Workplace violence has always disproportionately affected the healthcare industry; according to the Bureau of Labor and Statistics, between 2011 and 2018, there was an increase of 63% in injuries suffered by industry professionals (Reilly, 2023). Unfortunately, the pandemic has only exacerbated the ongoing problem; since the COVID-19 outbreak, we’ve seen a dramatic increase in these incidents, with nurses reporting as much as a 115% increase in incidents since 2021 (Reilly, 2023).
Some of the worst occurrences have ended in the death of providers. On May 3, 2023, a gunman entered a Midtown Atlanta medical building and opened fire (McKay, 2023). The incident would claim one provider's life and wound four others; it is known that the shooter had an appointment at the facility, but the motives for his actions are unclear (Fox Atlanta Digital Team, 2023). Another tragic example of this violence: a Tennessee surgeon was fatally shot on Tuesday, July 11, 2023, while in the exam room with a disgruntled patient in what appeared to be a coordinated attack (Lenthang & Mullen, 2023).
As the number of violent episodes at healthcare facilities rises, it begs the question: why?
Why has violence against healthcare professionals increased since the pandemic after a time when many tried to honor the harrowing work healthcare providers were undertaking? While it’s hard to quantify the cause definitively, the CDC has identified a few main factors that could be at the heart of this problem:
Increased patient morbidities
Exposure to violent individuals
Absence of strong workplace violence prevention programs to protect providers (CDC, 2023)
As we’ve previously covered, Staff Shortages are a real healthcare industry problem. Many providers have chosen to leave the field after such a tumultuous period during the COVID-19 Pandemic. This mass exodus further inhibits the ability to provide the standard of care many patients have come to anticipate leading to more frustration.
These factors create a vicious cycle that is hard to break; an understaffed facility leads to less patient safety, and more lapses in care yield greater patient dissatisfaction and a higher likelihood of a violent incident. And the more unsafe the work environment becomes, the less appealing the medical industry is to the current and incoming workforce, creating a more dire shortage of staff.
This is a conundrum the healthcare industry faces, and improving working conditions for providers is paramount to ensure the future of healthcare. Fixing the problem will have to be a multi-faceted approach with new legislation, workplace safety programs, and resources in the event of an incident.
The Occupational Safety and Health Administration (OSHA) has begun working on a new regulatory framework for violence in prevention in healthcare that will encompass, “hazard assessments, violence control measures, preventive training, and investigations and documentation.” (Reilly, 2023). This is only the first step in creating a robust system for handling the violence healthcare workers experience, but it’s an important, long overdue milestone.
Additionally, the federal government is beginning to work on new legislation that could improve the working environment for clinicians. The Workplace Violence Prevention for Health Care and Social Service Workers Act was initially proposed on February 22, 2021, by Democratic Representative Joe Courtney (Falcone, 2023). While OSHA has started the process of making the workplace safer, this bill aims to hold employers legally responsible for the safety of employees.
Under the proposed law, organizations that employ healthcare or social service workers would be legally required to:
Implement a risk assessment and prevention plan.
Provide workplace prevention training for employees.
Investigate occurrences of workplace violence.
Maintain records of that prevention measures for five years. (Flacone, 2023)
Oversight for these new requirements would be OSHA’s responsibility with routine inspections. Encouragingly, the bill was passed in Congress on April 16, 2021. Unfortunately, the Senate has not passed the Workplace Violence Prevention for Health Care and Social Service Workers Act.
The bill is widely supported by professional organizations, including the American Nurses Association, the American Federation of Teachers, and the National Nurses United (Falcone, 2023), who all feel that this is an important step to protect frontline workers. But it is facing some opposition not just politically but also from OSHA. In a letter to Congressman Courtney, OSHA explained that the costs to put these measures in place would be counterintuitive as it would put additional strain on an already stressed healthcare system and further jeopardize patient safety in some communities.
While the bill's future remains to be seen, and as OSHA and the U.S. Government continue their work on putting new measures in place, there are steps practices can take today that could start the process of better-protecting employees.
In our previous post on Workplace Violence Prevention, we outlined a few steps in creating a workplace violence policy, including:
Provide an explicit definition of workplace violence in relation to your business.
Identify possible aggressors.
Provide a detailed prevention strategy.
Create training programs, encourage monitoring and reporting threats, and outline a response plan.
Creating a comprehensive plan to address and hopefully prevent incidents is important to ensure your employee’s safety. Professional Risk can help you review your coverage options for workplace violence, as willful acts of violence that result in injury are often exclusions from your Workers’ Compensation policies. A Workplace Violence Policy will help with legal liability, counseling, and care for the injured worker. If you want to learn more about this coverage, contact one of our agents for additional information.
CDC. (February 7, 2020). Common Reasons for Workplace Violence. Post [Website]. Retrieved from: Common Reasons for Workplace Violence | WPVHC | NIOSH (cdc.gov)
Falcone, Sarah. (January 26, 2023). Legislation to Prevent Workplace Violence in Healthcare Awaits a Senate Vote. Article [Website]. Retrieved from: The Workplace Violence Prevention For Healthcare Workers Act Awaits a Senate Vote (nurse.org)
Fox 5 Atlanta Digital Team. (May 10, 2023). Two Victims of Midtown Atlanta medical building shooting now out of the hospital. Article [Website]. Retrieved from: Two victims of Midtown Atlanta medical building shooting now out of hospital (fox5atlanta.com)
Lenthang, Marlene & Mullen, Austin. (July 12, 2023). Tennessee surgeon fatally shot in ‘targeted attack’ by patient in exam room, police say. Article [Website]. Retrieved from: Tennessee surgeon fatally shot in 'targeted attack' by patient in exam room, police say (nbcnews.com)
McKay, Rich. (May 4, 2023). Police arrest suspect in fatal mass shooting at Atlanta medical center. Article [Website]. Retrieved from: Police arrest suspect in fatal mass shooting at Atlanta medical center | Reuters
Reilly, Peter. (July 6, 2023). Managing the risk of violence against health care workers: Effective solutions needed. Article [Website]. Retrieved from: Managing the risk of violence against health care workers: Effective solutions needed (medicaleconomics.com)