Tuesday, September 20, 2016 JAMA: Better Health Care Workplace Violence Prevention Plans Needed With half of all workplace assaults involving health care workers already, and the number of violent crime episodes in hospitals on the rise, it's time for health care facilities to address workplace violence "aggressively and comprehensively," say authors of an editorial recently published in JAMA. The "Viewpoint," (first-page sample only available for free) written by 2 employees of the Joint Commission and a representative from a Veterans Health Administration workplace violence prevention program, cites data from the Joint Commission, Occupational Safety and Health Administration (OSHA), and Bureau of Labor Statistics (BLS) to outline what they assert is a growing problem. Among the data: Within health care settings, approximately 24,000 workplace assaults occurred between 2010 and 2013, with most threats and assaults occurring between noon and midnight. Between 2012 and 2015, the incidence of violent crime events in hospitals rose from 2.0 to 2.8 per 100 beds. According to BLS, 50% of all workplace assaults involve health care workers, while workers in this labor segment only account for 20% of all workplace injuries. An OSHA study of 100 health care worker or patient fatalities in health care settings found that nearly a third (27%) were attributable to assaults and violence. A Joint Commission study of 33 homicides, 38 assaults, and 74 rapes in health care workplaces between 2013 and 2015 concluded that "root causes of these events were failures in communication, inadequate patient observation, lack of or noncompliance with policies addressing workplace violence prevention, and lack of or inadequate behavioral health assessment to identify aggressive tendencies in patients," authors write. Authors of the JAMA article assert that increasing workplace safety will require health care employers to step up the creation of violence prevention programs. These programs, they write, must be rooted in a recognition that "personnel underreport violent events because they believe these experiences are part of the job, reporting is either cumbersome or unlikely to result in action from leadership, or they fear retaliation for reporting." To counter that tendency authors urge the development of reporting systems that are "simple, trusted, secure, and with optional anonymity," result in "transparent outcomes and delivery of a report confirmation," and are "fully supported by leadership, labor unions, and management." "Safety in health care workplaces relies on leadership enacting appropriate polices; trained employees intervening and reporting; multidisciplinary teams using evidence-based threat assessments and management practices, communicating safety plans, and analyzing environmental context; and ongoing evaluation of program effectiveness," authors write. "A workplace violence prevention program should be a required component of the patient safety system of all health care organizations."