WORKPLACE VIOLENCE

Promoting a respectful workplace.Minimizing the risk of violence at the University Hospitals.

What’s included as violence?• Verbal abuse• Sexual

harassment• Intimidation• False rumors• Assaults• Suicide• Rape

• Threats• Domestic abuse• Stalking• Hostage taking• Sabotage• Terrorism• Kidnapping• Homicide

Basic types of workplace violence• Committed by an “outsider”;

usually involves theft; has criminal intent

• Committed by a customer or patient

• Worker to worker violence• Personal relationship violence

(spillover of domestic violence)

How much violence are we willing to tolerate?• In our hospitals, our policy is

zero tolerance.

• References: our hospital policies; OSHA Guidelines; JCAHO standards; Texas law; TDSHS hospital licensure standards

Elements in prevention

• Staff and leadership education

• EAP awareness and utilization

• Strong customer service approach

Warning Signs

• Type I (criminal intent): May be no signs; may be sudden.

• Type II (patient/customer to staff): Early signs of anger (e.g., red face; raised voice)

• Type III (worker to worker): Efforts to intimidate; blaming others; verbal threats; signs of drug or alcohol abuse

Warning signs, continued

• Type IV (domestic violence spillover): frequent personal phone calls; late/tardy/unexcused absences; injuries without explanation; disregard or obsession with personal hygiene.

Do we have these incidents now?

More assaults occur in healthcare and social service industries than in any other. (Reference: OSHA, 2002)

Areas at potentially greater risk:• Emergency Room• Admissions• Human Resources• Psychiatric

Services

• Hospital administrative areas

• Women’s Services• Health Referral

Center• Clinics

Hospital-wide approach

• Leadership & staff education• Risk assessment & plan for each

area• Documentation & tracking, trending• Available assistance & knowledge of

how to access them• Follow up as needed with staff

Elements of a unit-specific plan• Risk assessment of the area

• Staff training plan

• How to get additional help

Key points in de-escalation

• Introduce yourself and offer to assist• Ask and use the person’s name• Do all you can to respond to requests, at

the time, before leaving the area• Be ready to get/seek help. Stay alert.• Close the loop, in terms of requests.

How to respond?

• “Universal precautions” for violence (be prepared at all times)

• Safety first /“hero” is not in the job description

• Ask for help!

New Emergency Code!

• Code Silver is an overhead page that calls the police immediately to your work area.

• Code Rush is the page for help with a patient.

• Use this page if anyone is immediately under threat of violence, abduction or if there is any indication that there is a weapon present.

Documentation

• Note in the patient’s record any incident of responding directly to the patient, in a factual, behaviorally-based note

• Report to HR any instances of workplace violence, even if already noted in the chart

• Notify your director and/or the house supervisor right away (they also report these instances to HR)

Available Resources

• Your manager or supervisor• Human Resources/Employee

Relations staff• Office of Equal Opportunity &

Minority Affairs at UT Southwestern: 214.648.4344

The hospitals’ goal:

A safe, secure environment for our patients, their visitors, guests and our employees!