Physician Heal Thyself: California Sets Nation’s Highest Standard For Health Care Workplace Violence Prevention

The facts are distressing: according to federal Occupational Safety and Health Administration statistics, over half of all reported workplace violence incidents occurred against workers in healthcare and social assistance. Nurses are attacked at more than 3 ½ times the average national rate of occupational violence.

After years of recognition and lament concerning violence in our hospitals and the larger health care community, California is doing something about it in a big way. Through unprecedented statutory and regulatory mandate administered by the California Division of Occupational Safety and Health, a broad range of health care service providers – including hospitals, skilled nursing and intermediate care facilities, home health agencies, hospices, emergency medical services, medical transport companies, and drug treatment programs – have until April 1, 2018, to ensure that their written workplace violence prevention plan is in place, complete with investigation, response and communications procedures, and comprehensive incident reporting and record-keeping protocols.

Acute care hospitals are under further and more immediate obligation. Recordkeeping and reporting requirements concerning violent incidents specifically apply to hospitals as of April 1, 2017. Cal/OSHA has already informed affected employers of the requirement to use its online tool for the reporting of broadly defined violent acts, including the use of physical force against a healthcare employee by a patient or family member that results in, or has a high likelihood of resulting in, injury, psychological trauma, or stress, regardless of whether a physical injury is sustained.

Covered employers should give significant consideration to the following elements of a workplace violence prevention plan:

  • Designate and train a dedicated workplace violence prevention team, including decision-makers drawn from human resources, security, legal, individual business unit liaisons, facilities, and special resources including EAP representatives
  • Determine need for trained individual business unit teams for satellite facilities
  • Conduct a violence vulnerability audit to identify key gaps  in security, risk identification procedures, incident response and intervention training, internal and external emergency communications, and post-incident protocols.
  • Training of all employees on how to recognize the potential for violence, use of stabilization and control techniques and hospital alarm systems, engagement with security personnel, and reporting of violent incidents.

The new Cal/OSHA standards highlight the need for employers to conduct an interactive dialogue with the affected employee populations; the resulting training curriculum must reflect real-world situations for the specific business units. One size does not fit all: emergency rooms have a completely different set of circumstances and corresponding needs than, for example, maternity, and the hospital’s workplace violence plan and training curriculum must address these specific issues.

For over 20 years, Hirschfeld Kraemer partner Glen Kraemer has been on the front-lines of workplace violence prevention, assisting employers with the creation and training of comprehensive workplace violence prevention teams, and educating supervisors concerning warning signs and triggering factors while incorporating best practice management informed by legal and human resources considerations. During his many years of membership with the Association of Threat Assessment Professionals, he has frequently presented as a featured General Session speaker at its national Threat Management Conference, and has trained thousands of employer decision-makers on the integration of law, policy, and essential leadership communications in the service of creating a safe, healthy and productive workplace. He has assisted in the creation and training of numerous acute care hospital workplace violence prevention teams, and is currently working with clients on comprehensive design and implementation of the new Cal/OSHA mandate.

Should you have any questions regarding this new Cal/OSHA regulation, please contact Glen Kraemer at gk@HKemploymentlaw.com, or 310-255-1800.

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