Violence is a concern for everyone in a healthcare facility. If a facility is considered to be at risk for violence or experiences a violent event, its workers may not function effectively, its reputation may suffer, workers' compensation costs may increase, and patients may go elsewhere for treatment. The Occupational Safety and Health Administration (OSHA) defines workplace violence as "any threat of physical violence, harassment, intimidation, or other threatening disruptive behavior that occurs at the work site" (OSHA "Workplace Violence"). Accrediting agencies, including Joint Commission and DNV, require accredited entities to assess the risk of workplace violence and take steps to address it, and the Centers for Medicare and Medicaid Services requires that healthcare organizations provide a safe setting for patients and ensure that they are not subjected to any form of abuse or harassment. Additionally, in 2015, OSHA released updated voluntary guidelines for preventing violence in healthcare (OSHA "Guidelines").
Risk assessment provides a critical foundation for targeting violence prevention efforts. This self-assessment questionnaire (SAQ) is designed to help risk managers determine their facility's violence risk level and identify improvements or additions needed in their organization's violence prevention programs. Regardless of an organization's risk level, Health System Risk Management recommends that risk managers complete this SAQ in its entirety, as it may help an organization identify areas in which violence prevention policies or procedures need to be developed or revised. For example, all healthcare workers, including physicians and volunteers, should know what to do if a violent incident does occur and how to report such an incident. For the purpose of this SAQ, nonemployees are included in the definition of healthcare worker for two reasons: first, security is everyone's concern; second, anyone can be either a victim or an assailant. Facility policymakers should determine whether a reason exists to distinguish between employee and nonemployee healthcare workers.
ECRI recommends organizations complete this SAQ annually.
Although this SAQ addresses broad aspects of violence risk for individuals who work in the field (e.g., paramedics), ECRI also recommends that risk managers refer to Home Care: Staff-Related Risks for a comprehensive risk assessment specific to home care.
The resources listed below were considered in the development of this SAQ. The questions were adapted, in part, from an OSHA workplace violence checklist contained in the 2016 handbook Guidelines for preventing workplace violence for healthcare and social service workers. This list is not intended to be comprehensive.
Self-Assessment Questionnaires (SAQs) can be used to identify compliance with best practices and opportunities for improvement. They include questions based on laws, regulations, standards, professional society guidelines and statements, and best practices identified by the clinical literature. Each SAQ also includes an Action Plan to help document next steps and responsible parties.
SAQs are available both as PDFs, for use as-is, or as Microsoft Word documents, which can be edited to suit your organization's custom needs, such as by adding questions regarding local or state requirements that may not be represented.