• Blog Post

Patient and Staff Safety: Why They’re Intertwined

There’s a deep connection between patient and staff safety... and an easy-to-overlook way to improve it that can actually cut costs.


To show you how, I’ll start by telling you what I observed at an American Society of Healthcare Risk Managers (ASHRM) Annual Conference.

We were at the conference with our booth to promote our training program and talk with the represented hospitals, physician groups, risk insurers, etc., about how our offerings can help organizations prevent workplace violence and its associated costs.

It’s inspiring to gather at events like this with so many committed professionals who are passionate about their work.

The theme was Everyone Is a Risk Manager (and the everyone aspect of hospital safety is so true that I've written about that too).

Our booth was near the bite-sized learning stage — which featured 20-minute presentations on various topics. We heard about fall prevention programs and daily safety huddles aimed at improving communication... ASHRM research grant opportunities... and solutions for implementing an ERM program.
 

But something about staff and patient safety was easy to overlook


A few sessions scattered throughout the days focused on workplace violence risk, but I was still surprised to hear so many people say they were not really using any training to prevent and manage workplace violence. I heard from attendees:
  • “We’re a physician’s practice...”
  • “It’s costly, so I get a lot of pushback...”
  • “We don’t have a behavioral health unit...”
  • “Oh, that? That’s Security’s responsibility.”

These comments were echoed by a second set of questions that were equally puzzling to me:

Me: “Are you familiar with CPI?”

Risk Manager: “Um... no. What do you do?”

Me: “We provide training in workplace violence prevention. For safely managing assaultive and disruptive behavior.”

Risk Manager: “Oh, there’s a huge need for that right now,” and they began to browse our resources.

And then: “Excuse me. Do you have anything for patients?”

Me: “Yes, that’s what we do — we show you how to prevent workplace violence so patients and staff stay safe.”

Repeating these discussions with many people left me feeling a bit confused. Then I realized that people were differentiating what they consider “workplace violence.”

You see, I think many people would say that workplace violence is when someone enters your workplace and perpetrates the kind of violence such as the Aurora, CO movie theater shooting, or a shooting at a mall, or a naval yard shooting.
 

The truth is that workplace violence occurs along a continuum...


No question: an individual entering your healthcare facility with a weapon is an act of workplace violence and you need to prepare and practice to respond to such situations.

However, it’s crucial not to lose sight of the violence that nursing staff, security, and other hospital employees deal with DAILY.

That’s why at CPI, we talk about a continuum of workplace violence:

Patient and Staff Safety

Workplace violence occurs along a continuum of behaviors that may be present in any workplace on any given day. Sadly, many workplaces chronically struggle with some of the behaviors you see toward the left of the continuum, like disrespect or harassment.

Other workplaces, by the nature of their services, are also at risk for behaviors like verbal assaults and physical aggression. We have seen and heard story after story of bullying that escalated to physical aggression; we have seen and heard story after story of how an individual, who was verbally assaulting someone, threatened the person and then followed through with aggression such as retrieving a gun and returning to a facility to shoot someone.

Many of the healthcare facilities I talk with indicate that risk claims from workplace violence are in the top five — if not three — highest categories of claims. Their systems pay out hundreds of thousands of dollars in worker compensation claims annually, stemming from incidents linked to workplace violence.

Hospital systems are committing many resources to reduce risk claims associated with slips, trips, and falls; patient handling; or needle sticks and infection control — also high-risk claims categories — but I continually hear that it’s too costly to train staff to prevent workplace violence or manage it as it occurs.
 

Preventing workplace violence is a multi-faceted task


There may be things you can prevent using hardware or software, but largely, workplace violence reduction comes when you equip staff with the soft skills of awareness, verbal de-escalation, personal safety, debriefing strategies, and maybe physical intervention skills. Training is a necessary step in “engineering out” workplace violence. Investing in staff skills in this important subject can mitigate claims costs related to workplace violence. In some cases, reducing one claim could cover the costs of training all employees in your hospital.
improving patient safety in hospitals
Photo: Monkey Business Images / Shutterstock

So, the next time you ask for training dollars and are told the hospital can’t afford it, I encourage you to ask if your hospital can afford NOT to do it. Ask:
  • Can we afford to allow another head injury due to a patient assault?
  • Can we afford to manage the negative press when our facility isn’t known for resolving conflict well?
  • Can we afford staff shortage because bullying behaviors dishearten new staff?
 

95% of CPI customers say our training improves safety.
Source: TechValidate survey, TVID: 43A-992-8A3


Patient safety and staff safety are inherently intertwined


The more staff are equipped to recognize the different levels of escalation that an agitated patient or visitor might present — and the more staff are equipped to safely defuse those escalating behaviors as soon as possible — the safer staff and patients can be. As I often say:
 

It’s much easier to focus on high-quality care when you don’t have to worry so much about how to manage and negotiate the tricky waters of workplace violence.


When your staff have that know-how, that's when you decrease liability, worker compensation claims related to violence, and staff turnover — and increase patient satisfaction scores.

Equipping staff with the skills to recognize and respond to potential workplace violence might not prevent every incident, but many hospitals have significantly reduced the risks associated with workplace violence by investing in their staff. Some get injuries down to zero. Most decrease disruptive behaviors, code alerts, and physical restraint use. One proved with a QI study how much their investment paid off.
 

Start improving patient safety in hospitals AND staff safety now


I hope I’ve given you some ideas to consider as you push to improve patient and staff safety in your setting. Don’t hesitate to call us if you’d like to do what so many others are doing in really driving a profound culture shift to make everyone measurably safer.
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