, as they experience more assaults on the job, due to the stress of the pandemic and its overall impact on the healthcare industry.

Push for proposed solutions

In November 2019, the U.S. House of Representatives introduced and passed the Workplace Violence Prevention Act for Healthcare and Social Services Workers (HR 1309). If enacted into law, HR 1309 would require the Department of Labor (DOL) to develop occupational safety and health standards, requiring certain health care employers to develop and implement a comprehensive program to protect health care workers, social workers, and other workers from Injury violence in the workplace.

HR 1309 by requiring employers to:

(1) Addressing violence in the social services and home care sectors;

(2) Promptly investigate workplace violence, hazards and risks;

(3) Provide adequate training for workers who may be exposed to violent situations;

(4) maintaining appropriate documentation and records of workplace violence; and

(5) Discrimination and retaliation against workers who report incidents of violence or concerns are prohibited.

Recently, HR 1309 was received by the U.S. Senate and submitted to the Committee on Health, Education, Labor, and Pensions for review. If HR 1309 were to pass, it would eliminate the patchwork approach currently enforced by various state conservation laws. For example, Illinois and Maryland have passed laws that try to protect nurses and other health care workers from abuse, but they are different and not uniform. Some laws require employees to be trained on workplace violence, while others penalize perpetrators of violence against healthcare workers.

In March 2022, AHA urged the Department of Justice (DOJ) to support HR 1309 in a drive to address the alarming rise in workplace violence facing healthcare professionals. In support of its plea for help, the AHA cited the DOJ’s commitment to address “the rise in violence on commercial aircraft” by directing U.S. prosecutors to prioritize prosecutions when airline employees are harmed by passengers. (Letter dated March 23, 2022 to Attorney General Merrick Garland)

In its letter, the AHA highlighted that the protections recently granted by the U.S. Department of Justice to flight crews and airport staff under 18 USC § 46504 should be used to simulate similar federal protections for healthcare workers “from greater violence.” [health care employees] experience. “

Prevention Strategies and Implications for the Healthcare Industry

Before the pandemic hit, nearly 75 percent of the 25,000 workplace assaults reported each year occurred in healthcare settings. Shockingly, an estimated 30% of nurses and 26% of doctors reported violence, a clear indication of underreporting. However, given the recent increase in demand for clinical care, lack of resources and supply, and the overall pressure the pandemic has placed on the healthcare industry – underreporting may no longer be a viable option for many healthcare workers.

Therefore, healthcare employers must remain vigilant when implementing robust policies and procedures to not only protect their employees, but also prevent any potential liability exposures that result from failure to do so.

With the above in mind, healthcare organizations should develop and implement comprehensive policies and procedures to combat violence by visitors, staff, patients, or other individuals.

Such policies may include, but are not limited to: (1) a “zero tolerance” policy; (2) mandatory reporting; (3) a non-retaliation policy that expressly prohibits any adverse employment action against employees who report in good faith actual or threatened violence; ( 4) Clear and effective procedures for responding to workplace violence.

HR 1309 provides a federal framework under which health care employment policy can be modeled and implemented. However, industry employers should be proactive and ensure they implement comprehensive policies and procedures to provide a safe work environment for their employees. If they do not, healthcare employers should consult with their attorneys to ensure that their policies and procedures adequately protect their employees and the organization as a whole.

Abby E. Alexander is a healthcare litigation columnist for Reuters Legal News and Westlaw Today.

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The views expressed are those of the author. They do not reflect the views of Reuters News, which is committed to integrity, independence and impartiality in accordance with the principles of trust. Westlaw Today is owned by Thomson Reuters and operates independently of Reuters News.

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