The Bureau of Labor Statistics (BLS) reports that in 2013, over 23,000 significant workplace injuries occurred due to assaults on the job– and that over 70 percent of these assaults were in healthcare and social service settings.

According to the Occupational Safety and Health Administration (OSHA), health care and social service workers are almost four times as likely to be injured as a result of workplace-related violence than the average private sector worker. In April of this year, and based largely on that fact, OSHA updated its Guidance for Preventing Workplace Violence for Healthcare and Social Services Workers.

The revised guidelines, which updates OSHA’s guidance documents from 1996 and 2004, include research findings from various sources published in the past decade, and outline risk factors associated with working with patients or clients who behave violently.

The April 2015 publication also lists preventive measures that can be taken, and stresses the importance of developing and implementing a written workplace violence prevention program. Notably, OSHA spells out the elements of such a program to include express management commitment, worksite analysis, effective hazard prevention/control, health and safety training for both employees and managers, and accurate recordkeeping evaluation.

One particular decision issued since the issuance of the updated guidelines illustrates those points:

  • In June 2015, an Administrative Law Judge (ALJ) Judge affirmed OSHA’s earlier findings that Florida-based social service agency violated the General Duties Clause of the Occupational Safety and Health Act after a health care coordinator was stabbed to death by a mentally ill client who had a violent past.
  • OSHA investigators determined that the assailant had exhibited several high-risk factors and behaviors – including a history of violent criminal behavior – but that the company took no steps to protect its employees.
  • The OSHA’s decision was based – and then upheld on appeal – largely because the company had failed to conduct a hazard assessment of the health care coordinator’s position at any point.
  • Further, the company had not developed a written program to prevent workplace violence hazards, nor had it sufficiently trained its employees on prevention techniques.

That decision indicates that OSHA will follow the factors outlined in its updated guidance when assessing workplace-related violence reports involving healthcare workers. Hospitals, healthcare systems, and social service agencies committed to employee safety should use the guidance as a checklist of actions that should be taken to support that commitment, and to assure compliance with any review or audit by OSHA.


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