Injuries and Illness

Workplace Violence Prevention: Risk Assessment Guidance

A 25-yearold social service coordinator for a Maryland-based health company was worried about one of her clients. He had a history of violence and severe mental illness. She recorded her misgivings in her work journal, noting that being alone with this particular client made her uncomfortable. But it was part of her job to transport clients in her vehicle to perform mental and physical health assessments, and she faithfully did her job. In 2012, the client fatally stabbed her outside his Florida home.

Occupational Safety and Health Administration (OSHA) investigators found that the employer knew the assailant had exhibited criminal and violent behavior but took no steps to protect its employees. OSHA concluded that the organization did not conduct a hazard assessment or develop a written program to prevent violence hazards.

OSHA issued two serious citations and penalties of $10,500 for failing to protect workers from violence and for not reporting the worker’s death to OSHA. The employer contested the citations, which were upheld by the Occupational Safety and Health Review Commission.

Elements of a workplace violence prevention program

Earlier this year OSHA published a guidance document, Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers. It describes the elements of a workplace violence prevention program in detail. On June 25, OSHA announced that it had added several risks, including workplace violence, as key hazards for compliance officers to investigate when conducting healthcare inspections.


Workplace Violence Safety Meeting Kit – in English or Spanish. One out of every six violent crimes occurs in the workplace. And while workplace homicides grab the headlines, other forms of workplace violence happen much more frequently.


Risk factors can be related to patients, clients, and settings and include the following:

  • Working directly with people who have a history of violence, abuse drugs or alcohol, are gang members, and are relatives of patients or clients;
  • Transporting patients and clients;
  • Working alone in a facility or in patients’ homes;
  • Poor workplace design that may block employees’ vision or interfere with their escape from a violent incident;
  • Poorly lit corridors, rooms, parking lots, and other areas;
  • Absence of emergency communication methods;
  • Prevalence of firearms, knives, and other weapons; and
  • Working in neighborhoods with high crime rates.


MARCOM’s Workplace Violence Safety Meeting Kit shows employees how to recognize the warning signs of possible violent behavior, as well as how to avoid or defuse potentially dangerous situations. Click here to learn more!


Other risks are related to the organization, such as:

  • Lack of policies and employee training for recognizing and managing hostile and assaultive behaviors from patients, clients, visitors, or staff;
  • Understaffing and high turnover;
  • Inadequate security and mental health personnel on site;
  • Long waits for patients or clients and overcrowded, uncomfortable waiting rooms;
  • Unrestricted movement of the public in clinics and hospitals; and
  • A perception that violence is tolerated and victims will not be able to report the incident.

Need to assess other types of risks? You’ll find the guidance you need at Safety.BLR.com®.

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