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Tips on reducing violent incidents
3/23/2012
 
The Joint Commission and the nonprofit ECRI Institute recommend hospitals take comprehensive steps to reduce the potential for violence on their campuses.

Hospitals should conduct risk assessments, employ proper security measures and personnel, and provide violence-management and de-escalation training for high-risk employees. The Joint Commission recommends all employees in high-risk areas of a hospital receive violence-management and de-escalation training, including security personnel, human resources professionals, emergency department staff, nurses, volunteers, clergy members, and valets.

As ECRI explains it, one way to reduce the risk of violence, as well as remain compliant with the Joint Commission’s Environment of Care Safety and Security Standard (EC.02.01.01), is to ensure that staffs are trained on how to recognize people who are escalating and potentially becoming violent and respond accordingly.

An article published in the Joint Commission’s March 2012 Environment of Care News presents a comprehensive violence intervention training program, TEAM (Techniques for Effective Aggression Management), which is designed to defuse disruptive behavior before an incident escalates into a violent crisis.

In a Sentinel Event Alert in June 2010, the Joint Commission recommended the following steps, among others:
  • Work with the security department to audit your facility’s risk of violence. Evaluate environmental and administrative controls throughout the campus, review records and statistics of crime rates in the area surrounding the healthcare facility, and survey employees on their perceptions of risk.

  • Identify strengths and weaknesses and make improvements to the facility’s violence-prevention program.

  • Take extra security precautions in the Emergency Department, especially if the facility is in an area with a high crime rate or gang activity. These precautions can include posting uniformed security officers, and limiting or screening visitors (for example, wanding for weapons or conducting bag checks).

  • Work with the HR department to make sure it thoroughly prescreens job applicants, and establishes and follows procedures for conducting background checks of prospective employees and staff.
The Occupational Safety and Health Administration has its own set of recommendations. OSHA says the following five main components of any effective safety and health program also apply to the prevention of workplace violence:
  • Management commitment and employee involvement;

  • Worksite analysis;

  • Hazard prevention and control;

  • Safety and health training; and

  • Recordkeeping and program evaluation.
PHT members may take advantage of a number of free on-site trainings on Nonviolent Crisis Intervention and workplace violence, conducted by PHTS risk management staff. For more information, please contact Wendy G. Stephenson, MS, ARM, CPHRM, ASP, vice president, risk management at PHTS, at wstephenson@phts.com.