'It's not part of the job': How MUSC is combating workplace violence

Healthcare workers experience serious workplace violence incidents four times more often than employees in the private sector, according to data from the U.S. Department of Labor.

In fact, workplace violence is so common in healthcare, it's often ingrained in clinical culture, according to Valarie Bell Wright, an organizational change management and communication consultant at Charleston, S.C.-based MUSC Health.

"It's so prevalent that clinical staff think it's just part of the everyday job," she told Becker's in a phone interview. "We're trying to change that perception at MUSC."

Ms. Wright also serves as the communication lead for MUSC's Workplace Violence Committee, which is rolling out new workplace violence initiatives in partnership with the South Carolina Hospital Association's Hospital Safe Zones campaign and Solutions for Patient Safety.

Through the new initiatives, MUSC Health aims to boost staff awareness that workplace violence should not be tolerated; reduce workplace violence incidents; and encourage staff members to report incidents when they do occur.

A push for more reporting

To increase staff awareness and encourage reporting, committee members first visited meetings with administrators, directors and managers to introduce the new workplace violence initiatives.

"We asked leaders to cascade this message throughout the organization," said Ms. Wright.

The committee then turned to digital forms of communication to encourage staff members to report workplace violence incidents or unsafe conditions. Information on reporting was included in the hospital's internal newspaper, weekly emails from MUSC Health CEO Patrick Cawley, MD, and daily safety updates from Danielle Bowen Scheurer, MD, the hospital's chief quality officer.

The committee also created workplace violence awareness posters to hang in MUSC facilities. One poster features Dr. Cawley with the words, "You report. We support." Another depicts April Roscoe, manager of MUSC Health's safe patient handling and mobility program, and says, "It's not part of the job."

Ms. Wright noted MUSC Health is unique in that the hospital has a full-time security team and law enforcement division certified by the state. MUSC employees can report workplace safety incidents through either of these entities, or through an online page on the hospital's employee portal.

Preventing future incidents

Last year, MUSC Health recorded 133 workplace violence incidents, 99 of which involved altercations between patients and employees.

To teach staff members strategies to defuse difficult situations with patients and family members, MUSC launched workplace violence training workshops in April 2018.

The committee recruited an outside crisis prevention expert to lead the training, which is open to all staff members working on a unit, according to Cynthia Cathcart, MSN, RN, a nursing professional development facilitator in the department of clinical education at MUSC who helped create the workshops.

As part of the training, students from the College of Medicine act out workplace violence scenarios that actually occurred at the hospital, and staff members must respond.

"It's more than just giving them information," Ms. Cathcart said. "It's having them participate in the situation. They seem to really enjoy that simulation and hands-on experience."

MUSC Health holds the training sessions for individual units two to three times a month and is on track to train 750 staff members by the end of September. The hospital plans to increase sessions to once a week, with the goal of training more than 1,100 participants by the end of 2019.

"We want to train the entire medical center, or as many people as will participate," said Ms. Cathcart. 

While the number of reported workplace violence incidents at MUSC has gone up this year — likely due to the awareness campaign's big push for more reporting — Ms. Cathcart said she's already seen benefits from the training workshops. One participant emailed her to say he faced a tense situation with a patient shortly after taking the workshop.

"He wanted to thank us for encouraging him to participate and said he was able to use verbal de-escalation in his interaction with the patient," Ms. Cathcart said. "He said the technique worked and that he felt so good about having taken the class to better serve his patients."

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