In the previous blog in this series, “The Current State of Workplace Violence in Caring for Those with Disabilities,” workplace violence was shown to be more prevalent in the health care field. However, preventing workplace violence is much more than simply identifying and responding to an incident when it occurs. Preventing workplace violence is also a critical aspect of providing services to people with intellectual and development disabilities.
You must learn to identify the warning signs of workplace violence as they relate to caring for individuals with disabilities. Although communication can go a long way in de-escalating a situation, some events will continue to take place. As a result, you must implement a prevention program that adheres to guidelines and recommendations by the Occupational and Safety Health Administration (OSHA) and the Government Accountability Office (GAO).
What Are the Warning Signs of Workplace Violence?
The warning signs of workplace violence can go unnoticed initially. However, the Department of Labor identifies common conduct behaviors that coincide with increased rates of workplace violence. Some of these conduct indicators include the following:
- Problems with attendance. These problems may occur in either staff members or people with disabilities. In mental health facilities, people with disabilities may be more prone to lashing out if previous appointments had been canceled without reason or at the request of the provider.
- Decreased productivity. This indicates problems with judgment, deadlines, and mistakes. When a person encounters more problems in a particular environment, the likelihood of aggression increases.
- Inconsistent patterns of behavior. Unusual changes in work duties or behaviors may lead to workplace violence. For example, a person experiencing strange mood swings may be incapable of controlling his or her emotions when in the care of your staff.
- Concentration problems.
- Poor health and hygiene. Inability to care for oneself is an indicator of poor emotional or mental state.
- Continual refusal to accept responsibility.
- Extreme emotional disturbances, including depression and anxiety.
- Abuse of drugs or alcohol.
- An unkind environment. This indicator is primarily seen when a supervisor or caregiver behaves in a negative way toward another person. Think of someone talking down to you, and imagine how that feeling is expressed in those with IDDs.
What Steps Are Necessary to Prevent Workplace Violence in Health Facilities?
Education remains among the top means of preventing workplace violence in health care facilities. There are primarily two different types of education programs used, which include the following:
- Training to provide awareness.
- Training to provide response skill sets in the event of an incident.
These two broad terms can be applied to virtually any work setting. According to OSHA, a successful workplace violence prevention strategy must be built to reflect the specific challenges and pain points of the care setting, which may be a hospital, residential treatment facility, nonresidential facility, community care organization, or field-based care, such as home health. In addition, the workplace violence prevention plan must include the following five steps:
1. Management Commitment and Employee Participation – Management and staff members must agree to work together in the creation of the strategy. Furthermore, regular meetings and training are necessary components of this commitment, and all individuals must recognize that the safety of all persons served, workers, and other personnel relies on the dedication and successful creation of the strategy.
2. Worksite Analysis and Hazard Identification – This step reflects a careful assessment of the workplace to identify existing areas that may result in a workplace violence incident. For example, unlocked doors, unsecured areas, and unmonitored interactions between people can result in an incident. Furthermore, identifying what hazards are present and where they are likely to occur will help you define the steps necessary to prevent and contain such hazards.
3. Hazard Prevention and Control – This step actually reflects a series of policies to prevent interactions between staff members and interactions with persons served from becoming violent. This may include standards that warrant transfer of those with a history of violent behaviors from the facility to a more secure location, or it may be as simple as ensuring an appropriate number of staff members are on-site in the event of an aggressive outburst. Furthermore, understanding what types of triggers may exist for individuals with intellectual disabilities can help staff members avoid catalyzing an incident.
4. Training – Training programs must be extensive, including all possible scenarios and outcomes. In addition, staff must always remember that family members of friends of people with disabilities can become aggressive or violent. As a result, a comprehensive training program should include a breakdown of all policies, safe locations, proper procedures for handling aggression, standard self-defense practices, as seen in aggression-management training programs, and policies for recordkeeping of both drills and actual events.
5. Recordkeeping and Program Evaluation – Recordkeeping seems redundant, but it's useful in reassessing and adjusting a workplace violence prevention program as time passes. Under OSHA requirements, facilities must report workplace violence incidents within specific time frames, which may be as little as eight hours. Consequently, recordkeeping information relating to drills and actual events is mandated and verified when the GAO inspects health care facilities.
To help you create a successful workplace violence program, OSHA created a series of checklists available here, pages 30-40.
A Lasting Thought…
Government-based organizations around the country are turning their attentions to programs to prevent workplace violence. In Broward County, Florida, officials have implemented extensive programs, such as the WellBeing Program, to help improve the mental and physical states of employees. As a result, the likelihood of workplace violence decreases, and similar programs can be implemented in your organization immediately.
By taking a few simple steps to create a workplace violence prevention program in your facility, you can improve the safety and health of your staff members and those you serve. You have a duty to maintain a positive role in the community, and many similar organizations will turn to you in preparing their own prevention strategies. So, doesn’t it make sense for you to start planning your prevention strategy now?