Category Archives: Workplace Violence

Maine Hospital Fined by OSHA for Not Providing a Safe Workplace

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The Acadia Hospital in Bangor, Maine was fined $11,700 by OSHA (Federal Occupational Safety and Health Administration) on January 26th, 2011 for failing to provide a safe working environment for employees and improperly documenting workplace injuries.

They were referring to the fact that staff at the hospital had been subject to 115 attacks by patients between 2008 and 2010.  The report went on to say, “”The serious citation points to the clear and pressing need for the hospital to develop a comprehensive, continuous and effective program that will proactively evaluate, identify and prevent conditions that place workers in harm’s way,” said Marthe Kent, OSHA’s New England regional administrator.

OSHA’s report on The Acadia Hospital was at least partially the result of hospital officials making a policy decision to not use restraints on violent patients.   In fact,  Acadia Hospital’s CEO, David Proffitt, Ph.D., was very proud of this policy, saying in a published article in 2010,  “I want to share something I think is very exciting. The last mechanical restraint recorded at The Acadia Hospital was on June 21st, 2009.  This is a big deal.  We set a goal to end mechanical restraints and you have done so. It reflects a commitment to be the best at what we do.  And it gets better…… Our adult rate of restraint has been well below the national mean since May of 2009. . That means we are now in the top 3% of best performing hospitals!  I hope that fact inspires great pride in your self, your co-workers, and this hospital.  I know it does me!”.

Obviously, the no restraints policy wasn’t so great for the nursing staff!

Additionally, the OSHA report ordered the hospital to implement procedures to better protect staff, including screening patients for violent tendencies and offering more staff training on how to use physical restraints, though it did not specifically order the hospital to use them.

In the last eighteen months, OSHA has fined only a handful of hospitals for workplace violence-related incident, including Danbury Hospital, which had a homicide, and Oregon State Hospital in Oregon, which was fined in November 2010 for failing to give staff members self-defense training for dealing with violent patients.

According to The Statesman Journal,  OSHA fined the hospital $3,750 for violating three major safety violations:

  • Failing to provide timely training for staffers to use shields as “a tool to protect employees from projectiles, riots, and to approach patients in order to secure them.”
  • Not reporting to OSHA that a worker was hospitalized in late January after being assaulted by a patient.
  • Lack of written verification showing that a “hazard assessment” had been performed to ensure employees were provided with adequate personal protective equipment.

Looks like OSHA is gearing up to take workplace violence incidents more seriously in the future.   One of the backstories is that hospital employees talk to their unions, and the union leadership contacts OSHA on behalf of the employees.

The increasing problem with workplace violence in hospitals makes it absolutely imperative to start with a comprehensive program to combat and prevent workplace violence.

After Arizona, Does Congress Need Gun Legislation, or Just More Effective Security Risk Assessments?

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The terrible shooting in Tucson this week was widely seen as a wake-up call for members of Congress who probably spent at least part of the weekend wondering if their security was enough.

 I can answer their question – it is probably NOT enough.  The morphing of politicians into celebrities (call them Pol-ebrities??) is great as long as you get lots of TV time and the cameras are flashing and the contributions are rolling in.   The downside is the same one that led to John Lennon’s death – Celebrities draw the crazies.  Now that elected officials are becoming Pol-ebrities – they are becoming targets.

With proposals rolling in from all quarters, including putting a giant Plexiglas shield around the House floor, limiting the distance a constituent can stand in relation to a congressperson or senator, and many other ideas, it is clear me that what is missing is the use of standardized Threat/Risk Assessments.

 Security is always a trade-off.  How much money to spend to protect a public servant and legislator?  Is it worth an extra $25,000 per year per person, or should it be $100,000 per person per year – or should it be a million dollars?

Ask the potential target and I guarantee they are voting for the $100,000 solution.  Ask a beleagured taxpayer and they would think maybe $5000.00.  The problem is that it is impossible for an individual to do a true cost benefit analysis and decide how much money is enough?

Enough to provide ‘adequate” and ‘reasonable’ protection. 

Enough for a ‘normal event’?  What about a high-profile event?

Can you analyze it based on the numbers of people who attend a certain event?

All these questions are about 1/15th of a security risk assessment. 

Like the Department of Homeland Security – the executive protection should move to a more quantitative, risk-based model.  Traditional executive protection checklists are no longer enough.

There are so many elements that go into a threat risk assessment of an public, or private event.  We can look at the Tucson shooting and see that if the usual checklists were used, someone might have:

Checked the crime rate around the location (which turned out not to be at all relevant.)

Checked to see if any other congressperson had ever been attacked
at a town hall meeting in the last twelve months (perhaps more relevant).

These are just a few of the many checks that would have been performed prior to the event, but whether these were done partially, completely, or not at all, they are not risk-based, instead, the classic protection model is more threat-based than risk-based, when what you need is a combination of the two.

If we can create a standardized risk-based scenario for protection of these high profile Pol-ebrities, it would include all the basic information, plus data on the number of phone threats received by that individual legislator; and also, an aggregate of threats received by all legislators.  It would include blog and web searches to see how many times a particular name was mentioned or cited in a negative way.  (And yes, finding a web site that includes a rifle target signal over your district counts).

In addition, it’s interesting to get a historical perspective to see how many government representatives have been threatened, shot, stabbed or murdered in the last five years, and to see whether that trend is increasing or decreasing.

The shooting in Tucson was a workplace violence incident by a totally deranged person who had total access to his victims.   There was no advance screening, no physical barriers, no bodyguards waiting in the wings in case something went wrong.

Many of these missing elements, along with others, can be used to create useful threat risk assessments that can be standardized,   and automatically generated for all our high profile public servants to provide much more effective security for the people who need it most.  

Instead of treating each of these violent incidents as a completely isolated event, society needs to recognize these patterns that are emerging as legislators become celebrities, and that there is an increasing acceptance of violent solutions to individual problems.  These patterns need to be watched, tracked, and applied to each individual’s protection profile to improve personal security and prevent future violent attacks.