Up until the last three years the topic of violence in healthcare facilities received very little attention. Hospital security has moved beyond protecting patient information, eliminating infant abduction, and the security of prescription drugs. Forwarding thinking healthcare security administrators are raising staff awareness, and training staff in appropriate responses to acting out behaviors which will give those staff the tools they need to react accordingly to protect themselves, fellow staff, patients and visitors to the facility .

In June of 2010 the Joint Commission on Accreditation of Healthcare Organizations issued a Sentinel Alert noting the increase in healthcare violence. "Health care facilities should be places of healing, not harm. But, unfortunately, health care settings are not immune from the types of violence that are found in the other areas of our lives," says Mark R. Chassin, M.D., M.P.P., M.P.H., president, The Joint Commission. "The recommendations in this Alert give health care institutions and caregivers specific strategies to take action that will keep everyone safer."

The Joint Commission's Environment of Care standards require health care facilities to address and maintain a written plan describing how an institution provides for the security of patients, staff and visitors. Institutions are also required to conduct risk assessments to determine the potential for violence, provide strategies for preventing instances of violence, and establish a response plan that is enacted when an incident occurs.

Some Recommendations

The following are suggested actions that health care organizations can take to prevent assault, rape and homicide in the health care setting according to the Joint Commission and the International Association for Healthcare Security and Safety.

  • The facility should plan for a regular evaluation of the facility's risk for violence to include surveying the employees about their perceptions of risk.
  • Identify training needs to include recognition of potential acting out behavior, verbal diffusing skills, non-verbal communication, and personal response to active threats.
  • Provide training to all staff of the facility including administrators, not just those designated to provide security.
  • Provide information to all staff of the facility on the pre-arranged law enforcement response to active threats.
  • Test and evaluate the competency of those who have received the training, and the efficacy of the programs, processes, and procedures for dealing with violence and acting out behaviors.
  • Put an on-going program in place to reinforce training and demonstrate continuous improvement.

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