This surveillance system provides ongoing information on professional groups and hospital departments at risk and trends in violence reporting over time. It can be used to determine where appropriate violence prevention efforts are most needed, and to evaluate violence interventions.
Violence toward hospital workers is an internationally recognized occupational hazard. While patients are frequently perpetrators of physical violence, other employees are often responsible for acts of nonphysical violence. However, few hospitals have systems for documenting and monitoring worker-on-worker violence. This study encompassed all incidents of worker-on-worker violence recorded by employees in a hospital system database over a six-year period. Incidence rates per 100 full-time equivalents (FTEs) and rate ratios (RR) were calculated by year, hospital, and job category. The majority (87%) of worker-on-worker incidents involved nonphysical conflict. The overall incidence rate was 1.65/100 FTEs, ranging among the six hospitals from 0.54 to 3.42/100 FTEs. Based on multivariate analysis, no single professional group was at increased risk for worker-on-worker violence. Co-worker violence threatens the well-being of hospital employees and should be regularly tracked with other forms of workplace violence so that suitable intervention programs can be implemented and assessed.
Background
A key barrier to preventing workplace violence injury is the lack of methodology for prioritizing the allocation of limited prevention resources. The hazard risk matrix was used to categorize the probability and severity of violence in hospitals to enable prioritization of units for safety intervention.
Methods
Probability of violence was based on violence incidence rates; severity was based on lost time management claims for violence-related injuries. Cells of the hazard risk matrix were populated with hospital units categorized as low, medium, or high probability and severity. Hospital stakeholders reviewed the matrix after categorization to address the possible confounding of underreporting.
Results
Forty-one hospital units were categorized as medium or high on both severity and probability and were prioritized for forthcoming interventions. Probability and severity were highest in psychiatric care units.
Conclusions
This risk analysis tool may be useful for hospital administrators in prioritizing units for violence injury prevention efforts.
BACKGROUND
Documented incidents of violence provide the foundation for any workplace violence prevention program. However, no published research to date has examined stakeholders’ preferences for workplace violence data reports in healthcare settings. If relevant data are not readily available and effectively summarized and presented, the likelihood is low that they will be utilized by stakeholders in targeted efforts to reduce violence.
OBJECTIVE
To discover and describe hospital system stakeholders’ perceptions of database-generated workplace violence data reports.
PARTICIPANTS
Eight hospital system stakeholders representing Human Resources, Security, Occupational Health Services, Quality and Safety, and Labor in a large, metropolitan hospital system.
METHODS
The hospital system utilizes a central database for reporting adverse workplace events, including incidents of violence. A focus group was conducted to identify stakeholders’ preferences and specifications for standardized, computerized reports of workplace violence data to be generated by the central database. The discussion was audio-taped, transcribed verbatim, processed as text, and analyzed using stepwise content analysis.
RESULTS
Five distinct themes emerged from participant responses: Concerns, Etiology, Customization, Use, and Outcomes. In general, stakeholders wanted data reports to provide “the big picture,” i.e., rates of occurrence; reasons for and details regarding incident occurrence; consequences for the individual employee and/or the workplace; and organizational efforts that were employed to deal with the incident.
CONCLUSIONS
Exploring stakeholder views regarding workplace violence summary reports provided concrete information on the preferred content, format, and use of workplace violence data. Participants desired both epidemiological and incident-specific data in order to better understand and work to prevent the workplace violence occurring in their hospital system.
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