5. Confirm that the HR department
ensures that procedures for disciplining and firing employees minimize
the chance of provoking a violent
6. Require appropriate staff members
to undergo training in responding
to patients’ family members who
are agitated and potentially violent.
Include education on procedures for
notifying supervisors and security
7. Ensure that procedures for responding to incidents of workplace violence (e.g., notifying department
managers or security, activating
codes) are in place and that employees receive instruction on these procedures.
8. Encourage employees and other
staff to report incidents of violent
activity and any perceived threats of
9. Educate supervisors that all reports
of suspicious behavior or threats by
another employee must be treated
seriously and thoroughly investigated. Train supervisors to recognize
when an employee or patient may
be experiencing behaviors related to
domestic violence issues.
10. Ensure that counseling programs for
employees who become victims of
workplace crime or violence are in
place. Should an act of violence occur
at your facility—whether assault,
rape, homicide or a lesser offense—
follow-up with appropriate response
11. Reporting the crime to appropriate
law enforcement officers.
12. Recommending counseling and
other support to patients and visitors
to your facility who were affected by
the violent act.
13. Reviewing the event and making
changes to prevent future occurrences.
State regulatory and justice agencies
also have weighed in on workplace vio-
lence. With respect to healthcare, many
states have enacted legislation that makes
violence against emergency workers a
felony. Healthcare professionals should
research their particular state’s felony
Policies and Procedures
It is essential to have a well thought out
process and procedure to mitigate workplace violence; keeping in mind that a
goal of eliminating workplace violence is
Policies and procedures should be
developed, drilled, and practiced to
assure they accomplish the desired outcome. Some policies to consider implementing would include a workplace
violence policy, weapons policy, active
shooter policy, and a harassment policy.
A Threat Assessment Team should be
instituted. A Threat Assessment Team’s
role is to assess and recommend actions
relative to a known threat. Additionally, ongoing review of threat mitigation
techniques should be a regular activity
of the team. The team should also continually educate themselves on workplace violence.
As can be seen, the cultural acceptance
of workplace violence is changing. Man-
agement has become more educated on
regulatory issues around its tolerance
of workplace violence. Events around
the country in a variety of settings have
raised awareness of the likelihood of a
bad event occurring, which has added
caution. Management needs to take all
possible measures to ensure employees
feel safe at work. This needs to include
preparing employees in the event a
workplace violence event occurs and
giving them the tools to handle it. Just as
healthcare has changed so has the envi-
ronment in which care is given. Health-
care managers need to stay on top of the
safety of their facilities.
1Occupational Safety & Health Administration. Safety and Health Topics: Workplace
Violence. Available at: https://www.osha.
May 9, 2014.
2US Department of Justice. Office of Justice
Programs. “Special Report: Workplace Violence 1993-2009.” March 2011. Available at:
wv09.pdf. Accessed May 9, 2014.
3United States Department of Labor. Bureau of
Labor Statistics. “Census of Fatal Occupational Injuries Summary, 2012.” Available
nr0.htm. Accessed May 9, 2014.
4Occupational Safety & Health Administration. DIRECTIVE NUMBER: CPL 02-01-
052. Enforcement Procedures for
Investigating or Inspecting Workplace
Violence Incidents. Available at: https://
CPL_02-01-052.pdf. Accessed May 9,
5International Association for Healthcare
Security & Safety (IAHHS). 2012 Crime
and Security Trends Survey. Available at:
https://www.iahss.org/. Accessed May 9,
6Occupational Safety & Health Administration. Guidelines for Preventing Workplace
Violence for Health Care & Social Service
Workers. OSHA 3148-01R 2004. Available
osha3148.pdf. Accessed May 9, 2014.
7The Joint Commission. Sentinel Event Alert:
Preventing violence in the health care setting. Issue 45, June 3, 2010. Available at:
assets/1/18/sea_ 45.pdf. Accessed May 9,
Policies and procedures should be developed, drilled,
and practiced to assure they accomplish
the desired outcome.