Emerging Issues in Security

OSHA Issues New Guidelines for Healthcare Violence Prevention

The Occupational Safety and Health Administration’s (OSHA) new Guideline 3148 mandates healthcare facilities to make significant improvements in the hazards facing hospital and clinic employees. Facilities that receive Medicaid and Medicare can lose reimbursement funding if they aren’t in compliance by doing an annual all-hazards security risk assessment by November 15, 2017.

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OSHA’s directive identifies 17 types of healthcare facilities that are designated as Centers for Medicare and Medicaid Services (CMS), who could lose reimbursable funding for medical services if they don’t assess their facilities for workplace violence hazards. These hazards include attacks from active shooters and the potential for healthcare facilities to be the target of mass casualty events. The types of facilities include public and private hospitals, rehab clinics, home health agencies, hospices, psychiatric residential facilities, long-term care facilities, and medical clinics.

OSHA has defined five key elements for a workplace violence prevention program for healthcare and social services agencies. These include management commitment and employee involvement; a worksite analysis at each location; hazard identification, prevention, and controls; safety training for all employees (and not just for patient-contact employees); and up-to-date recordkeeping (as part of an existing injury and illness prevention plan) and ongoing program evaluations.

OSHA suggests these elements of a workplace violence prevention plan for healthcare facilities and other types of businesses and industries:

  • Create and distribute a clearly written policy of “zero tolerance” for workplace violence, verbal and nonverbal threats, weapons in the workplace, and related actions.
  • Ensure that managers, supervisors, employees, clients, patients, and visitors know about this policy.
  • Ensure that no employee who reports or experiences workplace violence faces reprisals for reporting threats or incidents that involve themselves or others.
  • Encourage employees to promptly report incidents, and have them help develop ways to reduce or eliminate violence risks.
  • Collect and maintain incident records to assess and measure progress.
  • Create a comprehensive, updated plan for maintaining security in the workplace. This includes establishing liaisons with local law enforcement agencies with jurisdiction over the facilities and other safety and security stakeholders who can help with these issues.
  • Assign responsibility and authority for the program to departments, teams, leaders, and employees with the appropriate training and skills.
  • Ensure that adequate resources are available for this effort and that the department, team, or specific directors, managers, supervisors, or employees develop expertise on workplace violence prevention in healthcare and social services settings.
  • Demonstrate management commitment to a work culture and environment that places as much importance on employee safety and health as it does on serving its patients and clients.
  • Use departmental briefings, trainings, and staff meetings to address issues such as ongoing safety discussions, supporting employees who report or have been victimized by healthcare violence, facilitating business continuity, and ensuring employee recovery through HR support or therapeutic counseling.