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Healthcare facilities confront workplace violence

By Michael Boardman, CEO/Founder, Readiness Associates


A former patient enters a California veterans home and shoots and kills three caregivers. Just days later at an Alabama hospital, an employee is killed and a contractor wounded by a man who then shoots and kills himself at the scene.

These two March 2018 incidents served as recent reminders that the nation’s healthcare facilities are especially vulnerable to workplace violence. Occupational Safety and Health Administration (OSHA) statistics compiled from 2002 to 2013 indicate that healthcare workers are four times more likely to experience workplace violence than workers in private industry overall.

According to OSHA, in 2013 workers in “healthcare and social assistance” organizations suffered 7.8 cases of serious workplace violence for every 10,000 full-time employees. OSHA added that such other large sectors as construction, manufacturing and retail had fewer than two cases per 10,000 employees.

OSHA cited a number of “workplace violence risk factors” in healthcare settings. They included, but were not limited to: working with people who are violent or under the influence; working alone; lack of emergency communication; working in neighborhoods with high crime rates; lack of training and policies for staff; high staff turnover; and unrestricted public access.

The possible sources of violence, said OSHA, were patients, visitors, intruders and co-workers. According to the Bureau of Labor Statistics (BLS), patients accounted for 80 percent of the violent acts in 2013. The 2014 American Nurses Association’s Health Risk Appraisal survey found that 21 percent of registered nurses and nursing students reported being physically assaulted; more than 50 percent were verbally abused over the same 12-month period.

As dramatic as those numbers may seem, in reality they are probably much worse. According to OSHA, “violence is vastly underreported,” since the statistics only reflected incidents that caused employees to miss work because of their injuries.

Workplace violence makes headlines, but it’s only one of many disasters that can befall healthcare organizations. Recognizing this, the U.S. Centers for Medicare & Medicaid Services (CMS) of the U.S. Department of Health and Human Services in November 2016 implemented the CMS Emergency Preparedness Program, requiring these organizations to perform risk assessments, communication plans, policies and procedures, training, testing and drills that align with the communities and first responders they serve.

CMS requirements are mandatory, and that means many organizations may find it necessary to seek outside, professional assistance to meet them.

Mike BoardmanCMS, workplace, OSHA