Tag Archives: Workplace Violence

After The Surgeon Kills Girlfriend at the Hospital – what next?

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Time for a Workplace Violence Assessment? You think?

The shooting death of 33-year-old Jacqueline Wisniewski at Erie County Medical Center left the community in shock last week, especially since the shooter was a surgeon!

The surgeon’s body was found Friday, near his home, with a self-inflicted gunshot to the head. And this tragedy illustrates why EVERY hospital and medical center should be required to do a Baseline Workplace Violence Assessment.

The warning signs were there, the surgeon had lost weight, had become moody and distant, and also had advanced special forces weapons training in his background.

That’s exactly why he passed a background check, but after that initial check, his blatant symptoms of personal problems were ignored, even by the very people who observed them.

Now the hospital staff is traumatized, a beautiful young nurse is dead, the Eric County Medical Center administrators can look forward to an in-depth OSHA investigation, with possible fines and even more disruption.

Don’t let your hospital be a victim of this kind of incident. A Workplace Violence Assessment can be completed in just 5 days, and will reduce the chance of a potential violent incident by over 75%.

Email me directly to get the new white paper on how to prevent workplace violence incidents at caroline-hamilton@att.net.

How long does it take for OSHA to develop standards – like for Workplace Violence?

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Why OSHA standards take so long to develop

The Government Accountability office reports to Congress on items of interest to Congress and their constituents.  One area that was recently examined was how long it takes OSHA to update standards, or develop new standards.  Here’s a look at the results:

By: David LaHoda, April 30th, 2012

A report by the U.S. Government Accountability Office (GAO) on why OSHA standards take, on average, more than seven years to complete found that “increased procedural requirements, shifting priorities, and a rigorous standard of judicial review” contributed to the lengthy time frame.

In responding to the GAO report, Randy Rabinowitz, OMB Watch’s director of regulatory policy said: “In the years since its creation, OSHA’s charge to protect workers from harm has been undermined by Kafkaesque demands for additional reviews of existing rules mandated by new statutes and executive orders,” according to The Hill. While OSHA’s internal inability to remain focused on priorities and regulatory follow-through was the counter argument presented by the U.S. Chamber of Commerce.

“While some of the changes, such as improving coordination with other agencies to leverage expertise, are within OSHA’s authority, others call for significant procedural changes that would require amending existing laws,” according tot he GAO report.

The GAO report recommended that that OSHA and NIOSH improve collaboration on researching occupational hazards. In that way OSHA could better “leverage NIOSH expertise in determining the needs for new standards and developing them.”

For the entire 55-page report go to http://www.gao.gov/products/GAO-12-330

Outlook on Risk & Security Compliance in 2012 – What to Expect.

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This New Year’s Eve, I thought at times my neighbors were using a rocket launcher and several assault rifles to shoot up the New Year.  Lucky for me,  I spent the awake time to contemplate the outlook for risk, threat and security issues for 2012 and here’s what I see for 2012.

1.  Government-Mandated Compliance Is Here to Stay for the Healthcare Industry.

I remember when the IT departments are many hospitals thought George W. was going to revoke the HIPAA Security Rule.  It never happened, and this year, for the first time, there is a regulatory body in place that is intent on REAL ENFORCEMENT.

The Dept. of Health & Human Services, Office of Civil Rights,  has expanded HIPAA Security and Privacy Rules to include “Business Associates” including lawyers working in healthcare, and the infamous “3rd Party Providers” who do everything from warehouse data to taking over the IT function of a hospital, and this trend will continue as pressure builds from consumers who’s medical and financial data continues to be compromised.

2.  Workplace Violence Prevention will become an OSHA mandate, if not in 2012, at least by 2015.  Based on the slug-like pace of OSHA, who only recently provided directives for high risk industries, and the pressure from the more than 30 states who have passed their own regulations,  the pressure to stop the number of incidents and to lower their intensities will increase and management will be forced to address it as a major corporate issue.

3.  Pressure on the financial industry to protect consumer information will increase.  Like many other areas, pressure is increasing to prevent the enormous data breaches we saw in 2011, like Tricare, the recent Stratfor hack by Anonymous, Wikileaks and HealthNet breaches.  Consumers are the squeaky wheel and they want the convenience of plastic and internet use, and they will not tolerate breaches, and they are all registered voters!

The FFIEC has already tightened up on both risk assessment standards, as well as
authentication guidelines for all financial institutions.

 

There will be a increase in requirements for risk assessment as an accountability feature to force managers to maintain better security in all areas of their organizations. 

Accountability means that individual managers will be held responsible for the decisions they make regarding other people’s:

1.  Financial Data

2.  Medical Records

3.  Safety from both Violence & Bullying in their workplaces.

Budgets can be cut, and staff can be reduced but consumers are demanding protection of their information, and themselves, and the regulators will make sure they get it in 2012!

Webinar Looks at New OSHA Workplace Violence Directive

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Workplace Violent Incidents have been on the rise in several specific organizations, including hospitals, home health organizations, social workers who do in home visit, and also late-night retail stores.

On September 8, 2011, OSHA suddenly released their internal Directive on what their OSHA investigators look for when they go to an organization to investigate a Workplace Violence incident.

Whether the incident involves a domestic violence incident, like when a husband shoots his wife at work; or whether it is patient violence against the Emergency Room nurses, it is a big problem that has been increased over the last 8 years.

We have set up a special no-cost webinar to review the new directive and see what it means for employers. Join us to look at how to protect your organization and make sure your staff, and patients stay safe.

Risk Assessment: How about Giving Guns Back to Former Mental Patients

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A recent New York Times article explained that a provision tucked in a bill to make it harder for people diagnosed with mental illness to possess firearms, actually restores the rights of mental health patients to get their firearms back. The legislation was passed after the massacre at Virginia Tech in 2007.

One of the main elements of risk assessment is a quantitative (meaning = real numbers) on what has happened in the past. Looking at 2 or 3 years of incident reports, for example, show how many times there has been an incident involving gun violence in a particular neighborhood, city or organization.

Another element is the history of a particular individual to see whether individuals with a diagnosed history of mental illness are MORE OR LESS likely to trigger (forgive the pun) – a violent incident.

If we run that scenario, we will find that individuals who previously had a violent incident with a firearm are MORE LIKELY than the standard population to have another incident.
And that especially holds true if other threat indicators are present, for example:

Termination from a Job
Romantic Difficulties
Foreclosure
Difficult Economy

There is a ‘risk multiplier’ effect that takes place that makes the risk higher. By combining different sets of threat categories with areas of weakness, we are create general predictions on the likelihood of repeated violent incidents.

Do the math – it doesn’t make sense for people with a history of mental illness to
get their guns back!

The 5 Missing Elements of Most Workplace Violence Prevention Programs

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The 5 Missing Elements of Most Workplace Violence Prevention Programs

After working with a variety of organizations on a baseline Workplace Violence assessment, there are several areas that seem to be common problems for most organizations.  These elements are not expensive, and not timing-consuming, so they are natural candidates for improvement.

A baseline workplace violence assessment is a survey of employees in different roles, combined with a threat analysis and an analysis of existing controls and a historical incidents that can be reviewed and aggregated.

Here are the top 5 most common missing elements, with potential solutions.

1.  Missing workplace violence awareness/training programs.  Many organizations report that they have set these up, that they have sent out emails to all employees, but we consistently find that the employees didn’t read the emails, didn’t know the training was available, or that it wasn’t included in their initial company orientation.

2.  Mis-categorization of workplace violence incidents.   There is a mistaken (in my opinion) idea that domestic violence incidents that happen at work should not be categorized or reported as a Workplace Violence incident.  This is a mistake, and leads to bad information about the true nature of the problem.  If someone comes and shoots her significant other at work (IN THE WORKPLACE) – it is a workplace violence incident.

3.  Staff feels subtle pressure from management not to report every incident.
In my research, management wants every incident reported, every time, but
staff members report that their own direct supervisors may discourage them by not taking time to discuss these pre-incidents, and also by chalking up comments as merely office gossip.

4.  Not linking Human Resources with Security on the issue of Workplace Violence Prevention.  This is a management issue, but organizations that create bridges between HR and security are way ahead because this is one issue where cooperation makes a big difference in results.  HR can’t do a security assessment and security can’t write termination policies and set up employment screening. They are both absolutely necessary.

5.   Not doing an Annual Workplace Violence Assessment.  Since late 2008, when the economy suffered major job losses,  the number of workplace violence assessments have increased dramatically, especially in the healthcare field.  Annual assessments are best way to stay on top of the ‘potential’ for violence in your organization.

Check out one of our regularly scheduled webinars to learn more about this important issue.

 

REMEMBER – Workplace Violence is the one threat that is PREVENTABLE!

 

                                        — Caroline Hamilton

                                                                 Caroline.r.hamilton@gmail.com

                                                                 chamilton@riskwatch.com

 


                                  www.riskwatch.com

Workplace Violence Against Hospital Staff Discussed

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Just got back from a regional meeting of hospital security officers in Myrtle Beach. Aside from the T’storms every night – and the college kids shooting off bottle rockets, it was a great conference.

It reinforced my feeling that violence against hospital staff is one of the biggest challenges facing healthcare professionals. Vermont passed a law this week making violence against a healthcare worker a FELONY instead of just a misdemeanor. That’s progress, similar laws are being passed in other states, too. The governor of Vermont signed the bill on May 12, 2011. Congratulations to Vermont — they were first on this important issue.

The REAL VALUE of a Hospital Security Program

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Violence in hospitals and against healthcare staff has been steadily increasing since 2004. A recent article in the Journal of the American Medical Association (JAMA), cited the National Institute for Occupational Safety and Health, NIOSH publication 2002-101, which indicated that healthcare workers face four times the violence potential as other occupations.

If you add in the many domestic violence cases that play out in our hospitals, you can double or triple that figure. For reporting purposes, OSHA does not count domestic incidents (like murders) that take place in hospitals as officially “workplace violence incidents”.

Anecdotal incidents such as the shooting of a physician at Johns Hopkins Hospital in Baltimore, Maryland in September, 2010, and the January 1st, 2011 stabbing murder of an engineer at Suburban Hospital in Maryland by an employee angry because he didn’t get a good performance evaluation, keep the issue on the front pages, and cause hospital staff to worry about their personal safety.

The Joint Commission issued a Sentinel Event Alert in June 2010, on violence in hospitals and how it can affect both staff and the patients themselves. Nurses are on the front lines, and they are the most likely to be attacked, a fact which has not been lost on the nurse’s associations who are actively lobbying for safer working conditions.

Workplace violence issues were traditionally something handled in the Department of Human Resources, but security departments are increasingly involved in violent incidents and are critical to safeguarding hospitals.

Why Violence in Hospitals is Increasing

Violence is not a concept that people usually associate with hospitals. For years, hospitals have been seen as almost a sanctuary of care for the sick and wounded in our society. However, the perception of hospitals has been changing over the last fifteen years due to a variety of factors.

1. Doctors are no longer thought of as “Gods”. This means they are
are more easily blamed when a patient’s condition deteriorates.

2. Hospitals are now regarded as businesses. This perception has been
been aggravated by television in shows like a recent “60 Minutes”, as well as
by the effects of the recession on jobs and the loss of health insurance.

3. Lack of respect and resources (funding) for hospital security departments
. Rather than being seen as a crucial protection for the hospital staff and
patients, many security departments are chronically underfunded and used
for a variety of non- security functions, such as making bank deposits for
the hospital gift shop.

4. Resistance to Visitor Management programs in many hospitals. Again,
because of the unsettling effect of the recession, violent solutions are
becoming more common in the United States in general, for example, the
recent Tucson tragedy.

The federal government issued a guidance document for dealing with violence issues in healthcare,
OSHA 3148.01R, 2004, Guidelines for Preventing Workplace Violence for Health Care & Social Service Workers

The Evolution of the Hospital Security Program

Even as recently as five years ago, many hospitals didn’t have a Security Director, instead they used the Safety Officer to double up and handle security. However, the Joint Commission and many professional hospital organizations recommend the formation of the Security Director position.

Now every almost every hospital has a Security Director who oversees the various security functions at the hospital. These cover a wide range of duties including managing either a contract security force, or developing and managing a proprietary security force; managing violent patients in the Emergency Department; managing incidents regarding kidnapping, infant abduction, cash handling, helicopter coordination, handling admission of prisoners, monitoring visitors, managing hundreds of cars and garages, dealing with harassment, sexual assaults and domestic violence issues which end up at the hospital.

As the Security Director has assumed responsibility for an expanded list of duties, the security budget has not always kept pace with the expansion of the security function.

Assessing the Value of Security to the Functioning of the Hospital

When we start to assess the value of the security program to a hospital, we have to start with the total value of the hospital.

One of the greatest surprises we find in conducting risk assessments on hospitals, is that they possess tremendous value but because they are so large, and perform so many different functions, individuals can’t always see the hospital as a whole.

To make it easy to understand, we can breakdown the value of a hospital into its component parts:

1. The value of the Facility – this is the current replacement value of the building, usually over 50 million dollars.

2. The value of the hospital Staff, including both administrative and medical staff members (use the value of their salaries for a year).

3. The value of specialized medical equipment, including all
the IT systems, X-rays, Cat scans, MRIs, and medical lasers, photon knives, etc.

4. The value of the actual revenue from the patients.

5. The value of the patient’s safety and their health information.

You can see that when we add up these asset values, and add another 10-12 categories, the hospital usually ends up with a value of $100 million to $500 million, or often higher. That is the total of the assets that are potentially ‘at risk’.

That is the value that the security function protects. Each of these asset categories can potentially experience a loss that would interrupt their operations, either for a limited time (like a gang fight in the lobby; or a theft of pharmaceuticals), or permanently (for example, a catastrophic fire).

The next step in the analysis is the see what kinds of controls are already in place to protect all these assets. Controls are mandated by a variety of federal, state and local laws, as well as best practices from insurance companies, and standards created by industry associations such as the Joint Commission, the Center for Missing and Endangered Children, the International Association of Hospital Security and Safety.

January 1st, 2011 Wake Up Call – Another Hospital Workplace Violence Incident.

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My happy 2011 celebrations were marred by another workplace violence homicide in my home state of Maryland.   I guess it’s not always ‘the most – wonderful time of the year’!

This incident brings up again the question of how to keep our hospitals and their employees, safe in the new year.  In a recent Wall Street Journal article, they brought the hospital workplace violence problem up to a management level – reporting that many doctors now say they feel unsafe at work.

In upscale Bethesda, Maryland, just a minute north of Washington DC, a 40-year old male employee of Suburban Hospital (part of the Johns Hopkins Health System since July 2009), was found dead in a non-patient area of the hospital on January 1 at 10 a.m.

Here are the details (from the Suburban Hospital press release, from January 2, 2011):

Yesterday morning, a Suburban Hospital employee was assaulted in a non-patient-care area of the hospital.  Despite the heroic efforts of the hospital’s emergency response team, attempts to resuscitate the employee were not successful.  He died at the hospital as a result of traumatic injuries sustained to his upper body.

The victim has been identified as Roosevelt Brockington, Jr.  He was 40 years old and he had been employed at Suburban Hospital since August 2006.    Mr. Brockington was a Lead Engineer in the hospital’s Plant Operations Dept,   where he was responsible for operating and maintaining the heating, ventilation and air conditioning systems.

Because of the ongoing police investigation, no further information about Mr. Brockington is being released by the hospital at this time.  Suburban Hospital is fully operational today and remains open to patients and visitors.

This incident was a little different from some of the other incidents which have been in the news lately.   First, it was not an inner-city hospital, but instead, a hospital in a very affluent area.  In fact,   Bethesda is one of the most affluent and highly educated locales in the country, placing first in FORBES list of America’s most educated small towns and eleventh on CNNMoney.com’s list of top-earning American towns.

Another difference was that it occurred in mid-morning – 10 a.m., not late at night. News reports about the incident surmised that it was not patient-related, but no one really knows at this early stage in the investigation.

 The victim, Roosevelt Brockington, Jr., was a resident of Lusby, Maryland.  For those who aren’t familiar with Lusby, it is a small town of less than 3,000 people in southern Maryland, over 70 mile commute from Bethesda. 

Having been to over twenty hospitals in 2010, I am struck by the difference between the northern east coast hospitals and the south Florida hospitals.   Many of the hospitals in south Florida have effective visitor management systems in place.  I visited a hospital in Florida just before Christmas, and they had the local choir singing carols in the background, while I took out my drivers license, had my photo taken, and received a visitor’s badge.

There seems to be a mind set in some of the northeast hospitals against trying to manage visitors.  This includes a lack of metal detectors, and a lack of visitor sign-in procedures.  I wonder if this is a cultural attitude – because many of the north east hospitals are older than their south Florida counterparts and may be more entrenched in their attitudes. 

The epidemic of workplace violence in hospitals is only starting to gain national attention since the Journal of the American Medical Association published a research paper on the increase in violence in U.S. hospitals in December 2010, and included the statistics from

The Centers for Disease Control and Prevention/National Institute for Occupational Safety and Health, summarizing Bureau of Justice Statistics data, estimate 1.7 million injuries per year due to workplace assaults, accounting for 18% of all violent crime in the United States and the rate of workplace violence in healthcare setting is about 4 times the national average.

There are a plethora of workplace violence prevention strategies that can be put in place and maybe this New Year’s Day wake up call will result in every hospital examining their Workplace Violence Prevention plans.