Violence towards health care workers in general hospital environments is a significant occupational hazard that threatens employee safety, health, work productivity, retention, and the quality of care. NIOSH has established strategic goals aimed at the reduction of psychologically unhealthy work environments generally, and workplace violence specifically, among the 17 million employees within the Health Care and Social Assistance sector. [However, hospitals lack practical and sustainable systems for workplace violence risk assessment and prevention. There is a pressing need for standardization of workplace violence data collection, epidemiological risk analysis, and translation of collected data into effective violence prevention efforts.] The long-term objective of this proposal is to develop standardized methodology for workplace violence surveillance, risk assessment, and prevention.
The specific aims of this project are to: (1) Develop and evaluate standardized, database-generated reports of documented violent incidents attuned to end-user specifications by representatives of hospital safety, occupational health, nursing, security, human resources, [and labor];(2) Develop and implement strategies [using the CDC/NIOSH Hazard Risk Matrix] for [studying database data and] helping hospital management [and labor] to prioritize [worksites for] violence interventions;and (3) Prospectively evaluate the effect of [a worksite walkthrough] intervention by comparing [violence incidence and injury rates, work satisfaction, and staff-perceived work safety culture at [randomized] intervention and control worksites]. This work will be carried out within a multi-site metropolitan hospital system with 14,500 employees. In previous work with the hospital system's [unique] database, this research team has developed methodology for calculating incidence rates and risk factors for [workplace] violence. The proposed participatory action research project will build further on that methodology, utilizing the existing electronic data collection system and database, and working in active collaboration with occupational health, safety, nursing, security, human resource and labor professionals within the hospital system. Using focus group discussions, we will develop user-[adapted], standardized, computer-generated reports of workplace violence incidence rates and risk factors based on the specifications of these [key hospital system stakeholders]. In the next phase, these workplace violence reports will be studied using the Hazard Risk Matrix as a framework for assessing priorities for allocation of violence prevention efforts. Based on the group's analysis, [a violence intervention in the form of a worksite walkthrough] will be implemented and evaluated, using a [randomized] design. Results from this research could potentially be the foundation for a standardized methodology for workplace violence surveillance, risk assessment and prevention that could be used in hospital systems nationwide [to improve worker health and safety].

Public Health Relevance

Workplace violence towards health care workers is an occupational hazard of epidemic proportion, significantly threatening the health and safety of 17 million employees. A critical barrier to [managing] this public health problem is a lack of effective methods for collecting, analyzing and [utilizing] data on violent events [in hospitals]. [If successful, this project will deliver an integrated system for standardized violence surveillance and worksite-adapted intervention with applicability for hospitals nationwide.]

National Institute of Health (NIH)
National Institute for Occupational Safety and Health (NIOSH)
Research Project (R01)
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Study Section
Safety and Occupational Health Study Section (SOH)
Program Officer
Lioce, Maria
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Wayne State University
Family Medicine
Schools of Medicine
United States
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Arnetz, Judith E; Hamblin, Lydia; Ager, Joel et al. (2014) Application and implementation of the hazard risk matrix to identify hospital workplaces at risk for violence. Am J Ind Med 57:1276-84