Healthcare industry employers can, and should, take reasonable steps to identify risks of workplace violence and implement appropriately tailored measures to prevent and mitigate such violence. That process often is referred to as a workplace violence prevention program. Such programs typically include a worksite analysis to identify hazards, actions to prevent and control risks, worker training, recordkeeping and review protocols, and—most importantly—sincere, consistent management commitment to the program.
Good workplace violence prevention programs address security, education, deterrence, intervention, emergency response, and recovery. Many programs begin with a thorough workplace analysis to identify risks and ways to mitigate them. Mitigating measures often include engineering controls (e.g., locks, cameras, metal detectors), administrative controls (policies and procedures), and training. Mitigating measures should be tailored to the employer’s particular circumstances. For example, a hospital in a high crime area likely needs a more robust plan than a private doctor’s office in a “safer” area. Fences, metal detectors, and armed guards may be impractical and unnecessary for some healthcare employers, but maybe not for others. There is no cookie cutter; an effective and responsible program requires considerable thought.
Administrative controls should apply to employees, patients, clients, visitors, contractors, and others who may enter the premises. Having a “zero-tolerance” policy toward workplace violence may seem obvious, but such policies must be rationally designed and applied, and should not be the only administrative control. Similarly, declaring a workplace a “gun free zone” is insufficient. Shootings are just one type (and a rare one) of workplace violence, and many shootings occur in gun free zones (attackers know these are “safe spaces” where no one is likely to shoot back). The shooting often continues in “gun free zones” until the police (and their guns) arrive. Someone who is willing to accept the consequences of committing murder is unlikely to be daunted by an employment policy or “no guns” sign.
Policies and managers should encourage employees to report all incidents and risks of workplace violence, and provide assurance that reports will be investigated and retaliation will be prohibited. Employees should be required or encouraged to notify the employer if they seek or obtain (or become the subject of) a protective or restraining order. In such circumstances, preventive measures may include distributing photographs of restrained persons to security personnel, receptionists, and others who are likely to encounter the person. Those personnel can be trained to isolate such individuals, notify designated managers, call the police, and take other appropriate action to mitigate risks. The possibilities are endless, but action and critical thinking are essential.
Training is a critical part of an effective workplace violence prevention program and helps employees (and employers) understand and appreciate potential risks and the importance of administrative controls. Employees can be taught to recognize signs of potential violence, such as threats, over-reaction to minor slights, bullying, and domestic relations issues. Managers can be trained to assess employees’ complaints for signs of anger, aggression and depression, and to intervene when appropriate. Proper training can reduce the risk of workplace violence occurring and can mitigate the impact of extreme violence, such as a shooting.
This series of articles just scratches the surface of workplace violence issues in the healthcare industry. The primary takeaway is that these issues are serious and unique, serious action is necessary to protect employees and others in healthcare environments. Many resources are available to help employers take such action, but only the employer can get the process started and take the appropriate actions.
George Adams is a partner in Fisher & Phillips’ Louisville, Kentucky office. His practice is exclusively devoted to representing employers in matters of labor and employment law. This article merely provides an overview of certain legal issues, and cannot be construed as legal advice. For more information, please call (502) 561-3990.