Using a System-Wide Database to Reduce Workplace Violence in Hospitals

Details

• Personal Author:
  Ager J ; Arnetz J ; Janisse J ; Luborsky M ; Upfal M
• Description:
  Violence towards health care workers is a significant occupational hazard that threatens employee safety, health, work productivity, retention, and the quality of care. Violent acts, most of which are attributed to patients and patient visitors, contribute to a dangerous and unhealthy work environment for the nation's 6.5 million hospital workers. However, hospitals lack practical and sustainable systems for workplace violence risk assessment and prevention. Over a five-year period, our research team partnered with the Detroit Medical Center (DMC) on a project that aimed to develop and evaluate data-driven methods for reducing workplace violence. The DMC provided a unique opportunity to study this occupational hazard due to its centralized, electronic reporting system and ongoing surveillance of adverse events, including acts of workplace violence. All phases of the project were conducted in collaboration with DMC stakeholder representatives of Human Resources, Quality and Safety, Nursing, Security, Occupational Health Services, and Labor. The study was designed as a randomized controlled intervention and was conducted in four phases: (1) Methods were developed for calculating rates of workplace violence that enabled us to compare the incidence of violence across hospitals, hospital units, professional groups, and over time. Focus groups were held with DMC stakeholder representatives to develop and refine database-generated reports of workplace violence according to stakeholder preferences. (2) In phase 2, we used the Hazard Risk Matrix to identify hospital units at increased risk for violence and violence-related injury. Using this matrix tool, 41 hospital units across the DMC's 7 hospitals were identified and randomized into one of two groups, intervention or control. (3) The intervention, a worksite walkthrough, was conducted at the 21 intervention units, where researchers presented 3 years' of unit-level workplace violence data for unit supervisors. Based on their unit's data, supervisors and staff were then asked to develop an Action Plan for violence prevention. No walkthrough intervention was conducted on the control units. (4) Intervention evaluation was based on (a) analysis of database-generated rates of patient-to-worker violence and violence-related injury at 6, 12, 18, and 24 months post-intervention; and (b) questionnaires to employees all 41 hospital units (both intervention and control) measuring ratings of their work satisfaction and work safety culture. Six months post-intervention, the risk of violent events was significantly lower on intervention units compared with controls. At 24 months, the risk of injury due to violence was significantly lower on intervention units, compared with controls. Intervention units reported significant increases over time in questionnaire scores for Management Support for Workplace Safety and Work Satisfaction, and a significant decrease in Work Stress, compared to controls. This is the first large-scale, randomized controlled study to demonstrate positive effects over time of an intervention aimed at reducing patient-to-worker violence. The intervention, a structured workplace walkthrough, provides a feasible method for initiating violence prevention strategies by supervisors and staff on individual work units. These methods for workplace violence surveillance, risk assessment and prevention can be integrated into the everyday working life of health care organizations and have the potential to improve hospital worker health and safety nationwide. [Description provided by NIOSH]
• Subjects:
  Health Care Facilities Workforce And Services Health Personnel Occupational Health Preventive Medicine Risk Assessment Risk Factors Safety Safety Management Violence Workplace
• Keywords:
  Hazards Health-care-facilities Health-care-personnel Injuries Injury-prevention Intervention Intervention Effectiveness Medical-facilities Medical-personnel Nurses Nursing Patient Handling Preventive-medicine Risk Assessment Risk Factors Safety-measures Safety-practices Violence-prevention Work-environment Worker-health Workplace Violence

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• Series:
  Grant Final Reports
• Publisher:
  National Institute for Occupational Safety and Health
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Final Grant Report
• Place as Subject:
  Michigan ; OSHA Region 5
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  OEP - Office of Extramural Programs
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  1-36
• NIOSHTIC Number:
  nn:20049700
• NTIS Accession Number:
  PB2017-102227
• Citation:
  Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, R01-OH-009948, 2016 Nov; :1-36
• Contact Point Address:
  Judith E. Arnetz, PhD, MPH, PT, Department of Family Medicine, College of Human Medicine, Michigan State University, 788 Service Rd, B103 Clinical Center, East Lansing, MI 48824
• Email:
  judy.arnetz@hc.msu.edu
• Federal Fiscal Year:
  2017
• NORA Priority Area:
  Healthcare and Social Assistance
• Performing Organization:
  Wayne State University - Detroit, Michigan
• Peer Reviewed:
  False
• Start Date:
  20110901
• Source Full Name:
  National Institute for Occupational Safety and Health
• End Date:
  20150831
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:c7ff96e6d05bdfdf1154c20ed25145506bd494bff537d6afe1291a69fb74f4ed2403d83f480793f0fd2a82ff732c3e43c185660e5a96dc56462690999b42be4f
• Download URL:
  https://stacks.cdc.gov/view/cdc/218658/cdc_218658_DS1.pdf
• File Type:
  [PDF - 1.96 MB ]