Workplace Violence Prevention

Abstracts from the Kaiser Permanente2018 National Quality Conference


Robert Durand, CPP, CHEP, HEM, CHSS; Jeff Kostos, CSP

From Colorado, Georgia, Hawaii, Mid-Atlantic States, Northern California, Northwest, Southern California, Washington, Program Offices

Background: According to the 2011 report from The Joint Commission, hospitals saw a significant increase in assault, rape, and homicide from 2007 to 2010. Between 2011 and 2013, workplace assaults ranged from 23,540 and 25,630 annually, with 70% to 74% occurring in health care and social service settings, according to Occupational Safety and Health Administration statistics. Violence-prevention programs reduce the risk of assault by training workers to recognize frequent cues such as drug use and threatening body language, and educating them about strategies to help defuse situations.
Methods: Kaiser Permanente’s mission to provide high-quality care within the communities we serve requires an understanding of individual member experience and needs. As we strive toward continuous care delivery improvements, the implementation of a Defense and De-Escalation model supports our efforts to live up to member expectations, improves outcomes for all our members, and supports the workplace safety credo of creating a workplace free from harm.
Results: 1. Cultural approach critical: Assure we are grounded in the philosophy and basic tenets of our care approach. 2. Regional operation ownership: Ownership assures strategic alignment and a sustainable future. 3. Alignment with key stakeholders: Assure ongoing engagement, avoid duplication and use collective best practices. 4. Philosophy embedded in policy and procedure: Enculturation of a philosophy of care provides the foundation for all we do and guides the efforts to ensure collective understanding. 5. Standardize reporting with metric-driven improvement: Standardized reporting collects the necessary information to observe trends and help with decision making.
Discussion: Protecting patients and staff from violent acts is fundamental to ensuring quality patient care. Creating the appropriate systems, tools, and education is vital to reducing the frequency of situations that may result in harm to our members and staff. The increase in violence in some departments, such as Emergency Departments, has resulted in difficulties in recruiting and retaining highly qualified personnel. Patients with medical emergencies deserve a place of care that is free of physical dangers from other patients, and care from staff that is not distracted by individuals with behavioral or substance-induced violent behavior. Every employee has the right to work in an environment free of harm.

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