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This award-winning blog supplements the articles in Hospital Infection Control & Prevention.

Can't See the Forest for the Trees: AHA Tells OSHA No Need for Violence Reg

Despite healthcare workers suffering four-fold the number of violent attacks as private industry as a whole, the nation’s leading hospital group tells OSHA that many measures are already in place and there is no need for a “one-size-fits-all” federal regulation.

“OSHA's support of research that identifies the effectiveness of best practices for different workplace settings and circumstances and its wide dissemination of information about these effective best practices would do more to ensure the advancement and promotion of workplace safety than its adoption of a ‘one-size-fits-all’ standard for compliance and enforcement,” the American Hospital Association said in comments to OSHA. “...[T]he establishment of a uniform workplace violence standard for the field guarantees that organizations will use a narrowly focused and thereby less effective compliance strategy in addressing the problem of workplace violence.”


So the adoption of anti-violence regulations for hospitals would leave healthcare workers even more vulnerable to the withering array of assaults they already suffer? Based on that logic, I’m assuming that nobody at the AHA uses their “one-size-fits-all” seatbelt while motoring down the freeway.

Most hospitals already have established organization-wide initiatives aimed at addressing workplace violence, the AHA emphasized, citing as evidence it’s 2016 Hospital Security Survey conducted by the Society for Healthcare Engineering and Health Facilities Management.

“A majority of hospitals responding (78%) conduct security risk assessment at least annually, with almost half using a combination of in-house and outside security experts to conduct these assessments,” the AHA said. “Workplace violence policies are in place for 97% of respondent facilities and 95% also have active-shooter policies. Moreover, in response to the increasing challenges of maintaining secure environments over the past two years, a majority of hospitals are using aggressive management training as a proactive way to prevent the occurrence of security incidents and to be better prepared to respond effectively should any incident actually arise.”

To clarify, OSHA has not proposed promulgating a one-size-fits-all standard, asking in a Request for Information (RFI), “How, and to what extent, would small entities in your industry be affected by an OSHA standard regulating workplace violence? Are there conditions that make controlling workplace violence more difficult for small entities than for large entities?”

In its comments to the agency, the Joint Commission recommended that OSHA “tailor a standard for smaller entities. For example, home care, ambulatory and behavioral health providers may have additional challenges in addressing workplace violence. …[We] stand ready to assist OSHA in the development of a standard and any other associated guidance.”

OSHA announced Jan. 10, 2017, that it will promulgate a proposed regulation on healthcare violence. OSHA issued the RFI on Dec. 7, 2016, asking for comments and suggestions as to how to best proceed with violence prevention strategies in healthcare. The comment period closed April 6, 2017.

According to OSHA, healthcare workers suffer workplace-violence-related injuries at an estimated incidence rate of 8.2 per 10,000 full time workers, more than four times higher than the rate of 1.7 per 10,000 workers in the private sector overall. Moreover, according to a government watchdog report that prompted the OSHA action, the incidence of violence in healthcare is likely underreported because workers fear negative repercussions.

Mmm…wonder what gave them that idea?

For more on this story see the June 2017 issue of Hospital Employee Health.

Gary Evans has written about infectious diseases, occupational health, medical ethics and a variety of other healthcare issues for more than 25 years. His writing has been honored with five awards for interpretative and analytical reporting by the National Press Club in Washington, DC