Tag Archives: workplace violence

Taking Aim at Workplace Violence

Workplace violence can happen any time and anywhere. This session at the RIMS 2019 Annual Conference & Exhibition reviewed a spectrum of workplace violence risk management tactics, including red flags that can foreshadow an event and training on what to do if an event does occur.

Speakers included:

  • Dr. Teresa Bartlett, senior vice president, medical quality, Sedgwick
  • David Rydeen, senior director, risk management, Raising Cane’s Chicken Fingers
  • Officer Chris Perez, Brockton Police Department

Workplace violence can stem from a variety of issues. Domestic disputes, mental health issues, drug abuse issues, disgruntled employees and racism are all drivers. OSHA reports that 2 million incidents occur each year, many of which (non-fatal incidents like bullying or harassment) go unreported.

Robbery-related homicides and assaults are the leading cause of losses in retail. In this setting, there are tactics to help. For instance, post clear signs that there is limited cash on hand/surveillance cameras in use, maintain an unobstructed view of and from the cash register and sales area and create and train on a clear policy as to what to do in case of an event.

Approximately 70% of attacks occur within the healthcare industry. Train your staff so they know what to do. Frequently involve police and first responders in that training. It is important to have protocols in place when events escalate and train on de-escalation skills.

See also: Workplace Violence: Assessment, Response  

Whatever the industry, it is important to know the warning signs. A mishandled termination or other disciplinary actions are often triggers. Know that you are not required to call someone in to work to terminate the person. Also be aware of weapons on the work site. Listen for motivations. If someone is suicidal, the person probably will not have problems hurting others. Drug or alcohol use on the job is also a red flag.

Try to be aware of employees’ personal circumstances. Your management really is the front-line defense and must be consistent and present. Family conflicts, financial or legal problems and emotional disturbance can all indicate problems. Gently address any noticed changes in a non-threatening way. Start with, “Your energy is different today. Is everything OK?”

Other behaviors to look for are:

  • Increasing belligerence
  • Ominous, specific threats
  • Hypersensitivity to criticism
  • Recent acquisition or fascination with weapons
  • Apparent obsession with a supervisor or coworker or employee grievance
  • Preoccupation with violent themes or interest in recently publicized violent events
  • Outbursts of anger

Know your resources. Meet with local city and country law enforcement in preparation of an emergency. Invite them to your building for a tour. Provide architectural diagrams of the site and make them aware of emergency routes and all entrances/exits.

See also: Broader Approach to Workplace Violence  

Risk managers must focus on designing a customized approach that matches the goals of their organization. Use clinical resources such as mental health professionals and nurses and look to umbrella policies for planning assistance. Plan for post-event strategies, including crisis management companies to meet with witnesses and a plan for HR to go to the homes of those affected and cannot return to work immediately.

Dealing with the aftermath is extremely important, especially for survivors. A variety of PTSD-related conditions can lead to a variety of mental health implications for employees. Access to psychological help will be essential. There are also return-to-work strategies that will need to be applied, including gradual exposure therapy or possibly assigning an employee to a job in a different department. All of these strategies are geared at proving that it is safe to return.

Workplace Violence: Assessment, Response

Workplace violence is a daily threat to workers in many industries. Aside from mass shootings, which grab headlines, more than 2 million workers are victims of violence every year.

The issue is a challenge for employers striving to maintain a safe working environment for their employees. By understanding the scope of the problem, the underlying reasons for violence and the types of violence that threaten specific industries and workplaces, organizations can make a significant impact on reducing incidents against their workers.

During a recent “Out Front Ideas with Kimberly and Mark” webinar, we had two prominent experts join us to discuss this very challenging issue:

  • Bub Durand, practice leader of medical group support services for Kaiser Permanente’s Northern California region
  • George Vergolias, PsyD, vice president and medical director for R3 Continuum

Scope of the Problem

OSHA defines violence as any act or threat of physical violence, harassment, intimidation or other threatening disruptive behavior that occurs at the work site. That includes everything from threats and verbal abuse to physical assaults and even homicide.

Many employers, however, are wary of even discussing the issue out of concern that people will view their particular companies as being overly violent. In fact, several potential speakers in retail and other industries we approached to join our panel declined for this very reason.

Despite their reluctance, we know that the workplace has increasingly become the site of violence, especially in certain industries.

Healthcare

Healthcare is the industry that generates more attention than any other with regard to violence – and with good reason. The most recent government statistics show there are 7.8 cases of serious violence per 10,000 employees, which far exceeds any other industry, and that number is likely much lower than the reality.

Many healthcare facilities, especially in high-risk areas such as emergency departments and Level I trauma centers, are routinely the sites of violent outbursts. Patients or their families attack providers all too frequently. Many of these workers have come to believe violence is just part of the job. Unfortunately, those in a position to change this often foster that culture. We may soon see an increase in the numbers of incidents reported, due to mandates for increased reporting, especially in California.

Schools

Mass shootings at schools have been getting lots of attention. However, not talked about is the fact that schools are increasingly the site of daily violence or threats by students against teachers and staff.

For example, one of the nation’s largest school districts reported a 10% increase in violence-related claims in the past five years. With incurred losses of $19 million, these claims represented 15% of the total and 12% of the system’s incurred losses. The numbers do not include many of the threats and harassment incidents, which often go unreported.

One reason for the increased number of violent incidents reported in schools may be the increased awareness of the issue and the potential for remedies, both legal and administrative. Another is the implementation of zero-tolerance policies that require or strongly recommend reporting. One more is the increase in kids acting on their emotions, more so than they did in past years.

Overall, workplaces have seen an uptick in homicide rates in recent years, even though the rate in the general population has decreased. Some experts speculate that may be due to increased stresses facing workers, such as financial pressures.

Social media may play a role in increased violence in the workplace, because it seems to empower some people to act in ways they normally would not. This sometimes spills over into real-world, face-to-face situations.

On a positive note, efforts to reduce violence in the workplace are paying off. While homicides among government employees increased 30% between 2003 and 2013, the rate decreased 30% in the private sector.

See also: Broader Approach to Workplace Violence  

Types of Violence

Developing violence-prevention programs requires knowing the type(s) of violence to determine the best approach. For example, gender may be part of the equation. Men are more likely to be killed at work during robberies, especially in retail establishments, while women are more likely to be victims of domestic violence.

Domestic violence is one category that is often not adequately addressed in the workplace. Many employers believe that, because the potential perpetrator is not an employee, he is not a threat to the workplace. Statistically, it is a very real problem that should be considered and included in violence prevention plans.

In fact, violence can be initiated internally or externally. It may be started by an employee within the company, or externally by a customer, former employee, vendor or someone connected with an employee.

There are also emotional vs. predatory incidents of violence. Knowing what drives each incident category is important to help prevent it.

  • Emotional violence generally occurs as a reaction to a threat or fear. An example would be two boys ready to duke it out in school. Neither actually wants to fight, but they also do not want to be humiliated, so they pretend they are ready. Diffusing this situation can be done by intervening and stopping both of them equally.
  • Predatory violence involves forethought, rather than being reactionary. A sniper is an example of predatory violence. Preventing these situations is much more complex.

Temporary States vs. Emotional Traits

Some attacks occur because the person is temporarily in a highly emotional state. It could be an emotional reaction, a psychotic episode or a drug-induced state. A permanent trait, on the other hand, means the person has a personality factor that is driving him to act in a demeaning or abusive manner. Those traits are more consistent and predictable over time.

An example of someone in a temporary state would be a father who has just been told his wife was killed and his child is in surgery following an auto accident, and he speaks very little English. His inability to fully communicate, and his efforts to see his son in the emergency room, could easily lead to a violent outburst. Security personnel might be inclined to handcuff the man, per protocol. However, such a situation can be diffused by understanding why he is acting the way he is and getting a language interpreter to speak with him calmly.

It is important to understand the context of the violence and not assign permanent traits to someone who is only in a temporary state. That can sometimes be tricky, especially if a zero-tolerance policy is in effect and mandates that security personnel handcuff any violent perpetrator. If someone is acting out in hostility, especially if it is atypical behavior for that person, asking questions can help prevent an incident. This can be especially effective in the case of students at school; pulling the person aside to find out what is driving his actions is often effective.

Assessing the Risk
There are many ways to determine the types and levels of risk to an organization.

  • Traditional assessment. One approach includes a traditional security risk assessment of the grounds, the physical security environment and the security practices and policies, using specific metrics and historical performance of law enforcement and risks in the local community as factors.
  • High-risk area assessment. As Bob explained, a new California law addressing workplace violence in healthcare has led Kaiser Permanente to conduct additional assessments of its facilities. One involves looking at high-risk areas, such as emergency rooms. The type of risks present there could include family members worried about patients who have been brought in, or patients left waiting because their injuries are not life-threatening, and they become impatient and agitated. These assessments look at the safety and physical security practices along with engineering controls.
  • Administrative and workplace controls. These focus on ways to distinguish employees from visitors. Kaiser Permanente, for example, requires workers to wear ID security badges from the waist up.
  • Employees’ knowledge. Part of assessing risk is to determine whether staff members know what to do at the first sign of a threat; do they know the security code to call, and what to expect as a response? Employees also are assessed to make sure they understand they may sometimes have to call in outside law enforcement and must know how to do that.
  • Physical layouts. A patient who presents a danger to himself and is brought in involuntarily needs to be placed in a safe room. The assessment would look for any dangerous objects in the area the person could use to injure himself. Staff members are quizzed to ensure they understand what needs to be removed from such an area.
  • Remote worker assessment. Many healthcare or hospice workers go to an offsite home or other location. Because the risks are often unknown in those environments, employees need to understand what to do. For example, the worker could ask whether there are any firearms in the home.

It is also important to assess both safety and security because they are different. Security would include a door in a particular location of the facility that serves as an exit, that visitors cannot enter. However, a worker who props the door open, even briefly, defeats the purpose. Employers need to promote a culture of safety within their organizations, as well enhancing security.

See also: New Idea for Active Shooter Incidents  

Training

The best workplace violence policies mean nothing if people are not trained on them. Employees need to clearly understand what to do in a given situation. Training should be conducted at least annually and with any new hires, and employees should be given competence testing regularly. Staff members need to be clear on the expectations of security personnel or they increase their own risk of becoming victims of violence. Proper training also improves legal defensibility.

An important point to emphasize in training is to examine the threats to each particular work site and each specific area of a work site. While the same policy may apply, there may be different priorities depending on the risks and the employees. A one-size-fits-all approach should be avoided.

It is also important for the trainer to understand what the policy says before starting the training. A zero-tolerance policy is different from others. Unfortunately, some companies seek training before a policy is fully developed.

In addition to training staff on policies, management must adhere to it. Otherwise, they risk creating a toxic work environment if someone reports a concern that is ignored.

The trainer needs an adequate amount of time to perform effective training. It is imperative to make sure employees fully understand the policies and procedures.

Threat Responses

There are a variety of ways for employees to mitigate violent threats in the workplace:

  • Be aware. Being aware of the surroundings, how the worker is feeling and how the other person is feeling is important. The other person is likely feeling agitated, so the worker must be able to stay composed.
  • Understand/do not judge. Where possible, engaging the person can prevent a violent incident. Workers can try to find something they like or have in common with the person.
  • Explain the consequences and alternatives. Angry people are not thinking clearly. Nor are they thinking about how actions will affect their lives or families. Calmly explaining the ramifications can help.
  • Change the tone of voice. Speaking calmly to an agitated person may help reduce his anxiety.
  • Avoid provoking. Telling the person to “just calm down” could make him more angry.

The goal is to help redirect the person so he slows down and begins to think more clearly.

Who Is to Blame on Oklahoma Option?

I’ve been highly critical of the Oklahoma Option, the alternative workers’ compensation system that was recently found to be unconstitutional by that state’s Workers’ Compensation Commission. I’ve been critical of the backers of the system, as well as the employers that willingly set up plans in this closed and tightly controlled scheme. And while I’ve questioned how the Oklahoma Insurance Department, headed by Commissioner John Doak, could have approved plans so obviously deficient in comparison to those in the workers’ compensation system, I’ve never accused commissiioners of being otherwise involved. I just assumed it was stupidity, incompetence or slothfulness that allowed plans, required to provide benefits that are “equal to or better” than those provided under the workers’ comp laws of the state, to be approved for use when they were ultimately substandard.

That all changed last week, during the second opt-out session held during the 32nd WCRI Annual Issues & Research Conference. The speaker who changed my point of view was James Mills, director of workers’ compensation and captive insurance at the Oklahoma Insurance Department. Mills went on at length about how proud they were at OID to have developed a “powerful system with options” for employers in their state. I do not recall his mentioning that those options have been found to discriminate against their employees, and were therefore unconstitutional. He did not address that at all. In fact, he spoke so positively about Opt Out that he sounded to me just like the concept’s biggest promoter, Dallas attorney Bill Minick. He was just like Minick’s mini-me, or a mini-Minick, if you will. It became apparent from his presentation that the OID approvals were not borne of incompetence; no, the agency was instead directly culpable in the development and promotion of a scheme that creates discriminatory sub-classes of employees in the state.

See Also: Strategic Implications of the Oklahoma Option

Mini-Minick did not explain how plans that have draconian reporting requirements (most require an incident be reported in 24 hours or less, or all benefits may be denied) got approved when the state system allows for 30 days. He did not explain how plans that exclude a wide variety of injuries or conditions, like asbestos exposure or workplace violence, could be approved when the state system covers them. He did not explain how plans that do not even let an employee testify at an appeal of his denial could get by the OID. Frankly, there are many areas where the alternative plans come up short when compared with the state system, and mini-Minick didn’t explain any of them. He simply touted the OID’s desire to work to preserve these options for employers.

Clearly, Commissioner Doak appears to be a healthy proponent of the Oklahoma Option. This made clear to me why plans that have left everyone around the nation scratching their heads got approved in the first place. Of course, not every action may be intentional. There is obviously room for a little incompetence, as well. This is, after all the same insurance department that in 2012 issued an email announcement that an Insurance Commissioners Award for Tornado Awareness would be given to “the girl with the biggest [breasts].” (Seriously. Click here to read about it if you doubt me). Pesky details like proofreading emails or comparing benefit levels don’t appear to be a top priority in Doak’s department.

I suppose it is appropriate the agency is run by a man whose last name rhymes with the sound Homer Simpson makes when he is completely flummoxed.

I was speaking with some people at WCRI the morning following mini-Minick’s session when this topic came up. One of the people pointed out how employers always take the blame in situations like this, but that what they were doing was approved and legal. The problem was the legislative and regulatory environment that created the system to begin with. There is validity in that view, although the employers still should be held to account for the plans they adopted. “Because I could” was never an excuse that worked for me when I was in trouble as a child, and I suspect it will not be widely accepted in the public eye today (unless, maybe, you are Donald Trump, but that is another topic entirely).

See Also: The State of Workers’ Comp in 2016

For the failures of the Oklahoma Option, there is plenty of blame to go around, but a good deal of it apparently lies with the folks charged with watching the hen house. And it does not sound as though they understand their mistakes, which means they are likely destined to repeat them.

Broader Approach to Workplace Violence

With the recent terrorist attack in San Bernardino, CA, fresh on people’s minds, workplace violence has received major media coverage, but little to no attention is paid to deaths by suicide even though rates in the U.S. have gone up considerably in recent years. Suicides claim an average of 36,000 lives annually, and, while most people take their lives in or near home, suicide on the job is also increasing.

The Bureau of Labor Statistics reported that workplace suicides rose to 282 in 2013, the highest level since the numbers have been reported. In 2014, the suicide rate went down slightly to 271, but that is still the second highest level. The annual average number of suicides deaths that occurred at work during the time period 2003 – 2014 is 237, for a total of 2,848. Since 2007, the numbers have been above the average.

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Source: U.S. Department of Labor, Bureau of Labor Statistics, Census of Fatal Occupational Injuries

The rise in suicide rates at work is even more significant given that overall homicides in the workplace have been steadily decreasing since the mid-’90s.

The obvious question is: Why is this startling rise in suicide rates at work occurring?

“The reasons for suicide are complex, no matter where they take place,” said Christine Montier, CMO of the American Foundation for Suicide Prevention. “Usually, many factors are at play.”

Many suicide prevention experts linked the increase in one way or another to the Great Recession. I believe the recession played a major role because it put a triple whammy on people. Housing, which has traditionally been the major investment and retirement source for Americans, was in the toilet. Foreclosures were at an all-time high. Companies were laying off people, and job prospects were slim.

I believe that many working people experienced daily stress about employment. Every day, they might be laid off. Many were severely overworked because they needed to pick up the slack caused by reductions in workforces. They faced continuous fear of taking time off for vacations or illness and had few options to leave because jobs elsewhere were scarce.

Put all these issues in the pot together, and some people could not see their way out of their dilemma except through suicide.

Researchers in a study published by the American Journal of Preventive Medicine suspect that suicides occur at work because the perpetrators wanted to protect family and friends from discovering their bodies.

In the midst of the fear of terrorist attacks and active shooting incidents, organizations are significantly challenged in how to deal with the spectrum of violence they may face. However, it is critical that organizations not shy away from addressing these issues and muster the resources to engage their employees.

Managers need clear guidelines on healthy approaches to manage and prevent violence in the multiple forms it can take. Two industries that have taken the issue of suicides at work head-on are construction and law enforcement.

What can management do?

Promote awareness

Stop thinking and acting like “it couldn’t happen at your company.Provide regular communications through the channels that are most effective in your company regarding the potential warning signs that employees or others are at risk of acting in a violent manner. See a list of the classic early warning signs of workplace violence here. Many of the signs are also telltale signs symptoms of depression and suicidal behavior.

Sally Spencer-Thomas, Psy.D., co-founder of Working Minds, a Colorado-based workplace-suicide-prevention organization, described a giveaway that’s more obvious than one might suspect: The employee will tell you.

When contemplating suicide, a person can be entirely consumed by the thought, she said. The problem may be coded in conversation—the individual may talk about death often, for instance.

As uncomfortable as it may seem, it’s important to bite the bullet and ask the awkward questions. “It is very hard to resist a human who is coming at you with compassion,” Spencer-Thomas observed. She suggests that HR professionals frame their questions in an understanding manner, giving the employee the opportunity to explain his or her condition. Statements such as, “I’ve noticed that …,” “It’s understandable given …,” and “I’m wondering if it’s true for you…” should be followed by a nonjudgmental statement.

Promote resources available to help employees

If your firm has an employee assistance program (EAP) or your healthcare provider offers counseling service, make sure that managers are trained about the program and skilled in how to make an effective employee referral. If your employee usage rates are below your industry average, you need to assess why and take action to increase usage. Talking to a professional counselor can make a big difference to a troubled employee.

If your firm does not offer an EAP, then identify community resources that can assist your employees and keep the list current.

HR should also have a strategy to deal with the devastating impact of a homicide or suicide at work.

I believe the time has come for executives to take a comprehensive approach to violence that occurs in the workplace and especially to bring mental health and suicide issues out of the closet into mainstream workplace conversations. We are past the point where organizations can think of suicide as a dirty little secret and hope it will go away. The time has come for meaningful action.

Don’t wait until something happens and people lose their lives. If you really mean that your employees are your most important asset, now is the time to step up.

How to Prevent Workplace Violence

Recent workplace and school shooting incidents underscore the importance of having comprehensive prevention and response policies and plans in place. We are finally coming to grips with the reality that workplaces are veritable lightning rods for violence.

In an article titled, “Business Continuity for Small Businesses,” Dr. Robert F. Hester said, “Safety, security and preparedness aren’t routinely a focus in our lives. Being on guard is not something Americans are used to or like doing. Still. . . the threat never goes away; only fades in memory.”

Workplace violence reflects employee perceptions of their workplaces and their personal issues. Workplaces are veritable lightning rods for violence. Our job is to minimize the risk through strategies and preparation.

Minimizing risks requires a critical assessment of your workplace security; prevention and response procedures; physical security measures; and administrative and operational policies.

Workplaces must appreciate that unhappy employees don’t wake up one morning consumed with getting even. They don’t! The escalation toward homicidal retaliation probably started months earlier, if not years, and the clues were missed or misunderstood. Supervisors need to examine work sites for autocratic supervision, toxic employees and criminal elements.

Sometimes, workplace policies create misunderstandings, when the workforce is taken for granted, and that can lead to conflict. Supervisors and managers need to intervene swiftly by monitoring and then communicating. They can show sensitivity to changes in family, medical, personal, financial and workplace relationships that are often exacerbated by workplace relationships.

Workplace violence prevention really requires a comprehensive view of workplaces and how best to integrate resources, collaborate on strategies and coordinate efforts. (Developing Your Comprehensive Workplace Violence Prevention Policy/Plan).

Workplaces must review their policies and plans annually and design the right atmosphere. Workplaces must be critical of their capabilities and limitations by asking tough questions. We must not allow convenience to dictate management’s decisions and attitudes. Employees (supervisors and managers alike) must be held accountable for inappropriate conduct as part of building credibility in violence prevention.

We must ask the following questions:

  • Do we understand the risks?
  • Are we responding properly?
  • Do we monitor and track incidents, situations and people?
  • How could an incident happen?
  • What did we miss that could have prevented the outcome through care, consideration and attentiveness?
  • What did we take for granted and why?
  • How do we interact or fail to intervene?

I ask that senior leaders begin a process today to assess their workplace settings to uncover hazards and resolve security gaps. Why wait to answer such questions tomorrow when posed by the media, OSHA or a jury?

Research shows that people delay because of:

  1. Denial about whether they have a problem;
  2. The resources required;
  3. A belief that they can simply terminate troubled employees;
  4. An inability to act quickly;
  5. Lack of staff and support;
  6. The cost of training;
  7. The expense of hiring a consultant.

But there is a need to be prepared for the when it happens rather than if it happens. The threat can come from a: current employee, former employee, disgruntled customer, client, patient or student, criminal or a domestic/intimate partner. I will not scare readers with immaterial statistics not specific to your respective workplaces at this point, but I will implore you to take immediate action to improve your workplace security.