California’s SB553 is the first comprehensive and multi-industrial violence prevention law in the United States and has been in effect for nearly a year. Many other states also follow their own workplace violence prevention laws or regulations, including New York’s Retail Workers Safety Act, which will take effect this year. California’s workplace violence regulations for healthcare facilities came into effect in 2017, and many other states have since enacted regulations to protect healthcare workers from workplace violence.
Currently, despite the patchwork of national laws and regulations, there are no federal Occupational Safety and Health Administration (OSHA) regulations addressing violence in the health care workplace.
For healthcare employers nationwide, tracking new state and federal legislation is at least part-time jobs from risk managers, safety professionals and HR leaders. Judging from what we continue to see today, there is no reason to expect the trend of new legislation or safety regulations related to workplace violence to slow down. Therefore, healthcare leaders may need to really consider focusing on trackable, verifiable prevention programs and effective training courses to stay ahead of legal trends.
Develop a comprehensive prevention plan
According to individual state requirements or local regulations, most healthcare employers believe that they are risk assessment in their first task in addressing workplace violence prevention. Employee participation in the risk assessment process is critical to the stakeholders in creating a program, as this often provides the basic data and input needed to identify problem areas and work on the solution.
When developing initial plans to address these issues, employers can begin to begin with a clear definition of the composition of violence in the workplace. Then, outline policies that must be implemented to mitigate the risks of these situations.
As the team works together to refine and improve these policies, it is important to establish a person or group responsible for the planned policies. It is best to have the person or group communicate and enforce these policies in a larger organization with zero tolerance for any violation. All policies and procedures may need to be reviewed regularly (ideally planned) to ensure continuous improvement.
An effective and compliant plan includes reporting and response programs so that there are clear and understandable procedures to report workplace violence. Employers can use a variety of reporting methods, including 1-800 hotlines, designated staff, email or text methods, and verbal and written methods.
Employers may also consider developing response plans to effectively resolve incidents and support affected employees. Response protocols are customized and can vary depending on the size and location of the facility, the type of customer or patient, and the type of service provided. They also often include a process to secretly investigate threats and incidents of workplace violence. Depending on the provider’s culture and structure, response and investigation responsibilities, it may be in risk management, human resources, security or operations departments. There is no one suitable method for response and investigation.
Ideally, the violence prevention program in each workplace is tailored to the workplace, workplace and work environment of a specific facility. The program of an effective small rural clinic is not necessarily suitable for large hospitals with campuses in urban neighborhoods. Engineering and administrative controls addressing workplace violence will vary and may need to adapt to address the risks and hazards clearly identified in the preliminary assessment.
Strengthening engineering controls for security measures may include improved lighting, security cameras and systems, and ID badges to ensure that only privileged individuals can access certain facilities.
Other administrative controls included in laws and guidelines from recent New York, California, and other states can also include panic buttons, personal alerts, open communication channels (hand radios), and scheduling changes to mitigate the risk of problematic participants. In some specific cases, these may even be needed.
Promote effective training courses
Training is an important part of any plan to prevent violence in the workplace and is best held regularly and ongoing meetings. Plans to prevent and address workplace violence can only be effective in strong implementation. Additionally, it helps track how employees receive and participate in training. Although training requirements depend on state laws and regulations, there are some commonalities.
First, consider training employees to train in all aspects of the employer’s workplace prevention program, including defining, reporting threats and violence, investigating, and seeking or attempting to minimize the harm of workplace violence.
Depending on the workplace and employees, effective training can also include guidance on how to identify warning signs of potential violence, such as behavioral changes, verbal threats, escalation and signs of distress. According to today’s healthcare industry, some employers have found that downgrade training, including communication technology and conflict resolution, is the fundamental part of effective training because it gives employees the confidence to resolve angry patients or angry visitors.
The final thought
Preventing workplace violence is an ongoing organic process. Federal and state regulations change frequently, so employers can consider regularly reviewing and updating prevention and training programs for scheduled schedules. Conducting regular or annual audits, seeking feedback from employees, and understanding best practices and emerging trends in preventing workplace violence is critical to continuous improvement in 2025 and beyond.
Photo: Gunmay, Getty Images
Karen Tynan is a shareholder of the Sacramento office of Ogletree Deakins, where she serves as the West Coast OSHA practicing chair. She also serves as co-chair of the company’s workplace safety and health practice group and the workplace violence prevention practice group.
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