Michael Dowling: The unthinkable priority now facing hospitals

Consistent with their core mission, all healthcare providers have been steadily focused on a series of key priorities: enhancing access to all, improving quality and outcomes, investing in employee engagement and satisfaction, managing their financial condition, improving their infrastructure and working collaboratively with the government. 

Much progress has been made, but all would agree that much more needs to be done — nobody would argue that success has been fully achieved. These priorities are the ongoing agendas of leadership and board meetings, as they should be.

But now, we have an additional and disturbing priority — one that, I would argue, we never imagined. 

We now must protect our hospital patients and employees from the growing threat of intimidation and violence. There has been a dramatic spike in staff assaults, with many leading to serious injury and some leading to death. 

The number of injuries from violent attacks against medical professionals was already on the rise pre-pandemic, increasing 86 percent from 2011 to 2018, according to the Bureau of Labor Statistics. In a spring 2022 survey by National Nurses United, nearly half of hospital nurses (48 percent) reported rising workplace violence, more than double the 21.9 percent who responded as such a year prior. 

This new, unfortunate reality now requires all systems to refocus and invest in a whole new set of activities and programs, which absorb resources that we all wish could be targeted more productively elsewhere. 

At Northwell, we call this new priority "The Safe Place Initiative." It includes the following actions, investments and measures:

  • An investment in educating visitors, patients and team members on proper behavior and how to promote dignity, respect and understanding. Thousands of pieces of informational signage and posters are prominently displayed emphasizing that harassment and verbal or physical assault will not be tolerated. Signs are also on display that remind all visitors that this healing place — the hospital and ambulatory facility are weapon-free zones.
  • A comprehensive investment in training employees on what to do in a potential active shooter situation; on how to de-escalate a potential violent situation; on how to "stop the bleed" in the case of such a circumstance. Over 50,000 of our employees have already received this training.
  • The enhancement of security in all locations by increasing the presence of security personnel, as well as increasing video surveillance and alarm systems.
  • The installation of weapon detection technology at the entrance of our facilities.
  • Education for staff on how to recognize signs of domestic and partner violence, and enhanced support offerings to team members impacted by such violence.

All of us, I am sure, would agree that this new and current reality is a sad commentary on the world we live in, but hardly surprising. Almost daily, we observe the predatory nature of politics, which has redefined behavior and what's acceptable, in addition to an endless cycle of insult and rage, distrust exaggerated by social media and ongoing assault on compromise and respectability. I still remember how Wall Street Journal columnist Peggy Noonan stated it in 2019: "People are proud of their bitterness now." 

None of this is a positive contributor to good health and wellbeing, which must be of major concern to all of us.

I do not take the responsibility of protecting Northwell's people lightly. While I am disappointed in the state of affairs that has stoked hostility and violence toward professionals who care for the sick, I will do all I can to help ensure Northwell employees are secure, safe and empowered to devote their talents and energy toward patient care.

In addition to equipping The Safe Place Initiative with the resources and attention it deserves, I also try to ensure fear, bitterness and hostility do not detract from the leadership that is exercised and felt within Northwell every day. 

Now is the time to champion kindness, respect and compassion. Times like this call for even greater generosity of spirit, the "better angels" of our nature. Positive leadership unites, promotes mutual trust, builds confidence and is optimistic. Perpetual optimism, as the late Gen. Colin Powell put it, is a "force multiplier." True leadership does not just accept what is, but creates a vision for a better tomorrow. 

As healthcare leaders, we have an expanded responsibility. We understand that life is always a contest between right and wrong, between good and bad, and we know which side we must always take. Leaders can have more positive influence than we appreciate, both inside their organizations and outside of them. Let us remember the words of French philosopher Pierre Teilhard de Chardin: "The future belongs to those who give the next generations reasons for hope."

Michael Dowling is president and CEO of Northwell Health, the largest healthcare provider and private employer in New York State.

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