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Healthcare workers don't feel confident in workplace safety plans | Safer Hospitals


As part of our ongoing series of stories looking at safety in hospitals, Tony Jace of the Crisis Prevention Institute discusses ways to help protect staff and support workers.

Too many healthcare workers don’t feel safe on the job, and don’t have confidence in their organization’s violence prevention policies.

Those are some key takeaways from the Crisis Prevention Institute’s second annual Workplace Violence Prevention Training Annual Report for health care.

About one in five workers (17%) say their staff is very or mostly unsafe, according to the report. More than half (55%) said violence prevention plans at their workplace were only somewhat effective, or simply ineffective.

Tony Jace, CEO of the Crisis Prevention Institute, tells Chief Healthcare Executive® those findings are disturbing.

“One in five healthcare workers now feel incredibly unsafe at work,” Jace says. “And I can't think of another market or industry where we just accept … 20% of our staff feel incredibly unsafe in their work environment.”

In an interview with Chief Healthcare Executive®, Jace shares thoughts on how hospitals and healthcare organizations can do more to protect workers, and also help workers feel better about the safety of their workplace. (See part of our conversation in this video. The story continues below.)

‘People want to feel confident’

The Crisis Prevention Institute trains hospitals, and organizations in other industries, about de-escalation strategies. In its report, which was released last week, the institute surveyed 1,196 hospital workers. Participants had a median of 10 years experience on the job, and the median hospital size was 92 beds.

The institute surveyed healthcare workers about their confidence in workplace safety and set a benchmark score of 76 for organizations with effective programs to prevent violence. The report assessed the violence prevention index score of 55. “We essentially stayed flat,” Jace says.

Hospitals haven’t focused enough on their violence prevention strategies and training staff.

“Some of the common things that keep coming up time and time again, are really the lack of resources, the lack of attention, the lack of getting time off the floor. Now, trust me, I get it. It is expensive,” Jace says.

But hospitals that aren’t employing robust violence prevention plans are going to spend more money to hire new staff, as employees choose to work at places where they feel safe, he says.

“People want to feel confident, they want to know that they're going into a safe environment,” Jace says. “Before you get to anything else, you'll have great culture and all this other stuff… amazing customer satisfaction, your staff need to feel confident, and they need to be safe.”

Some hospitals aren’t doing enough to inform workers about their violence prevention policies, Jace says. Hospitals and health systems also can see trust erode if they haven’t revisited their violence prevention plans in some time.

Staff also may feel less secure if their organizations aren’t engaging in regular training on safety issues, he adds.

“When you're not aware of the policy, or it's old, or you're not training de-escalation skills, staff don't feel confident,” Jace says.

Healthcare employees need a common language to communicate with each other in tense situations, since doctors and nurses routinely enter crisis situations, he says.

Hospitals also need to be offering training to all employees on workplace violence prevention, including de-escalation.

“The key is that there is a predictable escalation, potentially, of a crisis moment. And how you interact and apply strategies at every stage of that crisis moment, can either de-escalate or escalate. And so de-escalation is incredibly important,” Jace says.

“And that's one key takeaway from our study is … most organizations in healthcare do not train de-escalation on a system-wide basis.”

Getting abused ‘is not OK’

While Jace says more hospitals need to do more in the area of violence prevention, he does see some encouraging signs.

“There is certainly more attention to this issue than ever,” Jace says. “And I also believe that the awareness is at an all-time high. And part of that is certainly you know, obviously the pandemic that we went through.”

Doctors and nurses, particularly in emergency departments, have said they have seen more aggressive behavior from patients since the emergence of the COVID-19 pandemic. Jace also says there’s a greater willingness of nurses and other workers to speak out when they’ve been assaulted or encountered aggressive behavior.

“There's a realization that as a nurse, you do not need to go to work assuming that it's fine that you're going to get bruised or scratched or have your hair pulled,” Jace says. “That's not okay. People do not have to put up with that anymore. And they realize that.”

Healthcare leaders have lost the confidence of some employees on safety issues, but Jace says they have an opportunity to restore trust.

“I think there's been a bit of an erosion of trust .. from the leadership, to all the way down to the floor, over to the frontline workers,” Jace says.

Hospitals and health organizations need to show their staff that they are supported, he adds.

“Safety is one element of that support, but critically trust in the culture that you have their back, that you can empathize, and you, in some way, know what they're going through on a daily basis,” Jace says.

When leaders become too disconnected from the lived experiences of their workers, they don’t recognize how much their people are hurting.

“What happens is they carry that home,” Jace says. “Every night, they carry it home. And that backpack just gets more and more filled every day … And then that's why you see such a large percentage of healthcare professionals actively seeking to leave the field. Because we're not addressing just that daily burn that is going there.”

But Jace says the silver lining is that more health systems and hospitals recognize it’s time to do more to improve violence prevention, and address the concerns of their workers.

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