Workplace violence is a risk at any health care workplace. Whether from patients, residents, clients, or employees. The Occupational Safety and Health Administration (“OSHA”) estimates that three quarters of all workplace assaults reported annually – approximately 19,000 – occurred in health care and social service settings.

While OSHA does not have any specific regulations addressing violence in the workplace, OSHA’s General Duty Clause applies to covered employers and requires they provide their employees with a place of employment that is “free from recognized hazards that are causing or are likely to cause death or serious harm.” It is OSHA’s position that the General Duty Clause imposes a legal obligation upon an employer to provide a workplace free of conditions or activities “that either the employer or industry recognizes as hazardous and that cause, or are likely to cause, death or serious physical harm to employees when there is a feasible method to abate the hazard.”

In recent years, OSHA has published guidelines to the health care community – Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers – with specific recommendations to prevent violence in health care workplaces. OSHA also has a webpage dedicated to workplace violence, which provides helpful guidance and training materials.

In an effort to further assist health care organizations better prevent and address violence in their workplaces, in April the Joint Commission released a Sentinel Event Alert addressing physical and verbal violence against health care workers. The Joint Commission accredits and certifies health care organizations and programs in the United States.

The Joint Commission’s alert outlines seven steps it recommends health care organizations should undertake to help prevent and address workplace violence:

1. Clearly define workplace violence and put systems into place across the organization that enables staff to report workplace violence incidents, including verbal abuse.
2. Recognizing that data comes from several sources, capture, track and trend all reports of workplace violence – including verbal abuse and attempted assaults when no harm occurred.
3. Provide appropriate follow-up and support to victims, witnesses and others affected by workplace violence, including psychological counseling and trauma-informed care if necessary.
4. Review each case of workplace violence to determine contributing factors. Analyze data related to workplace violence and worksite conditions to determine priority situations for intervention.
5. Develop quality improvement initiatives to reduce incidents of workplace violence, including changes to the physical work environment and changes to work practices and administrative procedures.
6. Train all staff, including security, in de-escalation, self-defense and response to emergency codes.
7. Evaluate workplace violence reduction initiatives.

Health care organizations that fail to undertake available and appropriate measures to prevent and respond to workplace violence – like those provided in the Joint Commission’s Alert or OSHA’s existing guidance – may be susceptible to receiving an OSHA citation for violation of the General Duty Clause or potentially violating Joint Commission accreditation standards.

Taking proactive measures and regularly reassessing and evaluating your workplace’s plans to prevent and address violence can help provide a safe workplace for your employees and a safe environment for your patients and clients.

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