OSHA Releases New Guidelines for Preventing Workplace Violence

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Recently, the Occupational Safety and Health Administration (OSHA) released new guidelines for preventing workplace violence in the healthcare and social service industries. The publication updates the 1996 and 2004 voluntary guidelines. The guidelines were created based upon industry best practices and feedback from OSHA stakeholders. They provide recommendations for developing policies and procedures to eliminate or reduce workplace violence in range of healthcare and service settings.

Workers in the healthcare and service industries face increased risk of workplace violence due to:OSHA

  • Violent behavior from patients, clients and residents
  • Working directly with patients with a history of violence and/or drug/alcohol abuse
  • Working with the public or relatives of patients increase workplace violence probability

Others include:

  • Working with volatile, unstable people
  • Transporting patients, residents or clients
  • Working alone in a facility or in a patient’s home
  • Lack of emergency communication
  • Working late at night or early morning hours
  • Working in poor lit corridors, rooms, parking lots and other areas
  • Working in areas with high crime rates
  • Availability of firearms and weapons
  • Long waits for care and services
  • Overcrowded or uncomfortable waiting rooms

According to the Bureau of Labor Statistics,

  • 27 out of the 100 fatalities in healthcare and social service settings that occurred in 2013 were due to assaults and violent acts
  • Between 2011 and 2013, workplace assaults ranged from 23,540 to 25,630
  • 70-74% of the above assaults occurred in the healthcare and social service settings
  • Assaults comprise 10-11% of workplace injuries involving days away from work for healthcare employees
    • As compared to 3% of injuries of all private sector employees

Violence Prevention Programs

In the publication, OSHA notes the best way to prepare for an incident of workplace violence is to implement Violence Prevention Programs.

A written program for workplace violence prevention, incorporated into an organization’s overall safety and health program, offers an effective approach to reduce or eliminate the risk of violence in the workplace. The building blocks for developing an effective workplace violence prevention program include:

    • Management Commitment and Worker Participation
    • Worksite Analysis
    • Hazard Prevention and Control
    • Safety and Health Training
    • Recordkeeping and Program Evaluation

Management Commitment and Worker Participation

OSHA recommends management and employees are both involved in the decision-making while creating an effective prevention program. Employees are encouraged to participate in the development, implementation, evaluation, investigation and modification of the program.

Firestorm encourages management to include employees in the crisis-response and prevention training process.

risk assessment

Conducting a Risk Assessment and training your employees on signs to look for and the steps that need to be taken to carry forward during a crisis situation will make a significant difference in your organization. The stage is divided into three groups: guarded, elevated and severe. In each one of those stages, different actions are taken to manage the situation at hand.

We want to operate toward the lower end of the thermometer pictured above on the right, before acts escalate to a threat or a physical injury or a death.

Learn more about Behavioral Risk Threat Assessments here.

Worksite Analysis

Internal audits and self-assessments are encouraged by OSHA. The worksite assessments should be used to identify the possible risk factors, the types of hazard prevention and control measures that can be implemented to reduce or eliminate a workplace violence incident and the appropriate training that should be developed and given to employees.

Firestorm recommends all businesses (including schools) conduct an internal audit (self-assessment). Identifying potential risks before they occur is critical.

Consider Business Crisis-Risk

Why is Business Crisis-Risk so important?

  • A study of Business Crisis-Risk indicates that most crises can be foreseen; management may choose to remain unprepared, whether through inaction, complaisance, or denial.
  • Firestorm research has shown that business crisis-risk falls into identifiable patterns – ‘indicators’ shaped by severity and frequency
  • Identifying these risks empowers management to avoid or mitigate the financial and human impact events which have crippled many companies


To learn more about the importance of Business Crisis-Risk, download the webinar brief Enterprise Crisis-Risk — The Value of Internal Auditing.

To learn more about how to conduct a self-assessment within a school, download the webinar brief It Will Never Happen Here Conducting a Self-Assessment — How Do You Know What You Don’t Know.

Hazard Prevention and Control

For this building block, OSHA concludes employers must implement rules and regulations to physically eliminate or reduce any workplace violence hazards. Suggestions include:

  • Using physical barriers or door locks
  • Metal detectors
  • Panic buttons or silenced alarms
  • Better or additional lighting
  • More accessible exits
  • Closed Circuit videos
  • Curved Mirrors
  • Glass panels in doors/walls for better monitoring of behavior
  • Lockable bathroom and staff counseling and treatment rooms

The goal of Firestorm is to teach organizations to have an intervention much earlier in the process and before a crisis occurs. But when one does, the locked doors certainly can help. Having doors locked, while the work day (particularly the school day) is in session from the inside, creates a barrier for those with hostile intent. If classroom doors do not lock from the inside, students are exposed to additional harm.

Having the ability to barricade and lock doors buys time, because in a crisis and when those events occur, it’s about access and time. Download this brief to learn how to create a Predictive Actionable Intelligence Program. This program will help with understanding and identifying all of the elements of a crisis before they occur.

All of our goals are to help you identify your school’s next crisis. It’s not just that we can, but you can predict your next crisis.

Safety and Health Training
Jim Satterfield Quote

OSHA concludes that employers need to provide appropriate education and training to ensure that all staff members are aware of potential workplace violence hazards and how to protect themselves and their coworkers. Effective training should cover the policies and procedures for a facility, as well as hands-on de-escalation and self-defense training.

Firestorm utilizes its unique PREDICT. PLAN. PERFORM.® process in designing continuity programs, strategies and plans tailored to each client’s individual situation, industry conditions and needs. An effective program will identify an organization’s vulnerabilities – existing and potential – and institute procedures to monitor, plan, mitigate and train for impacts in the event of a crisis.

Comprehensive management and planning address these critical factors:

  • Business Assessment (Business Impact Analysis)– A clear overview of all business critical information and process flows, with identification of critical recovery time-frames.
  • In/Out/Across Analysis – Identifying critical dependencies to Information Technology, internal departments, external vendors, and key resources.
  • Risk Assessment – Defining the enterprise’s potential exposure and tolerance for uncertainty.
  • Enterprise-Wide Focus – A business continuity plan is NOT just an IT/network technology solution.
  • Actionable Plans – Guiding the step by step process of actions and responsibilities through the plan execution.
  • Training – Educating all employees about their roles and responsibilities, to the company and community.
  • Maintenance – Preparedness is an ongoing process of vigilance and adaptation as your business environment evolves.

Only resilient businesses survive disasters. Of all the disasters you have seen, the worst will be the one that happens to your company. Training management and employes is critical in surviving any crisis. Not sure if you’re prepared? Contact Firestorm, we’ll help you out.

Record-keeping and Program Evaluation

OSHA recommends employers review crisis plans routinely before, during and after a disaster occurs. Reviews should include:

  • Establishing a uniform violence reporting system and regularly review reports;
  • Reviewing reports and minutes from staff meetings on safety and security issues;
  • Analyzing trends and rates in illnesses and injuries cause by violent episodes or threats
  • Keeping abreast of new strategies available to prevent and respond to violence in the healthcare and social setting environments, and
  • Requesting periodic law enforcement or outside consultant review of the worksite for recommendations on improving worker safety

Practice Your Plan

Reviewing your plan involves periodically practicing a few elements of the plan itself. Some things, like your contact lists, need to be reviewed every month. Other elements will require action only every three or six months. If you practice your Plan you’ll know what to do without having to give much thought to it when an emergency situation does occur. Practicing also reveals any flaws in your plan. The key is staying prepared.

For detailed recommendations on steps to take before, during and after a crisis, download the free book Disaster Ready People for a Disaster Ready America. For now, we will focus on post-disaster recovery.

Below is an excerpt from the book:the book

Short-Term Recovery

As soon as you are sure the disaster is over you will move into the short-term recovery phase. Again, your first job is to stay safe. During this period (which could be anywhere from a few hours to several weeks), keep providing emotional support to each other because healing is a gradual process.

Depending on the kind of disaster you’ve gone through, you’ll need to start making some decisions. Do you or can you return home or do you need to find temporary housing? No matter the situation, do not rush to any conclusions. Instead, calmly and rationally assess your situation. Now is the time to consider the special relationships you have with family and friends on your contact list.

Long-Term Recovery

In the case of a particularly severe event, recovery can take a long time. In fact, it can take years before a community regains a sense of normalcy. Emotional reactions can really set in at this stage with children, and some adults, suffering from nightmares or depression. The disaster preparations you have made and practiced will help through this tough time. If the concerns persist, seek professional guidance and help; there is no shame in doing so.

Again, keep your wits about you, yet stand up for yourself when necessary. Be as flexible and resourceful as the situation warrants. Expedite the recovery process with your identity papers and financial records. If you have chosen not to have this information in your evacuation kit, now is the time.

 We are the Crisis Coach®

(800) 321-2219

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