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Workplace Violence · DOSH Policy Update Directive 5.07, updated January 2020 Added reference to...
Transcript of Workplace Violence · DOSH Policy Update Directive 5.07, updated January 2020 Added reference to...
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Workplace Violence
Healthcare law update and policyWSHSC, February 28, 2020
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Background
Jason Fodeman
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3Washington State Department of Labor & Industries
Incidence
▪ Between 2011 and 2013, work place violence caused 15,000-20,000 serious
injuries in health care workers yearly (require time away from work)
– Almost as many as in all other private industries combined
▪ In this same period, assaults accounted for:
– 10-11% of serious workplace injuries in health care
– 3% of serious workplace injuries in the private sector
▪ From 2002 to 2013 episodes of serious workplace violence in health care
and social assistance were on average four times more likely than in private
industry
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4Washington State Department of Labor & Industries
Incidence
▪ Widespread underreporting. Reporting rate for
– Nurses 30%
– Physicians 26%
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5Washington State Department of Labor & Industries
Incidence
▪ Violence against health care workers can happen in any setting– Psychiatric ward
– Emergency room
▪ The most common victims are– Nurses
– Nursing assistants
▪ Physicians are frequent victims
https://well.blogs.nytimes.com/2012/08/23/the-widespread-problem-of-doctor-burnout
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6Washington State Department of Labor & Industries
NEJM Review
▪ In 2016 the New England Journal of Medicine published a review on
violence against health care workers
▪ Most research has focused on
– Quantifying it
– Profiling and predicting perpetrators and victims
– Few studies on interventions to decrease violence
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7Washington State Department of Labor & Industries
NEJM Review
▪ The review highlighted several challenges and limitations in the
literature
– Data inconsistencies
– Different definitions of “violence”
– Significant underreporting
– Difficulty creating experimental models
▪ Limited research outside of the ER and psychiatric ward
▪ Literature review could not find a single peer-reviewed study
assessing the extent of the problem in outpatient medicine
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8Washington State Department of Labor & Industries
Impact
▪ Psychological consequences
• PTSD or PTSD symptoms
• Depression or depressive symptoms
• Anxiety
▪ Emotional consequences (anger, fear, guilt)
▪ Burnout
▪ Job dissatisfaction
▪ Low morale
▪ Diminished productivity
▪ Decreased organizational commitment
▪ Turnover
▪ Leave the profession
▪ Nonphysical violence can have a significant impact as well
www.statnews.com/2016/06/29/fighting-physician-burnout
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9Washington State Department of Labor & Industries
▪ OSHA, “Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers,” 2016, at
https://www.osha.gov/Publications/osha3148.pdf
▪ OSHA, “Caring for our Caregivers,” December 2015, at https://www.osha.gov/Publications/OSHA3827.pdf
▪ OSHA, “Workplace Violence in Health Care,” December 2015, at https://www.osha.gov/Publications/OSHA3826.pdf
▪ Phillips JP. Workplace violence against health care workers in the United States. N Engl J Med. 2016;374(17):1661–1669.
▪ Lanctot N, Guay S. The aftermath of workplace violence among healthcare workers: a systematic literature review of the
consequences. Aggress Violent Behav. 2014;19:492–501.
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Law and Policy Update
John Stebbins
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11Washington State Department of Labor & Industries
Overview
▪ Changes in Chapter 49.19 RCW
▪ Updated policy DD 5.07
▪ DOSH considerations for enforcement
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12Washington State Department of Labor & Industries
DOSH role
▪ The law has been passed by the legislature
▪ DOSH provided comment on the law, but is not
the author
▪ DOSH is tasked with enforcement of the
requirements
▪ DOSH has not done specific rulemaking and
uses existing rules which apply to the hazard
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13Washington State Department of Labor & Industries
Chapter 49.19 RCW Update
▪ Definition of “Health Care Setting” (HCS)
– Updated terminology “Behavioral health programs”
– Expanded to ambulatory surgical facilities
▪ This RCW does not cover state institutions
operated by DSHS
– Those institutions are covered by separate legislation
– Similar requirements, but not updated
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14Washington State Department of Labor & Industries
Workplace Violence Plan
▪ Each HCS must have a plan
– Must work with safety committee
▪ Update addresses:
– Security
– Work patterns, time alone
– Job design, equipment, and facilities
▪ Review incidents annually
▪ Develop and implement every three years (?)
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15Washington State Department of Labor & Industries
Training
▪ Within 90 days, except temporary employees (?)
▪ “Strategies to prevent physical harm with hands-
on practice or role play”
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16Washington State Department of Labor & Industries
Records
▪ No effective changes
▪ Reorganized
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17Washington State Department of Labor & Industries
DOSH Policy Update
▪ Directive 5.07, updated January 2020
▪ Added reference to safety committee rule
▪ Added reference to DD 5.05, WPV in general
▪ Notes that small employers exempt from safety
committee requirements must review safety
incidents at safety meetings.
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18Washington State Department of Labor & Industries
DOSH Policy Update
▪ States that WISHA rules for training employees
apply to temporary employees and references
DD 1.15, Dual Employers.
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19Washington State Department of Labor & Industries
Upcoming Legislation
▪ SB 6205/HB 2861
▪ Similar requirements for home care
– (DSHS jurisdiction)
▪ May leave a gap for home health workers
– (DOH jurisdiction)
▪ DOSH expectation is for all workplaces
– (DD 5.05)
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Jason Fodeman, MD, MBA(360) 902-5511 [email protected]
John Stebbins, CSP, CIH(206) 515-2870 [email protected]