Workplace Violence in Outpatient Physician Clinics

Details

• Personal Author:
  Pompeii LA
• Description:
  The purpose of this study was to 1) define the 12-month prevalence of WPV among clinic workers; 2) examine how clinics capture WPV events including how and where workers report these events; 3) describe WPV prevention practices and policies; and 4) examine associations between WPV in study clinics and their community level factors including criminal activity around the clinics. We conducted the primary data collection of surveying all frontline workers in both study clinic systems regarding their experiences with all four types of violence (e.g., type I=criminal, type II=patient/family-perpetrated, type III=worker-on-worker; type IV=domestic violence spilling into the workplace). This was the first NIOSH/NIH funded study to examine WPV in outpatient physician clinics, which was guided by the Ecological Model. This study examined WPV and prevention efforts at the worker, clinic, and clinic system levels. It also considered the context with which these clinics reside within their communities, including criminal activity within a 0.5 radius of the clinic, as well as neighborhood traffic patterns and business characteristics. The findings from this study will be used to inform prevention efforts within the clinic systems where the study was conducted and will fill a gap in the literature. The prevalence of type II violence reported by workers is on par with those reported in the hospital WPV literature. The contrast between the clinic managers and the frontline workers' responses regarding the prevalence of WPV suggests a disconnect between management perceptions of the issue and workers' experiences. It also reflects the lower-than-expected prevalence of events that should have been reported through a formal capturing system rather than directly reporting to a clinic manager. The high prevalence of events in clinics that are remote and without security presence makes them particularly vulnerable to adverse consequences when a WPV event occurs. A total of 159 outpatient physician clinics were included in the clinic characteristics survey in a large metropolitan area in southeast Texas. For the frontline clinic worker survey, a total of 2106 workers responded including 1064 pediatric clinic system and 1042 adult clinic system workers. Across the WPV types, the prevalence varied by systems. Among pediatrics, the prevalence of type I violence was 11%, type II was 60%, type III was 30% and type IV was 8%. Among adult clinics, the prevalence of type I was 6%, type II was 35%, type III was 23%, and type IV was 4%. Some of the main findings included: a) The prevalence of type II (patient/family-on worker violence) and type III (worker on worker) violence was similar to prior hospital-based studies. b) While not as prevalent, but still relevant, type IV violence (domestic-related violence) was reported among 4% of workers. c) The capturing of WPV events by clinics was significantly smaller than those actually reported by workers through this survey. d) Workers reported that they needed more training to prevent and/or de-escalate WPV events. e) Clinics had some standard safety measures, but glaring gaps were reported including, lack of security guard presence in/around the clinics, alarm security systems, and surveillance cameras in/around the clinic. f) Clinics lacked written WPV prevention strategies and corresponding worker training. g) Workers were directed/trained to report to clinic managers rather than through a formal reporting system. [Description provided by NIOSH]
• Subjects:
  Health Care Facilities Workforce And Services Health Personnel Occupational Health Safety Violence Workplace
• Keywords:
  Health Care Facilities Outpatient Facilities Physicians Policy Violence Prevention Workplace Violence
• Series:
  Grant Final Reports
• Publisher:
  National Institute for Occupational Safety and Health
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Final Grant Report
• Place as Subject:
  OSHA Region 6 ; Texas
• 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:
  1-11
• NIOSHTIC Number:
  nn:20069514
• 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-011930, 2023 Nov; :1-11
• Email:
  Lisa.Pompeii@cchmc.org
• Federal Fiscal Year:
  2024
• NORA Priority Area:
  Healthcare and Social Assistance
• Performing Organization:
  Baylor College of Medicine, Houston, Texas
• Peer Reviewed:
  False
• Start Date:
  20181001
• Source Full Name:
  National Institute for Occupational Safety and Health
• End Date:
  20210831
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:6bdcdd1572df19141d50726db0cdd7689fd43007f23239acb5de3e9c58c581c89922bf105219283a49c9459579f1e648a3179f8b3755d6fcb55fe51435f3bc4c
• Download URL:
  https://stacks.cdc.gov/view/cdc/219232/cdc_219232_DS1.pdf
• File Type:
  [PDF - 322.33 KB ]