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Workplace Violence in Health Care

Posted By Administration, Tuesday, April 19, 2016
Updated: Monday, April 18, 2016

The healing professions are at greater risk of experiencing violence in the workplace than most professions,
but many are working to reduce the risk.

by Patricia McTiernan, MS

Ann Scott Blouin
Ann Scott Blouin, PhD, RN, FACHE,
will discuss workplace violence and
methods of de-escalating it at the
NPSF Patient Safety Congress.


In March of this year, a patient shot and killed a urologist in New Orleans, then turned the gun on himself. The incident was shockingly reminiscent of last year’s killing of a surgeon at a hospital in Boston by a distraught family member.


Although the murder of health care professionals is an extreme form of violence that is relatively rare, overall, health care professionals are at far greater risk than others of experiencing violence in the workplace. According to the Occupational Safety and Health Administration (OSHA), in the decade between 2002 and 2013, the rate of violent incidents requiring time off for the worker to recover was more than 4 times greater in health care than in other industries. OSHA data show that there are almost as many serious violent injuries in health care settings as there are in all other workplaces combined.


What do we know about the why of all this? Ann Scott Blouin, PhD, RN, FACHE, executive vice president, Customer Relations, at The Joint Commission (TJC), says part of it has to do with how open and accessible health care settings are, as well as the emotional state that patients and family members may be in while at a health facility.


“There are lots of entry points, making security more challenging. Also patients and family members in a health care setting often have reasons to be upset or concerned,” says Dr. Blouin. “Often health care providers need to have difficult conversations with patients and their families.”


Another factor is the incidence of patients having not only medical and surgical conditions, but also underlying mental illness, which can contribute to the risk of violence. And if patients, visitors, or family members typically live in an environment characterized by violence, they may bring that perspective and sometimes weapons into the health care setting, says Dr. Blouin.


If there is a bright spot, it is that many organizations now recognize this risk and are taking steps to educate the workforce and make health care safer for those on the front line of care.


The Joint Commission published a monograph in 2012 on the topic of workforce safety in health care and later this year plans to launch a web portal available to all with resources and tools. Among the resources will be the American Society for Healthcare Risk Management’s Workplace Violence Risk Assessment Tool.


In 2013, the National Patient Safety Foundation’s Lucian Leape Institute issued a report calling workforce safety a precondition to patient safety; Joint Commission fully supports that perspective and has published Sentinel Event Alerts and Quick Safety Alerts around the topics of escalating workplace violence.


If she could share only one piece of wisdom about this issue, Dr. Blouin says, “Don’t take your patients’ or your own personal safety for granted.” She points out that there are proven tactics to de-escalate a potentially violent situation, and that anyone can learn them.


“For those working in behavioral health, a standard part of the curriculum is to learn de-escalation techniques and be able to help people move from being angry and upset to a calmer state. Anyone regardless of their education and experience, whether a nurse, a physician, an environmental service worker, or a security officer, can benefit by learning these techniques,” she says.

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Ann Scott Blouin will be speaking on the topic of workplace violence and tactics to counteract it during Breakout Session 301 at the NPSF Patient Safety Congress, May 24, in Scottsdale. Find out more about her session and the full program at


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Patricia McTiernan, MS is assistant vice president for communications at the National Patient Safety Foundation and editor of the P.S. Blog. Contact her at

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Tags:  2016 NPSF Congress  workforce safety 

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