Health providers sometimes do deliberately harm patients, either by assaulting them or administering medications or treatments. This "presents a considerable threat to institutions, even when the patient is unable to identify the responsible person."
The commission recommends performing criminal background checks on job candidates, especially those "who are to be placed in high risk areas, such as the ED, obstetrics, pediatrics, nursery, home care, and senior care settings."
The commission suggests that hospitals take the following actions minimize violent incidents:
- Work with the security department to audit your facility's risk of violence. Evaluate environmental and administrative controls throughout the campus, review records and statistics of crime rates in the area surrounding the healthcare facility, and survey employees on their perceptions of risk.
- Identify strengths and weaknesses and make improvements to the facility's violence-prevention program.
- Take extra security precautions in the Emergency Department, especially if the facility is in an area with a high crime rate or gang activity, such as having uniformed security officers, and limiting or screening visitors for weapons.
- Make sure the HR department prescreens job applicants and for clinical staff, and verifies the clinician's record with appropriate boards of registration. If an organization has access to the National Practitioner Data Bank or the Healthcare Integrity and Protection Data Bank, check the clinician's information, which includes professional competence and conduct.
- Confirm that the HR department ensures that procedures for disciplining and firing employees minimize the chance of provoking a violent reaction.
- Require appropriate staff members to undergo training in how to respond to agitated, potentially violent family members and include procedures for notifying supervisors and security staff.
- Ensure that notification procedures or code activations are in place and that employees are properly trained in their use.
- Encourage employees and other staff to report incidents or threats of violent activity. Train supervisors to recognize when an employee or patient is exhibiting behaviors related to domestic violence issues.
- Ensure that counseling programs for employees who become victims of workplace crime or violence are in place.
- If a violent act does take place, report the crime to law enforcement, recommend counseling and support to patients and visitors affected, review the event and make changes to prevent occurrences.
Cheryl Clark is senior quality editor and California correspondent for HealthLeaders Media. She is a member of the Association of Health Care Journalists.