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Notes from the Field: Your workplace violence prevention plan is a baseball bat?

During a recent mock OSHA inspection, I asked the office manager if I could review the written workplace violence prevention plan. She walked me to the front office area and said, “We don’t need anything written down, we just get this out.” Under the receptionist counter was a baseball bat.

“Are you serious?” I said in amazement.

The manager said the physician had brought it in and told the staff to “just use this if you feel threatened.”

Needless to say, I had a long discussion with the manager about the OSHA Guidelines for Preventing Workplace Violence for Health Care & Social Service Workers [1].

These guidelines are voluntary—OSHA does not have a standard specific to workplace violence—but without a plan OSHA could cite an employer under the General Duty Clause which requires employers to “furnish to each of his employees…a place of employment which is free from recognized hazards that are causing or are likely to cause death or serious physical harm,” according to the agency’s workplace violence Web page [2].

In workplaces where violence could occur and there are more than 10 employees, OSHA recommends a written violence prevention plan.

Healthcare facilities, including urgent care facilities and emergency departments (ED) are at a very high risk for a violent situation to arise. (See the HCPro Webcast below.) Patients seeking drugs and denied their access to these medications create the potential for violent altercations.

But it is not just EDs that are at risk to this kind of situation, as the slaying of a physician in a Kentucky medical practice last March proves [3].

And it is not just the risk of fatalities that makes violence prevention plans a good idea. I learned about an office receptionist recently who told a patient he needed to reschedule his appointment because he was 20 minutes late. This simple statement caused the patient’s son to remove his glasses and throw them at the receptionist. The glasses cut her face.

Not all violent situations can be avoided. They happen so quickly.

OSHA could also cite an office that has done nothing at all to train or protect the staff. The entire staff needs to know how to handle that angry patient screaming because he can’t have his meds, someone who brandishes or threatens to use a weapon, or even a patient or visitor who makes verbal threats and gestures.

Are the doors from the waiting room to the clinical area locked at all times to keep people from wandering in? Do you have a “buzzword” for the staff to use if they feel threatened by someone, and do staff know to call 911 immediately when hearing it? Are you going to install a panic button under the receptionist desk? What should you do when an obviously agitated patient demands to see the physician “right now”?

These are just some of the topics that need to be addressed in the facility’s plan.

Just as important as the written plan is training the staff on how to handle various scenarios that may arise. How to de-escalate potentially violent situations, how to evacuate or take cover for protection, and, in extreme situations as a last resort, self-defense techniques and using the tools immediately at hand to defend yourself: A letter opener, staple remover, and scissors are items commonly found in the front office, and sometimes even a baseball bat.

Take the time to create this plan and provide that training. Turn on the TV or read the newspaper; workplace violence happens everyday!

[4]Protect your staff and patients from violence in the emergency department. [4] Violence in healthcare—such as the recent incident at Johns Hopkins Hospital—is on the rise. Join HCPro for Violence in the ED: Proven Strategies to Keep Your Facility Safe, [4]a 90-minute Webcast where you’ll learn a five-step approach to keeping your staff and patients safe. Our experienced speakers will also guide you through regulatory requirements related to workplace violence and provide action plans to train staff to handle unruly patients and prevent dangerous situations.