Personnel Safety, Regulatory Developments

Joint Commission Issues New Workplace Violence Standards

The Joint Commission, which oversees accreditation of hospitals and other healthcare facilities, issued new and revised workplace violence standards that take effect January 1, 2022. The workplace violence prevention standards will apply to all Joint Commission-accredited hospitals and critical access hospitals.

The Centers for Medicare & Medicaid Services and many states, along with private insurers, only reimburse services performed at healthcare facilities accredited by the Joint Commission or another accreditation organization.

According to The Joint Commission, 73% of nonfatal workplace injuries and illnesses causing days of missed work in health care are connected to workplace violence. Because incidents of workplace violence may be underreported, the actual figure is probably much higher, the group said in an August 9 blog post. Healthcare worker exposure to workplace violence can lead to absenteeism, high turnover and higher costs, ineffective patient care, job dissatisfaction, and psychological distress.

The standards include a new definition of workplace violence as “an act or threat occurring at the workplace that can include any of the following: verbal, nonverbal, written, or physical aggression; threatening, intimidating, harassing, or humiliating words or actions; bullying; sabotage; sexual harassment; physical assaults; or other behaviors of concern involving staff, licensed practitioners, patients, or visitors.”

The new requirements establish a framework for hospitals and critical care hospitals in the following:

  • Managing safety and security risks: conducting an annual worksite analysis related to the facility’s workplace violence prevention program and taking actions to mitigate or resolve the workplace violence safety and security risks based on findings from the analysis;
  • Collecting information to monitor conditions in the facility’s environment: injuries to patients and others within the facility, occupational illnesses and staff injuries, incidents of property damage, safety and security incidents such as workplace violence, fire safety management problems, medical or laboratory equipment problems, and problems with utility systems;
  • Ongoing staff education and training at the time of hire, annually, and whenever changes are made to the workplace violence prevention program to include education, training and other resources in workplace violence recognition, response, and reporting; and
  • Leadership to create and maintain a culture of safety and quality throughout the hospital, including policies and procedures to prevent and respond to workplace violence; a process for reporting incidents in order to analyze incidents and trends; a process for follow-up and support for victims and witnesses affected by workplace violence, such as trauma and psychological counseling, if necessary; and a procedure for reporting workplace violence incidents to the hospital’s governing body.

The Department of Labor recently announced Occupational Safety and Health Administration (OSHA) plans for a Small Business Regulatory Enforcement Fairness Act (SBREFA) review of a rulemaking for workplace violence prevention in health care and social assistance. There currently is no federal workplace violence standard, but the agency has cited employers under the General Duty Clause §5(a)(1) of the Occupational Safety and Health Act following incidents of workplace violence.

The agency issued voluntary guidelines in 1996 for health care and social assistance and issued a request for information in December 2016 from healthcare employers, workers, and subject matter experts on the impacts of violence, prevention strategies, and other information about a possible federal standard. On January 10, 2017, the National Nurses United petitioned OSHA for a federal standard.