Archive for: Workplace violence prevention

Missouri hospital in ‘immediate jeopardy’ fires 12 workers, installs interim leadership team

By: September 13th, 2017 Email This Post Print This Post

Corrective steps being taken to protect patients and workers alike, hospital says

A hospital in Missouri at risk of losing its Medicare funding within the month installed an interim leadership team this week as it seeks to appease federal inspectors.

Mercy Hospital Springfield was placed in “immediate jeopardy” by CMS after an inspection last month found significant violations of the regulations pertaining to nursing services and patient rights. The hospital announced last week that it had fired 12 employees whose behavior in “highly tense situations” was deemed inadequate. That news was followed Tuesday by an announcement that the interim leaders would step in to right the ship.

“They bring a fresh perspective and will help bolster local resources,” said Jon Swope, interim president of Mercy Springfield Communities, in a statement announcing six temporary leaders.

Read the rest of this entry »

California hospital where worker was murdered still an example of violence plaguing healthcare

By: August 31st, 2017 Email This Post Print This Post

Six years after a psychiatric technician at Napa State Hospital was murdered by a patient, regulators within the California Division of Occupational Safety and Health (Cal/OSHA) approved a new rule last fall to protect healthcare workers from on-the-job violence.

The rule took effect in April, and I covered the story in our May edition of Briefings on Hospital Safety, noting that federal OSHA officials were asking whether drafting a similar nationwide standard would be appropriate and worthwhile. Since then, the Trump administration has pared back OSHA’s regulatory agenda and classified the initiative to prevent workplace violence in healthcare settings as among the agency’s “long-term actions,” with no date set for the initiative’s next action item.

Meanwhile, the workers at Napa State Hospital continue to report frequent assaults against employees and patients alike. Cal/OSHA is investigating an attack on May 9, 2017, that left one worker with serious bodily injuries, the Napa Valley Register reported this month. Officials did not specify the circumstances of the attack, but a 26-year-old man arrested the following day had reportedly punched a staff member multiple times in the head and face, with a closed fist, before lifting a medical table above his head in an effort to use it as a weapon against the worker.

A judge ordered the hospital to release unredacted documents about the incident to Cal/OSHA after complaints that previously released documents “were so heavily redacted that they provided no meaningful information” to state investigators, the Register reported.

There were 886 assaults on staff reported at Napa State Hospital in 2015, according to the California Department of State Hospitals violence report for 2016. That figure was about the same in 2014 and 2013, but it was higher in 2012, when 1,048 assaults on staff were reported.

The 886 assaults on staff in 2015 are in addition to the 1,053 reported assaults on patients.

“That’s 1,939 reported assaults and who knows what wasn’t reported,” Michael Bartos, MD, former medical chief of staff for Napa State Hospital, wrote in a letter to the Register editor last week.

“A facility with 1,200 patients that reports over 1,000 patient assaults in a single year could be considered somewhat less than a healing environment and with almost 900 staff assaults might not be the best place to work, even with generous state benefits,” Bartos added. “Despite the problems, the majority of front line staff including nurses, psychiatry technicians, social workers, rehabilitation therapists, psychologists and psychiatrists, are dedicated professionals doing their best under difficult circumstances.”

Treatment center slapped with $207k proposed fine as OSHA announcements grow rarer

By: August 16th, 2017 Email This Post Print This Post

Facility accused of failing to address workplace violence risks it had promised to remedy

A psychiatric treatment center in Massachusetts faces more than $207,000 in proposed penalties after OSHA accused the facility of failing to adequately protect employees from workplace violence, despite having promised specifically to do so.

Notice of the proposed action against Lowell Treatment Center, which is operated by UHS of Westwood Pembroke Inc., comes as OSHA has grown significantly quieter about its enforcement activity under President Donald Trump’s administration than it had been under former President Barack Obama. There have been fewer enforcement-related OSHA press releases issued in the seven months since Trump took office than there were in just the final month of 2016.

It remains unclear how OSHA decides which enforcement actions warrant a press release. An agency spokesperson was not immediately able Wednesday to answer questions about this threshold. But we know that this case entails allegations that the facility failed to keep specific promises it made last year in a formal settlement agreement stemming from an unfavorable 2015 evaluation by federal inspectors.

“Our inspectors found that employees throughout the Lowell Treatment Center continued to be exposed to incidents of workplace violence that could have been greatly reduced had the employer fully implemented the settlement agreement,” OSHA’s Boston-based regional administrator Galen Blanton said last week in a written statement.

The management company, which operates 350 facilities throughout the United States and United Kingdom, notified OSHA that it intends to contest the findings, according to the press release.

Micah Smith, an OSHA attorney with Conn Maciel Carey in Washington, D.C., said during a webinar Tuesday that the Obama administration had engaged in “regulation by shaming.” And any Republican in the White House would be expected to back off of Obama-era levels of enforcement, he said.

“We’re expecting to see this change, and that press-heavy enforcement model to be rolled back,” Smith said. “We haven’t seen any official actions, but in the early days of the administration, most agencies across the government have been encouraged or required to reduce their press activity.”

Smith said there were two or three OSHA enforcement press releases in June and July this year, compared to 25-40 for each of the same months last year. Even so, it’s important to note that OSHA’s priorities are just as unsettled as its staffing.

“As with all things, without the permanent OSHA team in place, we’re still reading the tea leaves a little bit,” Smith said.

The press release in this case comes two months after OSHA endured criticism for backing off an allegation that Bergen Regional Medical Center (BRMC) in Paramus, New Jersey, had an inadequate workplace violence prevention plan. Jordan Barab, a former OSHA official under Obama, drafted a lengthy blog post critical of the move, and he clashed on Twitter with Eric Conn, another attorney with Conn Maciel Carey, who was hired to represent BRMC’s defense against the citation.

Barab, who has also been critical of the marked decrease in the issuance of OSHA enforcement press releases, hasn’t blogged since OSHA issued its press release last week.

Update (8/23/17): Barab blogged yesterday about this case. “Although I am frequently critical of OSHA under the Trump administration,” he wrote, “never let it be said that I have failed to praise the agency when they do something good.”

‘Don’t Hold The Door’: Boston hospital uses multimedia approach to reinforce safety training

By: June 23rd, 2017 Email This Post Print This Post

Brigham and Women’s Hospital (BWH) in Boston is well-acquainted with the dangers an unauthorized person can pose when granted access to restricted areas. The facility suffered unflattering headlines earlier this year when the public learned that 42-year-old Cheryl Wang had bluffed her way into five ORs and other patient care areas late last year by posing as a doctor-in-training, despite having been dismissed from her surgical residency program.

Wang’s case—which brought an unsettling reminder of the 2015 security lapse that enabled a disgruntled man to corner and kill a BWH doctor in an exam room—drew attention to an extremely common security vulnerability known as “tailgating” or “piggybacking.” When walking through a doorway, it’s common courtesy to hold the door for whoever is behind you. That’s a problem, however, if the person behind you doesn’t have permission to go where you’re going.

To reinforce the lesson that every hospital employee has a responsibility to help keep unauthorized people out of restricted areas, BWH produced instructional videos that depict disturbingly mundane security lapses. The two dramatizations, titled “Be Aware” and “Don’t Hold The Door,” will be shown to all 18,000 of BWH’s employees.

“We intended for the videos to be provocative, to invoke a strong reaction, so that they would be memorable,” said Erin McDonough, BWH’s chief communication officer, in a statement.

One video depicts two workers chatting as they return to their stations from a coffee break, unaware that an unknown woman has followed them onto a restricted elevator. From there, the woman gains access to a maternity ward to abduct a newborn. The other shows a worker in scrubs politely holding the door for an unknown man.

Be Aware from BWH Public Affairs on Vimeo.

“Closing a door to someone feels uncomfortable and impolite, and it contradicts what many of us have been taught from a young age,” McDonough said. “We need our staff to know the potentially dangerous consequences of enabling people who do not have permission to access restricted areas—whether consciously or unconsciously—and give them tools that empower them to take action.”

The two videos are the centerpiece of BWH’s safety campaign, but they are buttressed by a multi-pronged approach that includes the following:

  • Signage. The points where unauthorized access is most likely to occur, including some 1,200 card scanners throughout BWH’s facilities, will be labeled with signs to remind workers to be aware of who’s coming with them.
  • Reminder cards. Workers will be issued additional cards that bear the slogan “Stop, Challenge, Assist,” with a phone number for hospital security, as a reminder to use their privileged access with caution and care.
  • Policies. Employees who are followed by an unauthorized person are now required to abide by two updated policies: Either question the person directly, or contact security to do so. There’s no option to merely dismiss the unauthorized access as nonthreatening.
  • Training. After hospital employees screen the two videos, they will role-play related scenarios with a security team, then follow-up to session with a Q-and-A to discuss what they learned.

In addition to training its own staff, BWH has opted to share the components of this campaign far and wide—a helpful gesture, considering that tailgating and piggybacking are a safety consideration in every healthcare facility.

“People who work in the healthcare setting have a natural inclination to help others,” said Dave Corbin, BWH’s director of security and parking, in the statement. “Our campaign emphasizes that being aware is one of the best ways for them to ensure the wellbeing of patients, their families and each other.”

Don't Hold the Door from BWH Public Affairs on Vimeo.

Hospital calls criticism from former OSHA official ‘ill-informed commentary’

By: June 14th, 2017 Email This Post Print This Post

I came across an interesting (and lengthy) post last week on Jordan Barab’s “Confined Space” blog about a hospital that successfully defended itself against an OSHA citation. Barab, a former OSHA official himself, had some harsh words for Bergen Regional Medical Center (BRMC) in Paramus, N.J., going so far as to accuse BRMC of trying to revise history.

“[T]he hospital’s contention that its workplace violence prevention program ‘has once again been found to be compliant’ is false,” Barab wrote. He pointed to a written warning OSHA sent BRMC in 2014, followed by a citation in 2015, as evidence that the hospital’s program had been deemed inadequate under the OSH Act’s General Duty Clause.

Since the blog post accused BRMC of misrepresenting the facts, I reached out to hospital spokeswoman Donnalee Corrieri for her response. She noted that Barab had left OSHA before a key stage in the discovery process, so his opinions appear to be based on information as alleged in 2015, rather than the full picture as uncovered throughout months of litigation.

“After considering all of the evidence, which OSHA did not have the benefit of when it [made] its initial allegation, OSHA obviously concluded that the initial citation was misplaced, and agreed to withdraw the citation related to workplace violence in its entirety,” Corrieri told me in an email.

“Mr. Barab’s ill-informed commentary seems to stem from his view that even a single instance of workplace violence means an employer’s [workplace violence prevention program] is somehow insufficient,” Corrieri added. “However, OSHA’s [workplace violence] Guidelines for healthcare acknowledge that ‘not every incident can be prevented.’ The reality is, the Medical Center consistently experiences fewer incidents of violence than its peer medical systems in New Jersey and nationally.”

For more on this, read my article in this week’s free weekly Hospital Safety Insider e-newsletter.

Workers’ Memorial Day: A somber reminder of progress made, work left to do

By: April 28th, 2017 Email This Post Print This Post

Carrie Rouzer was caring for a patient last July at Parrish Medical Center in Titusville, Fla., when a stranger barged in and gunned down both Rouzer, 36, and her 88-year-old patient before being subdued by security guards.

The shocking case, which drew attention to workplace violence as a real threat to healthcare workers, was certainly on the minds of groups who gathered Friday in Jacksonville and Miami in observance of Workers’ Memorial Day. The two sites were among hundreds nationwide holding local ceremonies commemorating the lives of those killed on the job, whether by violence or accidents.

The annual event is held on April 28, the day OSHA was established in 1971, as a reminder of the progress made in workplace safety in recent decades and the work yet to be done. Rouzer’s story, sadly, is among many others collected over the years.

Among the thousands of occupational fatalities recorded across all industries, between 100 and 150 occur in the healthcare and social assistance sectors each year, according to the Bureau of Labor Statistics. In 2015, there were 109. (Finalized numbers for 2016 will be released this December.)

When you consider how many hours workers put in, those 109 fatalities translate to a fatal injury rate of 0.6 per 100,000 full-time equivalent workers. That’s much less than the overall rate across all industries, which was 3.4 in 2015, according to BLS data. Workers in transportation and warehousing, by contrast, suffered a fatal injury rate of 13.8—which is 23 times higher than the rate in healthcare.

Within the healthcare sector, the numbers are broken down into three categories. Ambulatory healthcare services, which saw 47 fatalities in 2015, had a rate of 0.7. Nursing and residential care facilities, which saw 24 fatalities, had a rate of 1.1. And hospitals, which saw 21 fatalities, had a rate of 0.4. All of these numbers are down slightly from rates reported for 2006.

Although the fatal injury rate in healthcare remains low compared to other industries and has declined slightly in recent years, OSHA continues to look for ways to improve safety. Those improvements should be balanced against other considerations. But let’s take Workers’ Memorial Day as an opportunity to reflect on Rouzer’s story and others like it. Are we doing all we can reasonably do to protect workers? Is there more?

BLS-worker-fatality_Page_14

A summary report on the number and rate of workplace fatalities by industry and sector published by the U.S. Bureau of Labor Statistics groups healthcare with educational services. Full report: https://www.bls.gov/iif/oshwc/cfoi/cfch0014.pdf

 

Healthcare needs to get real about active shooters

By: October 27th, 2015 Email This Post Print This Post

I had the pleasure yesterday of spending a day at the 2015 annual conference of the American College of Emergency Physicians (ACEP), which is being held here in my beautiful hometown of Boston.

Being in the safety business, I sat in on a session about active shooter response preparation in healthcare facilities, led by an emergency physician and security director with Carolinas Medical Center in Charlotte. I didn’t leave with that feeling like we have our collective act together.

Are we really ready for someone to come into our hospitals with a gun, bent on causing mass carnage?

First, let’s start with the numbers. From 2000-2007, there were “only” about 6 shootings a year. From 2007 to today, the numbers jumped to 17 per year.

Many facilities are following the government’s recommendations to “run, hide, and fight” when confronted with a gunman. That’s fine training, if you’re in an office building. Run first, hide when you can, and fight back as a last resort.

But that won’t fly in hospitals and clinics where people are counting on you to help them survive. Poll numbers I heard quoted estimate that at least 40% of healthcare staff wouldn’t leave their patients’ sides, even when confronted with a shooter.

Hospitals need to train their staff to stay alive. Most active shooter incidents end within 7 minutes, and doctors and nurses are then required to turn around and treat the wounded and prevent as much death as possible.

So my question is this: What are you doing to prepare for an active shooter in your facility? Do you have specific plans? Are you training your staff, and what resources are you using?

Please drop me a line at jpalmer@hcpro.com and share your thoughts on this very real threat.

Thanks!

John Palmer

 

Upcoming Webinar: Active Shooters in Healthcare Facilities

By: September 11th, 2015 Email This Post Print This Post

Active shooters and armed violence represent a rapidly growing issue in America’s hospitals and healthcare facilities. These incidents occur on a near-weekly basis, which means it is time to face the fact that they can also happen in your facility.

Don’t wait until it’s too late to develop an emergency response plan. Join HCPro for a live webcast on Tuesday, September 23 from 1:00-2:30 p.m.

The program will be presented by healthcare safety experts Lisa Pryse Terry, CHPA, CPP, and Christian M. Lanphere, PhD, FP-C, NRP, CEM. They will teach participants how to lessen the risk of a violent confrontation and how to prepare facility staff in the event an armed intruder comes through their doors, and then will take your questions live.

For more information and to register for the webcast, call HCPro customer service at 800-650-6787 or visit http://hcmarketplace.com.\

Try our workplace violence prevention tools!

By: May 28th, 2015 Email This Post Print This Post

We’ve been telling you for some time now that you need to get a workplace violence prevention plan in place in your facility, and now it’s time for us to help you get started.

If you’re looking for a place to start, we have lots of downloadable tools and resources for you to use in your own facility. For instance, try the workplace violence assessment checklist as a place to start to determine the weak spots in your facility’s security. Next, give our safety tips poster to your employees during your next in-service training meeting.

According to Bureau of Labor Statistics, in 2013 more than 23,000 significant injuries were caused due to assaults at work. More than 70 percent of these assaults were in healthcare and social service settings. Health care and social service workers are almost four times more likely to be injured as a result of violence than the average private sector worker, OSHA says.

Further statistics show that about 27 out of the 100, or about 30% of the fatalities in healthcare and social service settings that occurred in 2013 were due to assaults and violent acts.

As a result, OSHA issued the update to OSHA 3148 in April, encouraging healthcare workplaces to develop a workplace violence prevention plan. It’s not so much an “encouragement” as it is a warning that inspectors will be checking to make sure you have a plan in place.

We’re here to help you do your job better and safer. Look to HCPro for all of your healthcare safety and security resources!

OSHA updates violence prevention guidelines

By: April 21st, 2015 Email This Post Print This Post

OSHA likes to tout itself as a governmental agency that looks out for workers in all industries. But they aren’t doing a very good job of announcing a huge change to guidelines that could help protect healthcare workers from the rising problem of workplace violence.

It took a couple of well-connected readers to let me know that OSHA earlier in April released an update to its Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers, known to many in the safety field as OSHA Rule 3148. Good luck finding any of this on the OSHA web site, by the way.

After an inquiry to OSHA public relations, I was sent the updated guidelines, which you should pay attention to if you are in charge of safety at your facility.

According to its own statistics, OSHA says in 2013 more than 23,000 significant injuries were caused due to assaults at work. More than 70 percent of these assaults were in healthcare and social service settings. Health care and social service workers are almost four times more likely to be injured as a result of violence than the average private sector worker, OSHA says. Further statistics show that about 27 out of the 100, or about 30% of the fatalities in healthcare and social service settings that occurred in 2013 were due to assaults and violent acts.

Under pressure to do something about this, the updated OSHA 3148 recommends that all healthcare facilities develop an effective workplace violence prevention program. Pay attention, because the word is that the Joint Commission is also following these changes closely.

The new OSHA guidelines are very specific in the types of workplace controls that employers should consider, especially when it comes to facility security and keeping track of employers. Examples include:

  • The use of silent alarms and panic buttons in hospitals and medical clinics
  • Providing safe rooms and arranging furniture to make sure there are clear exit routes for workers and patients
  • Installing permanent or hand-held metal detectors to detect weapons, and providing staff training on the use of these devices
  • Ensuring nurse stations have a clear view of all treatment areas, including the use of curved mirrors and installing glass panels in doors for better viewing, as well as closed circuit cameras to help monitor areas
  • Using GPS, cell phones, and other location technology to help keep track of staff working with patients in off-site locations
  • Protection front-end and triage staff using facility design elements such as deep counters, secure bathrooms for staff separate from patient treatment areas, and using bulletproof glass and lockable doors with keyless entry systems

In addition, the recommendations include employing administrative controls designed to track patients and visitors who have a history of violence, to better educate workers on the dangers and signs of impending violence, and to ensure better reporting procedures. Some of these recommendations include:

  • Providing clear signage in the facility that violence will not be tolerated
  • Instituting procedures that require off-site staff to log in and log out, as well as checking in with office managers periodically
  • Keeping a behavioral history of patients, including identifying triggers and patterns
  • If necessary, establish staggered work times and exit routes for workers who may be subjects of stalkers
  • Keep a “restricted visitor” list for suspected violent people, such as gang members, and make sure all staff are made aware

Also, OSHA recommends that employers provide updated training for employees, including:

  • Risk factors that cause or contribute to violent incidents
  • Early recognition of escalating behavior or recognition of warning signs
  • Ways to recognize, prevent or diffuse volatile situations or aggressive behavior, manage anger and appropriately use medications
  • Proper use of safe rooms—areas where staff can find shelter from a violent incident;
  • Self-defense procedures where appropriate
  • How to apply restraints properly and safety when necessary
  • Ways to protect oneself and coworkers, including use of the “buddy system”

For more information, the Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers can be found at https://www.osha.gov/Publications/osha3148.pdf

 

Bomb Threat Training

By: December 31st, 2012 Email This Post Print This Post

Question: Another practice in our medical complex had a bomb threat called in. What do I need to train our staff to do if it happens here?

Answer: The exact course of action will depend on whether the threat is received by phone, letter, handwritten note, email, or in the form of a suspicious package. Although what to do varies by situation, in all situations, do not:

  • Use two-way radios or cellular phones, because radio signals have the potential to detonate a bomb
  • Evacuate the building until after police arrive and evaluate the threat
  • Activate the fire alarm
  • Touch or move a suspicious package

The Department of Homeland Security has a good one-page document you can print out and put by each phone that receives outside calls to help staff members know what actions to take if they receive a suspicious call. It is available at http://emilms.fema.gov/is906/assets/ocso-bomb_threat_samepage-brochure.pdf

*This is an excerpt from The OSHA Training Handbook for Healthcare Facilities by Sarah E. Alholm, MAS.

Domestic violence at root of hospital fatality

By: June 18th, 2012 Email This Post Print This Post

The shooting at the Erie County (NY) Medical Center shows that violence in healthcare is not only limited to attacks on workers by patients and guests. Worker-on-worker and domestic disputes also are part of healthcare workplace violence concerns.

On June 13, Jacqueline Wisniewski, 33, was found shot to death in a stairwell in an Erie County Medical Center building, according to CNN, June 15. Police suspected Dr. Timothy V. Jorden, 49, a trauma center surgeon at the medical center and also believed to be in a relationship with Wisniewski.

Investigators found Jorden dead from a self-inflicted gunshot wound to the head on June 15, CNN reports.

Click here for an OSHA Healthcare Advisor post on efforts to protect federal workers from domestic violence.

Subscribe - Get blog updates via e-mail

  • test
  • HCPro Broadcast Events Calendar

hcpro.com