By Pamela Williams, Fisher Phillips, Houston
It has been estimated that healthcare employees are approximately four times more likely than workers in other fields to be victims of workplace violence. In 2015, the Occupational Safety and Health Administration (“OSHA”) issued guidelines for preventing workplace violence in the healthcare and social services industries. Since that time, OSHA has heightened its focus on this area and has issued employer citations relating to incidents involving workplace violence.
Interestingly, despite OSHA’s emphasis on workplace violence prevention, no specific OSHA standard addresses such hazards. As a result, OSHA enforces employer obligations to prevent workplace violence through the “general duty clause” (29 U.S.C. § 654(a)(1)). The general duty clause requires employers to keep their workplaces “free from recognized hazards that are causing or are likely to cause death or serious physical harm to employees.”
OSHA has cited several employers for violating the general duty clause by exposing employees to various hazards that resulted in physical assault of the workers. In fact, a Massachusetts psychiatric facility was issued citations of more than $200,000 under the general duty clause, based on OSHA’s conclusion that it did not provide a place of employment free from recognized hazards that were causing or were likely to cause death or serious physical harm to employees. These included verbal threats of assault, physical assaults, choking, punches, kicks, human bites, scratches, and pulling of hair by patients. While the citation’s high dollar amount may have been in part due to other factors, including potential issues surrounding prior inspections and resolutions, it indicates the heightened level of scrutiny OSHA is placing on workplace violence in the healthcare industry.
Proactive Measures that Can Reduce the Risk of Workplace Violence
Workplace violence has increased such that concerns regarding prevention must remain at the forefront of the American consciousness. As OSHA continues to focus on workplace violence in the healthcare industry, employers should take proactive measures to reduce risk to their employees.
Implementing and training employees on a company policy prohibiting workplace violence is a good start, but it is only the beginning of ongoing efforts that should be taken as part of a lasting commitment to prevent workplace violence. Additional measures that may be considered, and which have been specifically recommended by OSHA as acceptable abatement of hazards, are:
- Implementing a written workplace violence prevention program, which should include information about how employees can obtain medical attention and emotional support following incidents of workplace violence;
- Analyzing and identifying potential areas of concern and risk factors, including available points of entry and exit, items that could be used as weapons, presence of secured and locked rooms or units and spaces that could pose a risk of entrapment;
- Including a mandatory reporting requirement in the written workplace violence program;
- Identifying patients/clients with violent behavior/histories;
- Clearly communicating recent violent incidents to any employee who could potentially be exposed, including those who may not have regular contact with the patient/client involved in the incident;
- Creating and implementing a “buddy system” to aid in dealing with a potentially violent patient/client (where all staff are able to request and obtain double coverage when necessary, including, but not limited to, situations where an employee communicates that he or she feels unsafe being alone with a particular patient/client);
- Providing all employees with an easily accessible and reliable way to call for help when needed, including while on a home visit;
- Training all employees on effective and appropriate methods about how to respond during a workplace violence incident;
- Training all employees to recognize aggressive behavior exhibited by patients/clients and on techniques for timely de-escalating of the behavior;
- Instructing all employees about risk factors that cause or contribute to assaultive behaviors (including threats of violence);
- Developing and maintaining a recordkeeping system to ensure that all workplace violence incidents are investigated and that post-incident debriefing and root-cause analyses occur; and
- Regular review and update of the prevention program.
Although these measures may not provide a panacea for workplace violence, they will help employers strengthen their workplace violence prevention programs. Additionally, employers who adopt these measures likely will be in a better position if, and when, OSHA does enact a workplace violence standard.