Categry: HUMAN RESOURCES Subject/Title: Preventing Vilence in the Wrkplace Reference Number: HR_008 Apprved by: Executive Leaders Cuncil Effective Date: Nvember 14, 2008 Last Revised: December 1, 2011 Last Reviewed, but nt amended, by Wrkplace Health: June 5, 2013 1. Purpse The Prvincial Health Services Authrity (PHSA) and its Agencies (hereafter cllectively referred t as the PHSA) are cmmitted t prmting a safe, healthy and vilence-free wrkplace. The purpse f this plicy is t ensure that all reasnable steps are taken t identify, prevent and manage the risks t the persnal safety f PHSA staff, clients, and the public frm vilence in the wrkplace and that apprpriate actin is cnsistently taken t prtect all persns frm the effects f vilent behaviur. All healthcare services must have in place a Vilence Preventin Prgram (VPP) that fcuses n the preventin f vilent behaviur. Where the risks cannt be eliminated, they must be reduced t the lwest pssible level using cntrl measures develped in cnsultatin with staff and the apprpriate Jint Occupatinal Health and Safety Cmmittee (JOHSC). This plicy utlines vilence preventin respnsibilities fr the PHSA. Agencies and wrkplaces within the PHSA shuld develp their wn site-specific prcedures t meet the requirements f this plicy. 2. Scpe This plicy applies t all persns accessing the PHSA facilities, including emplyees, students, fellws, medical staff, physicians, residents, vlunteers, suppliers, cntractrs, visitrs, clients and emplyees f academic institutins in partnership with the PHSA. 3. Definitin f Vilence Vilence, as used in this plicy, means any incident(s) where persns are abused, threatened, harassed, stalked, r assaulted (including sexual assault) in circumstances related t their wrk, invlving a direct r indirect challenge t their safety, well being r health, which gives a persn reasnable cause t believe that they are at risk f injury. The term vilence, as used in this plicy, cvers: Vilent behaviur that is intentinal and Page 1 f 7
Vilent behaviur that is nt intentinal, due t injury r illness, including a psychiatric cnditin, i.e., the aggressr lacks the mental capacity t demnstrate intent. This behaviur is ften called aggressin. 4. Other Definitins Used in this Plicy Client: Critical Incident Stress Management (CISM): Critical Incident Stress: Cde White: Facility: Nn-Vilent Crisis Management System: Public: Risk Assessment: includes residents, patients and persns in care in PHSA facilities and/r prgrams. includes pre-incident educatin and pst-incident supprt systems such as Critical Incident Stress Defusing/Debriefing (CISD) ffered t supprt staff affected r ptentially affected by wrkplace vilence. any situatin faced by staff which causes them t experience unusually strng emtinal reactins and which has the ptential t interfere with their ability t functin, either at the scene r later. a crdinated team respnse t deal with unreslved threatening r vilent behaviur buildings and grunds f any PHSA hspital, residential care facility, health centre and any ther PHSA wrkplace. a nn-vilent, nn-harmful behaviur management system designed t prvide the best pssible care and safety f vilent persns, while ensuring safety f staff and/r thers. includes any nn-staff/nn-client while that persn is in a PHSA facility r n PHSA prperty. a step by step prcess t review a wrk site and wrk prcesses t determine what vilence preventin measures are in place, t identify ptentially hazardus cnditins, peratins, activities and situatins that culd cntribute t wrkplace vilence and t determine the risk f future aggressive r vilent incidents using the infrmatin gathered and t recmmend crrective actins t eliminate r mitigate risks identified. Staff: includes PHSA emplyees, managers, physicians, and ther healthcare prfessinals, cntractrs (cntract cmpanies will be expected t have their wn plicies in place as per legislatin), students, and vlunteers, while engaged in a PHSA wrk activity. Vilence Preventin Prgram (VPP): Wrkplace: includes an verall vilence preventin plicy, written plicies, prcedures and practices t eliminate r minimize risks f vilence, educatin and training, incident respnse, a cmmunicatin plan, risk assessment and regular review and revisin. means any place where a wrker is r is likely t be engaged in any wrk and includes any vessel, vehicle r mbile equipment used by a wrker in wrk (Wrkers Cmpensatin Act, Part 3, Div. 1, Sec. 106) Page 2 f 7
5. Statement f Philsphy All PHSA staff have the right t wrk in a vilence-free wrkplace. Patients and thers have the right t visit r receive health care in a therapeutic envirnment free frm risks t their persnal safety. This right extends t all areas where staff wrk, including the cmmunity. The plicy includes effective risk management, and at all times the fcus f activity must be n preventin. Hwever, when a vilent incident des ccur, actin must be taken t minimize its impact and prevent its recurrence as far as pssible, regardless f its surce. When vilent behaviur is a direct result f injury r illness, including a psychiatric cnditin, the emplyer will prvide prmpt, effective clinical management and cmpassinate care, while at the same time prtecting the safety f staff and thers wh may be affected. The PHSA is cmmitted t prviding a safe envirnment fr staff, clients, and the public and will supprt this cmmitment by develping, implementing, mnitring, and evaluating initiatives in supprt f this plicy. All staff, clients, and the public are expected t cnduct themselves in a manner which respects the rights f thers at all times. 6. Targeted Vilence All PHSA facilities must plan fr the unique safety and security requirements f clients and staff wh are the targets f vilence frm an abusive spuse. T apprpriately address the safety f clients and staff wh are at risk f targeted vilence, staff must have current knwledge and understanding f the safety, security and privacy needs f persns experiencing abuse. Clients r staff at high risk fr targeted vilence will include, but nt be limited t, anyne wh is in pssessin f a restraining rder. In cases where this infrmatin is knwn r made knwn t PHSA clinicians, managers r supervisrs, steps will be taken t wrk with the client/staff member t develp a wrkplace plan fr client/staff safety. 7. Respnding t Vilence PHSA utilizes a nn-vilent crisis management system t prevent and manage vilent behaviur. Restraint shuld be used nly as a last resrt where ther interventins have been unsuccessful. Staff will respnd t incidents f vilence using ne r mre f the fllwing interventin methds as apprpriate: nn-vilent crisis management techniques, e.g., nn-verbal/verbal de-escalatin a Cde White r multidisciplinary team apprach supprt f site based cntracted security services escalatin t 911 r ther lcal emergency respnse grup if required All incidents f vilence must be reprted t the respnsible manager/supervisr and be dcumented. Prcedures will be develped at the site level t reflect its needs and circumstances. Page 3 f 7
8. Supprt Any threat r act f vilence against persns r staff, arising ut f, r in the curse f, their duties, is nt acceptable and measures will be taken t hld persns accuntable fr their actins up t and including the pursuit f criminal charges. If the persn cmmitting the threatening r vilent act is a staff member, apprpriate prgressive disciplinary actins culd be taken, up t and including terminatin f emplyment r privileges. In circumstances where emplyees feel threatened by the immediate risk f wrkplace vilence, they may invke OHS Regulatin 3.12 (WrkSafeBC, refusal f unsafe wrk) t initiate an investigatin f the situatin. The PHSA will supprt the wrk refusal prcess. Where emplyees wrk alne r in islatin, the PHSA shall implement a wrking alne prgram. The PHSA cmmits t minimizing the risk f vilence by prmting: wrkplace safety fr staff. plicies that ensure staff are prvided infrmatin and training n fllwing safety practices and preventing and respnding t vilent incidents. the empwerment f staff t make and act n decisins regarding risk f vilence. the establishment f written practices t identify and address risks fr each wrksite using input frm all wrksite staff. a prgram which ensures critical incident stress management (CISM), pre-incident educatin and pst-incident supprt systems (e.g. defusing/debriefing) are in place and ffered t supprt staff affected r ptentially affected by wrkplace vilence. a Vilence Preventin Prgram (VPP) that, as a minimum, cmplies with WrkSafeBC Occupatinal Health & Safety regulatins, the Wrkers Cmpensatin Act and the applicable cllective agreement(s). safety fr clients and the public in PHSA wrkplaces by develping apprpriate prgrams in supprt f the brader mandate f the Ministry f Health Plicy Cmmuniqué 2005-01. 9. Accuntability All PHSA and Agency staff have respnsibilities regarding the preventin f vilence in the wrkplace. 9.1 Senir Administratin Ensures the prvisin f a Vilence Preventin Prgram (VPP) including plicies, practice standards and prcedures fr dealing with wrkplace vilence. Ensures that directrs, managers and supervisrs are aware f VPP requirements. Prvides resurces and supprt fr the Vilence Preventin Prgram including supprt fr the Vilence Preventin Advisry Cmmittee (VPAC). Prvides resurces and supprt fr persnal, administrative and envirnmental cntrls, including educatin and training f emplyees and respnders. Supprts brad and widespread cmmunicatin related t the Vilence Preventin Prgram. Page 4 f 7
9.2 Managers & Supervisrs Ensure identificatin f risks fr vilence, risk assessment and cntrls are in place fr their wrk area. Infrm staff f any risks due t vilence in their wrk area. Ensure that wrk area specific (as required) VPP prcedures are develped and cmmunicated t staff. Ensure staff are aware and understand that vilence shuld nt be accepted as part f the jb. Ensure evidence-based training and educatin is prvided t staff, including requirements fr new staff. Ensure incidents f vilence are reprted, investigated and any necessary crrective measures are implemented and mnitred fr effectiveness. Ensure staff are infrmed f and able t access resurces available t them after experiencing an incident f vilence, including instructing staff t seek First Aid services advising staff t cnsult a physician fr treatment and/r referral referring staff t Critical Incident Stress Management (CISM) services referring staff t the Emplyee and Family Assistance Plan (EFAP), if available. Prvide supprt t staff wh wish t pursue criminal charges against the perpetratr if they are injured/harmed as a result f incidents f vilence. Regularly review the Vilence Preventin Prgram (VPP) t ensure its effectiveness in eliminating and minimizing risks fr their prgram areas. 9.3 Staff Fllw plicies and prcedures created in accrdance with the requirements f the Vilence Preventin Prgram (VPP). Participate in training/educatin activities t ensure awareness and understanding f the Vilence Preventin Prgram, including the recgnitin f risk factrs, and the management f threats/incidents f vilence. Reprt all acts f vilence, including any activity that has a ptential fr vilence, t the manager/supervisr and cmplete relevant dcumentatin. Cntact the Wrkplace Health Call Centre (1-866-922-9464) t reprt injuries r incidents related t vilence r aggressive behaviur Seek first aid if injured. Access CISM and Emplyee and Family Assistance (EFAP) services where apprpriate. Participate and cperate in accident/incident investigatins. Prvide input int the risk assessment prcess. Fllw the wrk refusal prcess where wrk is perceived t create a risk f vilence (WrkSafeBC, OHSR 3.12, refusal f unsafe wrk). 9.4 Jint Occupatinal Health & Safety (JOHS) Cmmittees Page 5 f 7
Make written recmmendatins t the emplyer regarding vilence preventin. Participate in the risk assessment prcess, including measures t prtect staff. Review incident statistics n a regular basis and make recmmendatins and develp actin plans as needed. Evaluate the nging effectiveness f the Vilence Preventin Prgram (VPP) t include site/prgram specific plicies and prcedures and prvide critical feedback t the apprpriate emplyer representative. Participate in a lcal, annual evaluatin f the VPP with the Vilence Preventin Advisry Cmmittee (VPAC). Advise managers and supervisrs regarding lcal training needs. Participate as required, and ensure apprpriate incident investigatins and wrkplace inspectins are carried ut. 9.5 PHSA Vilence Preventin Advisry Cmmittee (VPAC) Prvide recmmendatins t the PHSA Senir Administratin regarding vilence preventin. Prvide guidance and directin t JOHS Cmmittees and management fr wrkplace Vilence Preventin Prgrams within the PHSA wrksites. Mnitr and evaluate the prgress f wrkplace Vilence Preventin Prgrams in the PHSA using evidence-based practices. Prvide guidance fr staff educatin and training. Cmmit t attend VPAC meetings and prvide cnstructive feedback n prgrams t address preventin f wrkplace vilence. 9.6 Safety & Preventin, Wrkplace Health Prvide Crprate supprt t the verall PHSA Vilence Preventin Prgram (VPP). Mnitr and evaluate the wrkplace Vilence Preventin Prgrams in the PHSA alng with JOHS Cmmittees and the VPAC t ensure that they remain effective and cntinue t cmply with all relevant legislatin and plicy requirements. Prvide advice and guidelines t managers and staff t assist with cmpliance with VPP requirements. Prvide supprt and advice t the VPAC and JOHS Cmmittees regarding vilence preventin issues. Prvide statistical infrmatin n vilent incidents against staff t JOHS Cmmittees fr review. Ensure the delivery f apprpriate training and educatin prgrams fr all staff in cllabratin with agency-specific learning and develpment departments. 9.7 Integrated Prtectin Services Supprts PHSA Vilence Preventin Prgram (VPP) in cnjunctin with Wrkplace Health Page 6 f 7
Ensures cntracted security persnal are trained in nn-vilent crisis interventin principles and techniques Ensures that cntracted security persnnel deplyed at PHSA sites respnd STAT t all aggressive/vilent incidents. Prvides statistical infrmatin n aggressive incidents t JOSH cmmittees fr review. Assists in the evaluatin f the VPP prgram annually in cnjunctin with Wrkplace Health and JOSH cmmittees. Assists emplyees/physicians wh with t pursue legal actin after an aggressive incident. 10. References 1. Wrkers Cmpensatin Bard f BC (1999), Occupatinal Health and Safety Regulatin, Part 4, Wrking Alne, Wrkplace Cnduct and Vilence in the Wrkplace regulatins: Sectins 4.21 4.23, 4.24 4.26, 4.27 4.31 2. BC Ministry f Health Plicy Cmmuniqué #2005-01 Octber 31, 2005 Preventin and Management f Aggressin and Vilence in the BC Health Care System 3. Preventing Vilence in Healthcare Five Steps t an Effective Prgram, Wrkers Cmpensatin Bard, 2000 4. Guidelines: Cde White Respnse, A Cmpnent f Preventin and Management f Aggressive Behaviur in Healthcare, Health Assciatin f BC, WCB, OHSAH, 1999 5 Elements f a Best Practice Vilence Preventin Prgram fr BC Healthcare, Prvincial Vilence Preventin Steering Cmmittee, OHSAH, 2008 6. PHSA Respectful Wrkplace Plicy, Oct. 11, 2005 7. PHSA Emplyee Wellness and Safety Plicy, 2005 8. PHSA Security and Prtectin Services brchure 9. Fraser Health Authrity Preventin and Management f Aggressive Behaviur Plicy April, 2006 10. Vancuver Castal Health Wrkplace Vilence Preventin Plicy, Nv. 14, 2006 11. Interir Health Preventin and Management f Aggressin & Vilence t Others, Draft, May 23, 2008 Page 7 f 7