Physician viewpoint: Hospital safety starts in onboarding

With the rise of violence in hospitals, health system leaders should embed safety into training for new staff and transparent conversations with employees, according to an opinion piece published Nov. 20 in Time

Robert Glatter, MD, a physician and the editor at large for Medscape Emergency Medicine, and Peter Papadakos, MD, a professor at University of Rochester (N.Y.) Medical Center, cited an American Hospital Association report that found healthcare employees endure more workplace violence and injury than workers in any other environment. 

Dr. Glatter and Dr. Papadakos recommend hospitals begin safety training in onboarding, prepare staff for agitated patients and violent outbursts with de-escalation training, work with local law enforcement for active shooter exercises, maintain a digital log of everyone in the building, and install "safe areas" with bulletproof glass for staff and patients. 

They also said side entrances can be "problematic" with managing care coordination and filtering people entering the hospital. 

"The public must be prepared to go through security checkpoints and screenings much like TSA screenings at U.S. airports," they wrote. "Security can range from the obvious (metal detectors) to more covert approaches by security teams serving as 'greeters' or as 'ambassadors.' 

"Because an overly aggressive security presence can be off-putting to patients and visitors, the goal is to instill measures that are invisible. Staff with security training can welcome visitors, and direct them to elevators, clinics, labs and various units within the hospital itself."

Teaching nonverbal cues to all staff members and having panic buttons in accessible areas can also help in an emergency setting, they said. These tips can help restore hospitals as "sanctuaries that heal."

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