Compliance Perspectives: 14 Steps to Protect Lab Staff from Workplace Violence

July 18, 2022

This article originally appeared in G2 Intelligence, Lab Compliance Advisor, July 2022, published on the G2 website on June 22, 2022.

One of the truly grotesque impacts of the COVID-19 pandemic is how it has placed a target on the heads of healthcare workers. The same doctors, nurses, and hospital staffers that were lauded as heroes at the start of the pandemic have come under threat of violence from hate mongering ignoramuses who refuse to accept medical reality. On June 1, threat escalated into actual violence when a man carrying a rifle and handgun opened fire on the campus of Saint Francis Hospital in Tulsa, killing two doctors, a hospital worker, and a patient who was in the wrong place at the wrong time.

New Laws Aim to Protect Healthcare Workers from Violence, Threats, and Intimidation

The Tulsa massacre has added impetus to efforts to pass legislation imposing extra penalties for intimidating, threatening, or assaulting medical workers akin to current laws protecting pilots and aircraft flight crews. Utah and Wisconsin have adopted healthcare worker protection laws this year. Similar legislation is under consideration in a number of other states, including Connecticut, Kansas, Massachusetts, Michigan, and New Jersey.

And now the US Congress has taken up the cause. This week, the House of Representatives introduced a bipartisan bill called the Safety from Violence for Healthcare Employees (SAVE) Act. Several influential healthcare organizations have endorsed the bill, including the American Hospital Association.

“The SAVE Act will put in place legal protections to help deter violence inside our nation’s hospitals and keep these vital institutions safe and secure for patients and our nation’s healthcare professionals,” noted Larry Bucshon, R-Indiana, a physician and co-sponsor of the bill, in a statement. 

Of course, the imperative of labs to protect their workers against violence is nothing new. The Occupational Safety and Health Administration (OSHA) and state laws require employers to take measures to identify, assess, and minimize workplace violence hazards and take proper steps to respond to any incidents that occur. While rules differ by state, particularly with regard to whether the OSHA duty to prevent workplace violence also extends to workplace harassment, the basic measures required are pretty much the same everywhere. At the end of the day, there are 14 things you must do to comply:

1. Perform a Workplace Violence Hazard Assessment

As with any other workplace danger, hazard identification and assessment make up the first step in preventing workplace violence. Labs must determine whether there are risks of violence at their particular facility and, if so, how severe they are based on factors like:

  • Previous incidents of violence at the site;
  • How dangerous the neighborhood is, which you can assess with the help of local law enforcement;
  • General experience in clinical labs;
  • The circumstances in which work takes place; and
  • How severe the consequences would likely be if violence were to occur.

2. Select Appropriate Controls

Once the assessment is complete, employers must implement controls to eliminate or, if that’s not practicable, minimize the risks identified. Follow the so-called hierarchy of controls approach, starting with engineering controls, followed by administrative or work controls (which is essentially the only appropriate control for harassment), and use of PPE as a backstop and measure of last resort. Work controls must include procedures for recognizing and responding to acts of violence and calling for immediate help.

3. Implement a Prevention Program

Create and implement written policies, programs, and procedures (which we’ll refer to collectively as a “prevention program”) to put your workplace violence controls into action.

4. Guard Against Workplace Domestic Violence

In doing your assessment and selecting controls, consider the risk of domestic violence that may occur at your lab, e.g., where a lab employee is married to a spouse with a history of violence.

5. Make a Commitment Statement

Include as part of your prevention program a written statement from your president or executive officer that recognizes employees’ right to a work environment free of workplace violence and expresses management commitment to take all practicable measures to eliminate or minimize violence hazards.

 6. Establish Procedures for Reporting Threats and Acts of Violence

The prevention program must include clear procedures lab staff can use to internally report workplace violence they experience or witness. While designating a lab supervisor to receive such reports, be sure to provide an alternative, outside outlet to whom employees can report in case the supervisor or management is involved in the alleged violence.

7. Establish Investigation Procedures

Establish a mechanism to ensure prompt, fair, and comprehensive investigation of reported workplace violence complaints or incidents, preferably by an outside person with investigation experience and who can be counted on to investigate objectively. Consider processes for resolving reports or complaints via conciliation. Make sure the prevention program describes the investigation procedures and means of notifying the parties of the investigation results and any corrective actions taken.

8. Make Privacy Assurances

Include assurances that you won’t disclose the name of the person(s) involved and the circumstances of the matter being investigated unless disclosure is required to do the investigation, implement corrective actions, or otherwise allowed or required by law.

9. Establish Response Procedures

The prevention program should indicate how the lab will respond to acts of workplace violence found to have occurred, including a promise to hold wrongdoers accountable and implement appropriate corrective measures to fix any problems the investigation identifies.

10. Provide Assistance and Support to Victims

Support and assistance might include:

  • Giving victims information about medical, psychological, or other support services available within the geographical area;
  • Advising victims to seek medical treatment and post-incident counselling; and
  • Counting time spent in referred treatment and counselling as work time.

11. Provide Appropriate Information to Workers at Risk

Provide any workers that you determine are exposed to workplace violence risks information about the extent and nature of the risk and how to guard against it. Some states specifically require employers to notify workers about persons with a history of violence that they’re likely to encounter at work, provided that the disclosure is limited to the minimum amount of information necessary to put the worker on notice of the danger:

  • OK: Co-worker John Doe has a history of violent behavior;
  • Not OK: Co-worker John Doe has a psychiatric condition that makes him prone to commit violence.

12. Provide Appropriate Training

Provide training on how to recognize and respond to workplace violence, including active shooter events (see the Model Tool on the G2 website) and call for immediate help if it occurs. Maintain records of the training you provide.

13. Report Workplace Violence Fatalities, Injuries, and Incidents

Keep in mind that incidents of workplace violence are subject to normal OSHA and workers’ comp injury reporting requirements. Some states also require employers to submit annual workplace violence reports.

14. Review Your Hazard Assessment and Prevention Program

Last but not least, review your workplace violence hazard assessment and prevention program at regular intervals—generally every three years—and as needed in response to incidents, new hazards, or changes in conditions that the previous hazard assessment and program didn’t account for.

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This article originally appeared in G2 Intelligence, Lab Compliance Advisor, July 2022, published on the G2 website on June 22, 2022.

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