Archive for: Workplace violence prevention

Safety Month Showcase: Prevent workplace violence by recognizing threatening acts

By: June 25th, 2018 Email This Post Print This Post

The National Safety Council has designated June as its annual National Safety Month as a way to focus on “reducing leading causes of injury and death at work, on the road, and in our homes and communities.” In accordance with that, HCPro’s safety team will highlight a different healthcare-oriented safety topic each week in the month of June by sharing an excerpt from one of our many books, all available on HCMarketplace.com.

The focus this fourth and final week of June is workplace violence. The excerpt is from “Preventing Emergency Department Violence: Tips, Tools, and Advice to Keep Your Facility Safe,” authored by Lisa Pryse Terry, CHPA, CPP.

In her book, Terry provides healthcare personnel and security professionals with guidance for how to deal with violent patients and visitors, active shooters, uncooperative behavioral health patients, and disruptive prisoners. Terry also helps healthcare professionals recognize signs of violence, take steps to defuse tension, and respond appropriately. Plus, she offers real-life examples and training tools and provides sample response protocols and emergency department design ideas to help readers develop plans and make improvements in their facilities.

In this excerpt, Terry writes about recognizing threatening behavior in the ED.

The clock is ticking. The risk of a loved one not being treated quickly enough before her condition worsens causes great anxiety for a family member who begins pacing and becomes increasingly angry (potential risk). Seeing the crowded ED and assuming the staff are too busy to provide immediate attention for his family member triggers the perpetrator to seek immediate medical attention by commandeering staff to assist him (stimulus). An unattended door with a restricted access sign for employees only provides an opportunity for the perpetrator to grab and force a clinician to help now (opportunity to act). Violent behavior erupts, nurses are terrified, and chaos ensues.

The theoretical situation above could have been avoided with proper training and ability to recognize threats early. Understanding how perpetrators behave is key to managing threats. There are some commonalities among individuals who pose a threat. Recognizing threatening behaviors allows resources to intervene at the earliest possible stage.

Most all perpetrators consider, plan, prepare, and then act. This allows intervention at multiple points along the violence spectrum. But effective intervention to decrease threats is dependent on training and experience that enable security officers, public safety, and police officers to fully recognize and identify the early signals. Intervention also relies on nurses and healthcare staff understanding the signs of pending violence.

Nursing by nature requires staff to be physically close to patients who can quickly become agitated or violent. Close contact increases the likelihood that a nurse or other clinician will become the victim of physical violence, especially if the signs of violence are not recognized early. This increases the need for clinical staff training on the violence spectrum as well as related security training, de-escalation techniques, and personal safety training.

A collaborative effort and integrated training for healthcare security staff and clinicians increases safety for everyone. It also helps define roles and responsibilities if an event occurs. Collaboration reinforces what to expect if an event occurs and how resources can be quickly assimilated.

Security and healthcare staff who are able to proactively deal with threats and/or threatening behavior early—detecting threats early, evaluating them, and knowing how to address them—may be the single most important key to preventing and managing violence.

So how do security and healthcare professionals identify the signs to decrease threats?

In Chapter 3, we discussed the impact of the violence spectrum and the importance of managing threats of violence. All staff should be trained on the components of anger and impending violence, which present in three primary ways:

  • Physical reactions—These reactions include an individual’s response to anger, frustration, and potential violence such as an adrenaline rush, increased heart rate and blood pressure, and tightening of muscles for the “fight or flight”
  • Cognitive Experience—This involves how an individual perceives he or she is being treated. If he believes he is being treated unfairly, prejudicially, or in any negative way, the risk of becoming angry and violent escalates.
  • Behavior Changes—Individuals considering a violent action or response will display behavioral changes such as change in demeanor, verbal or voice changes, and nonverbal cues of agitation and frustration such as tapping fingers, rapid eye movement, or pacing.

Security and healthcare staff must understand the significance of verbal and nonverbal cues. Key threat management strategies focus as much on nonverbal communication as they do on verbal communication. According to various researchers, body language is thought to account for between 50 to 70% of all communication.

  • In a crowded waiting area, a family member feels claustrophobic and becomes agitated
  • A worried parent continually reaches out for the nurse’s arm in hopes of getting more attention
  • An agitated spouse paces back and forth in front of the doors leading to restricted treatment areas
  • The eyes of a frustrated patient dart back and forth continually.
  • An anxious spouse believes it is taking way too long to get an updated report on his wife, and begins clenching his jaw
  • A forensic patient visually scours the treatment room for a weapon of opportunity

These are all signs of potential violence. Space, touch, body movement, and perception of time are all ways people express their frustration and anxiety. Proactively identifying these particular behaviors of concern can help reduce the risk of violence in the ED and contribute to a better patient experience.

Responding to nonverbal cues may be as simple as providing a brief update on the status of a loved one; giving a person a reassuring smile and greeting; explaining that it’s important to conduct thorough testing to provide the best treatment possible; acknowledging a person’s feelings; or offering to get an anxious parent a cup of water while she waits. Eye contact can also indicate genuine interest and concern for a person and alleviate anxiety. In an overcrowded ED, speaking to the agitated person and offering to help him find a more comfortable place to wait can defuse anger.

Verbal communication is also an important indicator of agitation, frustration, and pending violent actions. Tone of voice, loudness, inflection, intonation, and rapid speech are red flags. Once verbal communication escalates to cursing, threats, and disrespectful language, rapid de-escalation is critical to lessen risks.

Working together, security and healthcare professionals can decrease or minimize threats to safety and block opportunities to act. They can integrate case management into the security management strategy to lessen the threats. Effective threat management strategies incorporate the STEP process.

  • S: De-escalate, contain, or control the subject who may take violent action
  • T: Decrease vulnerabilities of the target
  • E: Modify physical and cultural environment to discourage escalation
  • P: Prepare for precipitating events that trigger adverse reactions

 Utilizing the STEP Process is an effective means of managing threats. Some questions to ask in the process include:

  • What is motivating the individual to become a threat?
  • Has the individual communicated his/her intentions as a threat?
  • Is the individual demonstrating physical actions of threat?
  • Does the individual have access to weapons?
  • Are there unusual objects that could be used as weapons?
  • Are there bystanders to consider and remove from harm’s way?
  • Has the person taken aggressive action (pushing, striking)?
  • Is the person argumentative?
  • Is he/she displaying unwarranted anger?
  • What is the stimulus for action and how can it be removed?

Responding positively to verbal signs of anxiety is extremely important in the ED environment.  Keep your voice calm, repeat what you hear to reassure the person you understand, look the person in the eye when she is speaking, and seek to understand the underlying cause of agitation. People who visit the ED are usually nervous and fearful of a diagnosis or treatment process. Many things in the ED environment can put that fear into overdrive and then violence occurs. Watching for the earliest signs of violence and utilizing strategies to overcome fear and anxiety are an essential part of the healthcare security team’s job.

To purchase “Preventing Emergency Department Violence: Tips, Tools, and Advice to Keep Your Facility Safe,” please click here.

OSHA cites another healthcare facility for not protecting staff from violence

By: May 16th, 2018 Email This Post Print This Post

Be aware that OSHA is continuing to cite healthcare organizations for not protecting their staff from workplace violence.

In the latest announced penalty, an acute care inpatient behavioral health facility in Bradenton, Florida is facing more than $71,000 in fines for “failing to institute controls to prevent patients from verbal and physical threats of assault, including punches, kicks, and bites; and from using objects as weapons,” according to information released by the U.S. Department of Labor.

OSHA cited Premier Behavioral Health Solutions of Florida Inc. and UHS of Delaware Inc., which operates Suncoast Behavioral Health Center in Bradenton, after investigating a complaint that employees were “not adequately protected from violent mental health patients.” The citation, announced May 2, follows the OSHA citation of another UHS subsidiary in 2016 “for a deficient workplace violence program.”

“This citation reflects a failure to effectively address numerous incidents over the past two years resulting in serious injuries to employees of the facility,” said Les Grove, OSHA Tampa Area Office Director, in a published news release.

OSHA, CMS, The Joint Commission (TJC), and other regulators are cracking down on failures to protect workers from violence. TJC issued a Sentinel Event Alert in April and OSHA is considering proposing a new standard to deal just with workplace violence, which currently is cited under the General Duty clause requiring employers to protect workers from hazards “that are causing or are likely to cause death or serious harm.”

The OSHA citation report offered up a list of problems and potential solutions for Premier Behavioral Health Solutions and UHS to consider. Those solutions included:

  • evaluating the configuration of the nurses’ workstations to keep patients from jumping over desks or otherwise gaining access to personnel as well as weapons such as staplers, phones, cords, pens, and computers
  • develop a “disruptive behavior response team” and provide that team with “clear written procedures for how employees should respond to clients making threats, showing aggression, and assaults
  • evaluate intake procedures to better identify incoming patients with potential for violence
  • ensure security cameras are continuously monitored
  • provide panic alarms
  • discourage employees from wearing necklaces or lanyards that can be used for strangulation, and encourage staffers to secure “loose hair so that it is not accessible to patients, to minimize the risk of neck strains and hair pull injuries”
  • to regularly train staff in methods to protect themselves when patients become violent
  • conduct effective investigations and root cause analyses into violent events
  • establish a comprehensive medical and psychological counseling and debriefing for employees experiencing or witnessing violent assaults or incidents

Premier Behavioral and UHS have 15 business days from when they were notified of the citations and penalties to pay the fines, request an informal conference with OSHA’s area director, or contest the findings before the independent Occupational Safety and Health Review Commission.

This OSHA citation follows a similar case last year in which a psychiatric treatment center in Massachusetts faced 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. That center said it was contesting OSHA’s allegations.

In another case, a hospital in New Jersey was able to successfully defend itself against allegations that it had failed to protect workers from workplace violence.

Editor’s note: This post is from AJ Plunkett, our colleague over at DecisionHealth.

New IAHSS guideline aims to help healthcare facilities respond to workplace violence

By: March 20th, 2018 Email This Post Print This Post

Looking to reduce the likelihood of workplace violence in healthcare, the International Association for Healthcare Security & Safety Foundation (IAHSS) released a new Threat Management guideline earlier this month stating that “healthcare facilities should establish a process and multidisciplinary team to identify, assess, validate, mitigate, and respond to threats of violence or other behaviors of concern.”

The multidisciplinary threat management team should, says IAHSS, identify threats and determine their seriousness and severity. Additionally, IAHSS recommends the team develop intervention plans that protect potential victims and address problems that precipitate threats, document the threat assessment process with privacy and confidentiality in mind, and conduct a review after addressing each threat.

The IAHSS guideline suggests the development of a threat management program “that is informed by data and research in this area.” To do so, IAHSS says that healthcare facilities should designate individuals who are responsible for, amongst other things, educating staff and promoting the reporting of threats; assessing all reports of concerning behavior; implementing timely response plans; and advocating for victims and offering support and counseling if needed.

IAHSS says all healthcare staff should get education —  based on their job function and potential risk — about identifying concerning behavior, reporting protocols, activating an emergency response, and documenting threats and incidents.

The new Threat Management guideline was initially developed by the IAHSS Council on Guidelines and incorporated feedback from IAHSS membership, the Emergency Nurses Association, and the American Hospital Association, according to a press release announcing the guideline.

“Implementing the intent of this guideline will be one of the least expensive and effective steps an organization can take to reduce the likelihood of violence,” Tom Smith, chair of the IAHSS Council on Guidelines, said in a statement. “The Threat Management Guideline establishes a framework for healthcare organizations to proactively identify and manage threats of violence. Input from our colleagues at the AHA and ENA helped us enhance the quality and value of the final product.”

The issuing of the guideline comes several months after a report by IAHSS, entitled “Mitigating the Risk of Workplace Violence in Health Care Settings,” encouraged healthcare facilities to take immediate steps to mitigate violent incidents.

Deadline suspended for Missouri hospital facing second ‘immediate jeopardy’ finding this year

By: September 27th, 2017 Email This Post Print This Post

A hospital in Missouri had been given until September 22 to bring its operation into compliance with the CMS Conditions of Participation (CoP) after surveyors last month found significant problems pertaining to nursing services and patient rights. That deadline has been suspended, however, as federal regulators review the findings of a follow-up visit.

State surveyors returned last week to Mercy Hospital Springfield to determine whether the facility has fixed the problems that led to the “immediate jeopardy” findings in August, a spokesperson for the CMS regional office in Kansas City said this week. Suspending the deadline gives CMS time to review what the follow-up surveyors found, the spokesperson said.

In early September, the hospital announced that it had recently fired 12 employees after determining that their behavior in “highly tense situations” had been inadequate. Remaining staff members would receive additional training on de-escalation techniques and preventing patient abuse and neglect, the hospital said. The following week, an interim leadership team stepped in.

“Everything we’re doing is to ensure the well-being and safety of everyone, including our co-workers,” hospital spokesperson Sonya Kullmann said.

Details from the August inspection are not yet publicly available, but records obtained via the Missouri Sunshine Law and the federal Freedom of Information Act indicate that Mercy Hospital Springfield has struggled recently to recognize incidents of possible abuse and neglect. The Missouri Department of Health and Senior Services and CMS each released the findings of a complaint investigation conducted in early January and the hospital’s subsequent plan of correction. (To review the 219 pages of records released by the state, download the PDF.)

Read the rest of this entry »

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.\

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