By Michael Rosenberg and Jana Bartley
‘Ann’ is an emergency room nurse at a busy downtown hospital. She is approximately 5 feet 1 inch tall and weighs somewhere around 120 pounds. She was working the overnight shift when a homeless patient came in. This patient was former military and suffered from PTSD and drug abuse. He was approximately 6’2” inches and weighed over 230 pounds. As Ann took this patient into the examination room and closed the door, he went into relapse. He grabbed Ann, lifted her up and ripped off her blouse. She kept hitting the panic button in the room but it either did not work or there was no immediate response. Ann then kicked him in the genitalia and ran out of room yelling. The police, who were fortunately at the hospital at that moment, were able to subdue and restrain the patient. When I asked Ann about reporting the incident, she told me “I never reported it.” I asked her why and she told me, “I was at the end of a 12 hour shift. I was physically exhausted, probably suffering from shock myself and all I wanted to do is go home. I really did not want to spend 30 minutes logging into the hospital system to go through the paperwork and file an incident report. My next shift was a week later and by that time, I just moved on.”
Stories like this are far too common. According to a study by the Institute of Work and Health across six hospitals in Ontario, between 37.5 and 72.7 per cent of all physical assaults are NOT reported.
We see it in healthcare every day. Workplace violence and harassment have become so pervasive that there is a feeling of helplessness. ‘What can we do about it?’ people sigh. ‘What is the point of reporting it? Nothing ever gets done.’ another person comments.
The ramifications of this go beyond the hospital. Incidents of workplace violence that hospitals report to the government significantly underestimate the problem. Without accurate information, the problem will not be fully understood nor resolved and the resources necessary to address the problem will not be sufficiently provided by either the government or the hospitals themselves.
Why people do not report incidences of workplace violence
Studies have found three major reasons that people do not want to report workplace violence. They are:
- It is too onerous to report
Most reporting systems are on internal hospital servers and have to be accessed through logging in onsite. They are inaccessible off site, unless the person is allowed to access the system through a Virtual Private Network (VPN). Most hospital personnel, however, do not have permission for this type of access, so they have to stay late on their hospital workstations to submit an incident report.
- Nothing is done about it anyway
Neither follow-up nor communication is provided by management about what has happened in the incident report. Even when action has been taken or an investigation completed, the person who initiated the incident report usually has no idea if anything has happened to the incident or why.
- There is a belief that the issue is too insignificant
The only thing the people feel is worth the time and effort to report are major incidents. An example of a minor incident is the lights in the parking garage. A person goes to their car after the end of a long shift and notices that the light is out in the garage. Although they may feel uncomfortable about the light, they really do not want to drop everything, go back to their work station and put in a report. Instead they go to their car and go home. A period of time passes and nobody reports the light being out in the garage because it is too minor and too inconvenient. One day somebody is assaulted in the garage because it has become unsafe and a minor issue has become a major crisis. It is important to encourage people to report all potential health and safety concerns, even ones that appear minor.
The solution can be broken down into 3 components:
- Encourage reporting
When in doubt – report! Should be your new motto. Even though you need clear standards on what to report, encourage people to report even minor incidents. The reporting system should also allow for incidents to be categorized by importance.
- Use validated risk assessments
Validated risk assessments can be used as a snapshot in time to identify potential risks that can lead to workplace violence and health and safety issues. Using validated risk assessments allows you to be preventative instead of just reactive to health and safety issues, such as workplace violence.
- Use easily accessible incident reporting technology with tracking
Use incident reporting systems that can be accessed through any electronic device, such as smart phones, tablets or personal computers/laptops. As the research indicates, people do not want to stay late at the end of a long shift to put in an onerous incident report. By allowing them to access it through their own personal electronic devices, they can submit an incident report when they get home and are able to relax. The technology should also feature the ability to track the incident report they have put in. Then, employees can see its progression through the system and know that their concerns are being addressed and taken seriously.
The data tells a story
Combining risk assessments with real time incident reporting creates data. This data allows the hospital to know how safe they really are. It also provides them with the tools that they need not just to respond to health and safety concerns, but to prevent them as well.
Michael Rosenberg, MBA, is the President of WPV Corp., a company that specializes in technology solutions to workplace violence issues. Jana Bartley, RN, MBA, LNC has been a registered nurse for over 25 years and is the President of Integrity Healthcare Consultants.