Risk Management Tools & Resources


The Five Essential Elements of a Violence Prevention Program

Violence is a significant concern and an unfortunate reality in healthcare. Incidents of serious workplace violence (those requiring days off for the injured worker to recuperate) are about four times more common in healthcare than in private industry.1 Violence can occur in any geographic location and any type of facility, and it can come from a variety of sources, including patients, visitors, healthcare providers, and staff members.

Because violence represents such a serious concern for healthcare organizations, developing and implementing strategies to address hostile and aggressive incidents is imperative. To support these efforts, the Occupational Safety & Health Administration (OSHA) developed Guidelines for Preventing Workplace Violence for Health Care and Social Service Workers. The guidelines offer five major elements of an effective workplace violence prevention program, which are as follows:


  1. Management commitment and worker participation. Teamwork is essential in a crisis situation. A well-trained team needs to be in place before an incident occurs so they are able to execute the plan effectively when needed.
  2. Worksite analysis. Worksite analysis consists of a methodical evaluation of the hazards within the environment. This can include hazards related to human factors as well as the physical building. Every facility has a unique set of hazards that should be addressed. Simply put, ask yourself “Where am I vulnerable?”
  3. Hazard prevention and control. After the worksite analysis is completed, a team should review the information and develop a response plan to address vulnerabilities. The plan might include fixing a broken lock, making staffing modifications, installing video surveillance, developing policies, educating staff, implementing drills, or even changing workflow patterns. Again, each facility is different — what works for one might not be appropriate for another.
  4. Safety and health training. All staff should be properly trained on the security measures developed for the facility. Staff members need to be familiar with their roles and have an opportunity to practice. Table top drills have some value in educating staff initially, but physically practicing with drill activity is where the most value lies. The goal is to save lives, and everyone needs to be prepared.
  5. Recordkeeping and program evaluation. Recordkeeping is an essential element of any business. Accurate recordkeeping allows your organization to stay on top of relevant issues. Whether it is incident reports, training history, or drill records, you need to have an accurate pulse on your facility to properly plan for the safety of your patients and staff. Program evaluation should be incorporated into the plan to capture the things you can improve on and the things you are doing well.2

Although healthcare workers cannot always anticipate violence, they may take comfort in knowing that a well-designed prevention plan is in place. As the ECRI Institute explains, “Although it is difficult to completely eliminate violence in healthcare settings . . . there are many ways to reduce the potential for violent occurrences and to minimize the impact if violence does occur.”3 Taking proactive steps to address violence reinforces the organization’s commitment to the safety and security of patients, employees, and visitors.


1 U.S. Department of Labor Occupational Safety and Health Administration. (n.d.). Workplace violence in healthcare: Understanding the challenge. Retrieved from www.osha.gov/Publications/OSHA3826.pdf

2 U.S. Department of Labor Occupational Safety and Health Administration. (2015). Guidelines for preventing workplace violence for health care & social service workers. Retrieved from www.osha.gov/Publications/osha3148.pdf

3 ECRI Institute. (2017, May). Violence in healthcare facilities. Healthcare Risk Control. www.ecri.org/components/HRC/Pages/SafSec3.aspx

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