Risk Management Tools & Resources


The Five Essential Elements of a Violence Prevention Program


Violence is a significant concern and an unfortunate reality in healthcare. The health sector accounts for about a quarter of all workplace violence, and healthcare and social service workers are five times more likely to be injured than other workers.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. Both managers/leaders and employees should be involved in developing and facilitating the organization’s workplace violence prevention program.
  2. Worksite analysis and hazard identification. 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 completing the worksite analysis and hazard identification, a team should review the findings and develop a response plan to address vulnerabilities. The plan might include simple or complex strategies, such as 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 prepare.
  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 ECRI 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.

For more information on this topic and other emergencies, see MedPro’s Risk Resources: Emergency Preparedness and Response.


1 Lim, M. C., Jeffree, M. S., Saupin, S. S., Giloi, N., & Lukman, K. A. (2022). Workplace violence in healthcare settings: The risk factors, implications and collaborative preventive measures. Annals of Medicine and Surgery, 78, 103727. doi: https://doi.org/10.1016/j.amsu.2022.103727

2 U.S. Department of Labor Occupational Safety and Health Administration. (2016). 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. Health System Risk Management Guidance. Retrieved from www.ecri.org/components/HRC/Pages/SafSec3.aspx

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