OSHA Developing New Standard Affecting Health and Human Service Industry

According to OSHA’s 2019 statistics, “healthcare and social assistance workers in private industry experienced workplace-violence-related injuries at an estimated incidence rate of 10.4 per 10,000 full-time workers – for a total of 14,550 nonfatal injuries.” The rates are even higher for psychiatric, substance abuse, and residential mental health care facilities. Despite these staggering statistics, OSHA does not have a specific standard on workplace violence for employers. Currently, the General Duty Clause found in Section 5(a)(1) of the OSH ACT of 1970 is enforced in situations involving workplace violence. Most citations issued by OSHA’s compliance officers due to workplace violence typically involve the health care industry.

This has led OSHA to focus on the early development stages of a new workplace violence standard. In March 2023, OSHA called together a Small Business Advocacy Review (SBAR) panel. They received representation from organizations in industry sectors such as hospitals, residential behavioral health facilities, residential care facilities, home health care, emergency medical services, social assistance, correctional health settings, ambulatory mental health care, ambulatory substance abuse treatment centers, and freestanding emergency centers. OSHA identified potential topics in the draft standard to be considered by the panel, including:

• A programmatic approach to workplace violence prevention
• Workplace violence hazard assessments
• Workplace violence control measures
• Preventive training
• Violent incident investigations and recordkeeping
• Antiretaliatory provisions
• Approaches that avoid stigmatization of health care patients and social assistance clients

While the exact rollout date of the new standard is unknown at this time, employers can proactively begin evaluating their organization’s current prevention program. The following measures can be implemented or reviewed for effectiveness:

Written Procedures: Organizations should begin by developing a policy on workplace violence containing zero tolerance. The policy can be a standalone policy, part of the organization’s safety manual, or it can become part of the employee handbook. The policy should begin by expressing management’s commitment, as well as stressing the importance of employee participation. Other items to be included in the written policy include hazard identification, hazard prevention and control, training, and recordkeeping.

Hazard Assessment: Consider all possible hazards that may lead to an instance of workplace violence, including recent terminations that may have been particularly difficult. Conduct a walkthrough inspection of your facility and grounds to determine the security of all entry points. Are doors left propped open during breaks? Are windows latched and locked? What areas need further securement?

Physical Controls: These are referred to as ‘engineering’ or physical controls used to reduce or eliminate workplace violence hazards:

• Keyless door entries and buzzer systems with cameras in the reception area
• Convex mirrors at the end of hallways that expand visibility for safety
• Panic buttons mounted under desks or attached to a breakaway lanyard that immediately alert local law enforcement of emergencies
• The arrangement of furniture to avoid entrapment
• Safe rooms that can be used during lockdown situations
• Adequate lighting in the parking lot and around the building perimeter
• Door defense systems, such as door jams based upon the swing or hinge of the door

Administrative Controls:

• Ensure doors leading to counseling or administrative offices are kept locked; employees should always escort clients, patients, consumers, or other visitors to and from the reception area
• Reach out to local police and emergency responders; provide them with a current copy of your building schematics and invite them to your facility to become familiar with the layout and offer security advice
• Conduct annual training and regular drills
• Provide a system for employees to report incidents or potential incidents without fear of retaliation; it should include a timeframe for a response to the reporter on the outcome of the investigation and any action(s) taken

For more information and helpful resources, OSHA provides guidance on workplace violence prevention programs, or please reach out to Lisa Bellis, senior vice president of risk management & loss control at Brown & Brown, at 610-348-7986.

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