Employee health professionals should be aware of the training requirements of the recently finalized Cal-OSHA regulation1 to prevent violence in California healthcare facilities, which may serve as a template for a national standard.

Depending on the facility, violence awareness and prevention training may fall to employee health in conjunction with security staff. The Cal-OSHA standard includes the following key provisions on the training of staff:

  • The employer shall provide effective training to employees that addresses the workplace violence risks that the employees are reasonably anticipated to encounter in their jobs.
  • The employer shall have an effective procedure for obtaining the active involvement of employees and their representatives in developing training curricula and training materials, participating in training sessions, and reviewing and revising the training program.
  • Training material appropriate in content and vocabulary to the educational level, literacy, and language of employees shall be used.
  • All employees working in the facility shall be provided initial training when the plan is introduced, and when an employee is newly hired or newly assigned to perform duties for which the training was not previously provided. Healthcare workers who perform patient care duties, and their supervisors, should receive annual “refresher” training.

Training programs should include the following:

  • An explanation of the employer’s workplace violence prevention plan, including the employer’s hazard identification and evaluation procedures, and general and personal safety measures the employer has implemented.
  • How the employee may communicate concerns about workplace violence without fear of reprisal.
  • How the employer will address workplace violence incidents, and how the employee can participate in reviewing and revising the plan.
  • How to recognize the potential for violence, factors contributing to the escalation of violence and how to counteract them, and when and how to seek assistance to prevent or respond to violence.
  • Strategies to avoid physical harm.
  • How to recognize alerts, alarms, or other warnings about emergency conditions such as mass casualty threats and how to use identified escape routes or locations for sheltering, as applicable.
  • The role of private security personnel, if any.
  • How to report violent incidents to law enforcement.
  • Any resources available to employees for coping with incidents of violence, including, but not limited to, critical incident stress debriefing or employee assistance programs.
  • An opportunity for interactive questions and answers with a person knowledgeable about the employer’s workplace violence prevention plan.


  1. Cal-OSHA. Workplace Violence Prevention in Healthcare. 2016: http://bit.ly/2ia1xF4.