Beth Israel Deaconess takes aim at workplace violence

Abstract photo of a crime scene
Beth Israel Deaconess Medical Center in Boston is focused on security after a fatal shooting at nearby Brigham and Women's Hospital.

Following the shooting death of a surgeon at Brigham and Women’s Hospital in 2015, neighboring facilities re-examined their own security protocols.

Beth Israel Deaconess Medical Center

At Beth Israel Deaconess Medical Center, which is located less than a mile from Brigham and Women’s in Boston, employees felt vulnerable that an act of violence occurred so close to home, said Christopher Casey, director of security services at the hospital, so Beth Israel launched a number of new interventions aimed at making staff members feel safer.

The murder “shook our staff tremendously to the core,” Casey said.

Casey was one of three speakers at an Institute for Healthcare Improvement webinar on workplace violence in the industry. He was joined by two Beth Israel colleagues: Marsha Maurer, R.N., the hospital's chief nursing officer, and Pat Folcarelli, R.N., interim vice president of the hospital’s Silverman Institute for Health Care Quality and Safety.

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Though healthcare workers make up just 11% of the workforce, they’re victims of 57% of workplace assaults, Folcarelli said. Nurses are particularly vulnerable and likely to bear the brunt of threats and violence.

Folcarelli said Beth Israel’s interventions encouraged staff to more freely report assaults or threats, offered support to employees and prepared teams to deal with the worst possible situations, like an active shooter.

The hospital flags patient records for previous incidents of physical or verbal assault, warning clinical teams that there is a history of such behavior. It also standardized its response to patient elopement so that clinicians know when it’s effective to chase a fleeing patient.

It also formed a threat assessment team, made up of staff members from across the hospital including leadership, clinicians, legal representatives and security, that can handle the more rare serious threat, Folcarelli said. That way, a specific staff member is not left to determine alone if a patient or family member is more bark than bite.

“We have ability to think through what support we need to give to our staff up to and calling the local police jurisdiction,” she said.

To encourage greater reporting, Beth Israel in 2016 launched a management tool in which supervisors discuss with team members events of the prior 24 or 48 hours and specifically ask about threats and assaults, Maurer said.

Thus far, the hospital has seen the number of reports increase significantly, though it’s still too early to tell if these programs have reduced the number of violent incidents occurring in the hospital. Maurer said it’s likely that the number of threats or minor assaults could continue to grow alongside the opioid epidemic.

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Executives that want to effectively support staff need to make issues like workplace violence a clear priority, she said. Include violence prevention in an operating plan and be visible in showing commitment to improvement.

“Every signal is that this is a big deal,” she said.