Under pressure: Best practices for dealing with the complex problem of workplace violence in healthcare

Workplace violence in healthcare is a serious, complex and growing problem.

Research has found that healthcare employees experience the highest rate of injury from workplace violence and are five times more likely to suffer from these injuries than other workers. Situations that were once easy to deescalate or resolve have become harder to handle. A result: many healthcare workers feel unsafe.

During a Becker's Healthcare podcast sponsored by NRC Health, Erika Spicer Mason moderated a discussion with two healthcare workplace experts about best practices for hospitals and health systems to address this significant challenge:

  • Shelby Chapman, Director of Patient-Family Experience, Children's Hospital Colorado
  • Toya Gorley, Improvement Advisor, NRC Health

Four key takeaways were:

  1. Microaggressions can be as damaging to healthcare teams as larger incidents of workplace violence. Repeated verbal escalations like yelling, threatening and using demeaning language can chip away at employees' confidence, self-esteem and resilience. In some cases, it leads to employee turnover. "Verbal escalation is happening on an increasingly frequent basis, and it has a major impact on our teams," Ms. Chapman said. "Sometimes it affects a person's ability to show up empathetically for the next family walking through the door."

  2. NRC Health has created a framework for dealing with workplace violence. This framework is called "Creating a Culture of Mutual Respect and Workplace Safety." It contains 11 bodies of work that are necessary to mitigate and address workplace violence. Key activities include employee training to de-escalate situations, data collection to inform how severe and frequent disruptive events are, processes to help employees deal with workplace violence and more.

    "Throughout the framework, we use the phrase 'disruptive event'; not 'disruptive people.' We want to focus on the event, rather than pointing fingers at people who are vulnerable and may not be their best selves. We want to leave space for empathy and compassion, while at the same time dealing with behaviors that may be harmful," Ms. Gorley said.

  3. To create safe healing environments, Children's Hospital Colorado has developed several policies and programs. The institution created a flyer focused on its partnership model with patients and families. "That information is posted in exam rooms and inpatient rooms. It helps reset expectations about behavior and our desire for partnership and mutual respect for all families," Ms. Chapman said.

    To improve physical safety, Children's Hospital Colorado developed a visitor management policy to ensure that only the people who have a reason to be in the facilities come through the doors.

    This year, the organization has rolled out a tip sheet to support team members who work on the phone. This includes key phrases and recommendations to guide employees through over-the-phone escalations.

  4. When it comes to workplace violence, leaders must support employees. When workplace violence occurs — whether a microaggression or larger event — leaders must partner with employees to address the issue and hopefully prevent additional events in the future. "We need to send the message that disruptive situations aren't part of the job," Ms. Gorley said. "Leaders need to connect employees with the resources required to heal from these tragic situations."

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