Frontline healthcare workers face a continued threat of violence, which puts staff well-being and patient care at risk. With violence incidents on the rise, a top priority for healthcare leaders is ensuring a safe work environment.
During a May Becker’s Hospital Review webinar sponsored by Evolv Technology, Jason Grellner, vice president and head of healthcare for Evolv Technology, discussed effective strategies for implementing violence prevention policies, staff training and fostering a culture of safety and preparedness. Evolv Technology provides AI-based, noninvasive solutions for concealed weapons and early threat detection.
Five main takeaways were:
- Workplace violence in healthcare takes multiple forms. There are three main types of workplace violence: affective (patient- or patient family-on-staff), predatory (opportunistic or targeted) and defensive (aimed at stopping an act of aggression).
Affective violence also fits a narrower category known as relationship-driven violence. “Affective violence typically is from individuals who come into our healthcare settings and [act out of] fear, anger and anxiety,” Mr. Grellner said. - Making workplaces safe is essential to stem attrition and mitigate staffing shortages. The U.S. is currently facing a shortage of around 600,000 registered nurses (RNs). Despite a 2% decrease in RN turnover in 2024, nurses continue to leave organizations at an alarming rate: 22.3% leave in their first year and 50% quit within two years. A major factor driving this is workplace violence.
Hospitals often try to make up for nurse shortages by hiring travel RNs, whose hourly rates are significantly higher than employed nurses. However, this is not a sustainable strategy.
“We need to do things that make workplaces for our coworkers more welcoming, show them that we care and that we’re doing things to keep them safe,” Mr. Grellner said. “If organizations can eliminate just 20 traveling nurses [because employed nurses don’t quit], that’s an estimated cost savings of almost $1.5 million annually.” - To get a handle on workplace violence, organizations need to look at their numbers. That entails looking at their public safety, law enforcement, HR and worker compensation reports, as well as crime statistics in the areas surrounding their facility. That’s a lot of different places to pull information from and most providers do not have a single source that collates and presents that information.
Once they understand what is going on inside and outside of their facility in terms of violence, organizations should ideally adopt the “five D” perimeter solution:
- Deter people from coming onto campus and committing crime.
- Detect those that may already be there to commit crime.
- Delay potential impending acts of violence.
- Deny entry into certain areas.
- Defend if it comes to that.
“Those five Ds are predicated on everything we do in layering our healthcare defenses,” Mr. Grellner said.
- CPTED experts are a key partner in helping organizations strengthen security. Crime prevention through environmental design (CPTED) expertise, which may be tapped internally or by hiring an external consultant, is essential for facilities at a time of rising violence incidents. CPTED experts can provide guidance on designing architecture that makes it harder to perpetrate crime.
Bringing in an outside consultant to conduct these assessments can be especially valuable because “familiarity dims the vision,” Mr. Grellner said, referring to opportunities internal experts may miss due to being too accustomed to the environment. “It can open the eyes of your security team to possible issues they hadn’t even thought of before.”
Other approaches to boosting security include using window coverings to make glass walls bullet-resistant, reinforcing access control to buildings, and implementing video management systems and automatic license plate readers (ALPRs). Notably, ALPR technology can serve the dual purpose of defending the periphery of a hospital campus and helping patients with wayfinding, so their appointments can be expedited and their experience made more seamless. Another critical layer is concealed weapons detection technology, which enables hospitals to proactively identify threats before they enter the facility. By discreetly screening visitors, patients, and staff for weapons without disrupting the flow of care, this technology helps enhance frontline safety while preserving the open, welcoming environment essential to healthcare settings. - How can healthcare organizations start making their facilities violence-free? It starts with designating a single person in charge of workplace violence, tasked with coordination of all relevant committees but also empowered to make changes. “If you try to rule by committee, it will take much longer to get these things done, if they get done at all,” Mr. Grellner cautioned.
Organizations also need to establish a collaborative relationship with external responders who form a part of their emergency management committee. “These people will be responding to your hospital if there is an incident, so they need to know it as well as you do,” Mr. Grellner said.
Further, facilities need to develop a violence assessment tool, which helps identify behaviors associated with violence risk, and conduct de-escalation training that has a physical component to it. “Leaders need to take the same training as every other worker to lead by example and use de-escalation techniques in everything they do, making it part of their vernacular,” he said.
To register for upcoming webinars, click here.
