MMHA 6220 Week 3 Workplace Violence Policy Example

Workplace Violence Prevention Policy for Staff Who Work in Patients' Homes: Risk Flags at Intake, Check-Ins for Flagged Visits and the Right to Leave Without Penalty

Student Name

Walden University

MMHA 6220: Human Resource Management in Healthcare

Instructor Name

Month Day, Year

Workplace Violence Prevention Policy for Staff Who Work in Patients' Homes: Risk Flags at Intake, Check-Ins for Flagged Visits and the Right to Leave Without Penalty

1. Purpose

This policy protects Bellwood Valley Home Health employees from violence and threats while they work, especially in patients' homes, where they work alone and without the protections of a facility. It sets procedures for identifying risk before a visit, staying in contact during flagged visits, leaving unsafe situations and reporting incidents. Health care and social assistance workers face a high risk of workplace violence, and much of it goes unreported (Phillips, 2016). The agency named here is invented; any resemblance to a real agency is coincidental.

2. Scope

This policy applies to every employee who enters a patient's home, including home health aides, nurses, therapists and social workers, and to office staff who receive threatening calls, messages or visits. It applies to threats or violence from patients, family members, other household members, neighbors and anyone else encountered during work.

3. Definitions

Verbal threat: a statement or gesture, in person, by phone or in writing, that communicates an intent to cause physical harm.

Physical assault: any intentional physical contact intended to harm, including hitting, kicking, grabbing, spitting or pushing, or an attempt to do so.

Third-party threat: a threat or assault by someone other than the patient, such as a relative, household member, visitor or neighbor.

Risk flag: a notation in the scheduling system and patient record indicating a known safety concern, assigned at one of three levels: Level 1 (caution), Level 2 (check-in required) and Level 3 (modified visit required).

4. Responsibilities

The administrator is responsible for the policy, its resources and its annual review. The director of clinical services assigns and reviews risk flags. Schedulers apply visit requirements for flagged patients. Every employee follows the procedures, reports incidents and may stop any visit they believe is unsafe. The HR manager maintains incident records and training.

5. Procedures

5.1 Risk flag at intake

During intake, the intake nurse reviews referral notes and asks the patient or family about weapons in the home, aggressive animals, people in the home with a history of violence, and earlier incidents with health care workers. A Level 1 flag is assigned for concerns such as an unrestrained dog or a history of verbal aggression. A Level 2 flag is assigned for a weapon in the home that is not secured, a household member with a history of violence or a prior threat to staff. A Level 3 flag is assigned for any prior assault on staff, an active threat or illegal activity observed in the home. Flags are reviewed after every incident and at every recertification.

5.2 Check-ins for flagged visits

For Level 2 and Level 3 patients, the employee checks in with the office by phone or through the agency's scheduling app on arrival and on departure. If the office does not receive a departure check-in within 15 minutes of the expected end time, the scheduler calls the employee. After two unanswered attempts, the scheduler calls the director of clinical services, who decides whether to call 911.

5.3 Modified visits

For Level 3 patients, visits are made in daylight hours, by two employees together or with a security escort, or the patient is offered visits at a clinic or by telehealth where clinically appropriate.

5.4 The right to leave

Any employee may end a visit and leave at any time if they believe they are at risk, without penalty and without needing permission. The employee leaves first and then calls the office. The agency will arrange for the patient's needs to be met by other means and will not discipline an employee for leaving in good faith, even if the threat later proves less serious than it seemed.

6. Training

Every employee completes training at hire and annually on recognizing warning signs, de-escalation, leaving safely, check-in procedures and reporting. Training uses scenarios from home visits and draws on a free federal online course on workplace violence for nurses, which covers risk factors, prevention strategies and the aftermath of incidents (National Institute for Occupational Safety and Health, 2013).

7. Reporting

Every incident, including verbal threats that did not lead to harm, must be reported to the director of clinical services by the end of the shift, and a written incident report must be completed within 24 hours. The agency will not retaliate against any employee for reporting an incident or for leaving a visit. Reports are reviewed within three business days, and the employee is told what action was taken. Employees who are injured are referred for medical care and to the employee assistance program.

8. Support After an Incident

An employee who experiences a threat or assault is offered paid time to seek medical care and to recover, a debriefing with the director of clinical services within two business days, and a referral to the employee assistance program. The employee is not required to return to the patient's home, and reassignment does not count against the employee's caseload or pay. If the incident involved a crime, the agency supports the employee in reporting it to police and does not discourage reporting.

9. Review

The HR manager reviews incident data quarterly and the administrator reviews the policy annually with employee representatives from each discipline.

Cross-Reference to OSHA Program Elements

Table 1

Policy Sections Mapped to the OSHA Guidelines' Five Program Elements

OSHA's guidelines are advisory; this table shows how the policy covers each element they describe.

The cross-reference follows the federal violence prevention guidance written for health care and social service employers, which describes five program elements and include specific recommendations for home health workers (Occupational Safety and Health Administration [OSHA], 2016).

References

National Institute for Occupational Safety and Health. (2013). Workplace violence prevention for nurses (CDC Course No. WB1865; DHHS [NIOSH] Publication No. 2013-155). Centers for Disease Control and Prevention.

Occupational Safety and Health Administration. (2016). Guidelines for preventing workplace violence for healthcare and social service workers (OSHA 3148-06R). U.S. Department of Labor.

Phillips, J. P. (2016). Workplace violence against health care workers in the United States. New England Journal of Medicine, 374(17), 1661-1669. https://doi.org/10.1056/NEJMra1501998