It s not just part of the job. James Phillips MD BIDMC Emergency Medicine Harvard Medical School
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1 It s not just part of the job. James Phillips MD BIDMC Emergency Medicine Harvard Medical School
2 CME Information Physicians who participate in today s webinar are eligible to earn up to 1.0 AMA PRA Category 1 Credit This activity meets the criteria of the Massachusetts Board of Registration in Medicine for risk management credit. Other health professionals will receive a certificate of attendance Information on the evaluation and the CME certificate process will be given at the end of this presentation Only registered attendees will be able to receive CME credit
3 Workplace Violence Against Healthcare Workers in the US November 2, 2016 Summary of Disclosure Information The Department of Continuing Education and Certification (DCEC) of the Massachusetts Medical Society has determined that none of the individuals in a position to control the content of this CME activity, and/or their spouse/partner, have any relevant financial relationships with commercial interests to disclose.
4 Speaker Introduction James Phillips, MD Board Certified Emergency Medicine Physician at BIDMC Director, Counter Terrorism Medicine Program BIDMC Disaster Medicine Fellowship Instructor, Harvard Medical School
5 Workplace Violence in Healthcare What is Healthcare Workplace Violence? Is HWPV a significant problem? What can be done about HWPV?
6 Close to Home Rosenbaum L. Being like Mike - Fear, Trust, and the Tragic Death of Michael Davidson. N Engl J Med. February 2015
7 What is Workplace Violence?
8 How Bad Can It Really Be?
9
10 Assault Attack Harassment Emotional Assault Aggravated Assault Verbal Disrespect Verbal Assault Physical Threat Sexual Harassment Sexual Assault Sexual Battery Physical Assault Battery Assault with Deadly Weapon Assault on Protected Person
11 Getting the Word Out
12 Comparison to Other Industries
13 WPV in Non-Hospital Settings What are non-hospital medical settings?
14 WPV in Non-Hospital Settings What are non-hospital medical settings? Emergency Medical Services (EMS) Ambulatory Care Clinics Physician Offices Surgery and Procedures Centers Nursing Homes Home Health Programs
15 WPV in Hospital Settings Which settings are most violent? Which workers are targeted most frequently?
16 Type II Violence Against Physicians
17 Violence Against ED Residents
18 Type II Violence Against Physicians
19 Cause and Effect
20 Cause and Effect
21
22 Barriers to Reporting HWPV Underreporting is due in part to a health care culture that is resistant to the belief that providers are at risk for patient-initiated violence and to a complacency in thinking that violence is part of the job. McPhaul KM, Lipscomb JA. Workplace violence in health care: recognized but not regulated. Online J Issues Nursing 2004; 9: 7
23 Barriers to Reporting HWPV No reporting mechanism in place Reporting takes to long No follow up to reports because nobody cares Lack of police support Lack of administrative support Complacency Fear of retribution from supervisors Complexity of the legal system and court time Fear of reprisal from the assailant
24 You want fries with that? the current intense focus on customer service in health care serves as a deterrent to reporting workplace violence, since the concept of customer service results in the mentality that the customer is always right. Blando J, Ridenour M, Hartley D, Casteel C. Barriers to effective implementation of programs for the prevention of workplace violence in hospitals. Online J Issues Nurs 2015
25
26 Other Risk Factors
27 Firearms and Active Shooters
28 Metal Detectors
29 Lack of Training
30 What can be done?
31 What can be done? Clearly disseminated zero tolerance policy toward any form of violence Chart flags for violent patients Training in recognizing and managing potential and actual violence Management commitment and staff involvement Comprehensive follow-up for assaulted employees
32 What can be done? Visible security presence Visitor sign in and identification tag Secure entry doors and locked psych area Secure staff work areas Visible cameras Regular hazard vulnerability analysis (HVA)
33 let s discuss
34 Questions? James Phillips, disasterfellowship.org Thank You
35 Evaluation and Certificates Registered attendees will receive an from MMS within 5-7 business days with a link to the online evaluation After submitting the evaluation, attendees will be directed to the MMS CME Certificate Portal where physicians will receive CME credit; others will receive a certificate of attendance
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