Category Archives: Workplace Violence Prevention

The 5 Missing Elements of Most Workplace Violence Prevention Programs

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The 5 Missing Elements of Most Workplace Violence Prevention Programs

After working with a variety of organizations on a baseline Workplace Violence assessment, there are several areas that seem to be common problems for most organizations.  These elements are not expensive, and not timing-consuming, so they are natural candidates for improvement.

A baseline workplace violence assessment is a survey of employees in different roles, combined with a threat analysis and an analysis of existing controls and a historical incidents that can be reviewed and aggregated.

Here are the top 5 most common missing elements, with potential solutions.

1.  Missing workplace violence awareness/training programs.  Many organizations report that they have set these up, that they have sent out emails to all employees, but we consistently find that the employees didn’t read the emails, didn’t know the training was available, or that it wasn’t included in their initial company orientation.

2.  Mis-categorization of workplace violence incidents.   There is a mistaken (in my opinion) idea that domestic violence incidents that happen at work should not be categorized or reported as a Workplace Violence incident.  This is a mistake, and leads to bad information about the true nature of the problem.  If someone comes and shoots her significant other at work (IN THE WORKPLACE) – it is a workplace violence incident.

3.  Staff feels subtle pressure from management not to report every incident.
In my research, management wants every incident reported, every time, but
staff members report that their own direct supervisors may discourage them by not taking time to discuss these pre-incidents, and also by chalking up comments as merely office gossip.

4.  Not linking Human Resources with Security on the issue of Workplace Violence Prevention.  This is a management issue, but organizations that create bridges between HR and security are way ahead because this is one issue where cooperation makes a big difference in results.  HR can’t do a security assessment and security can’t write termination policies and set up employment screening. They are both absolutely necessary.

5.   Not doing an Annual Workplace Violence Assessment.  Since late 2008, when the economy suffered major job losses,  the number of workplace violence assessments have increased dramatically, especially in the healthcare field.  Annual assessments are best way to stay on top of the ‘potential’ for violence in your organization.

Check out one of our regularly scheduled webinars to learn more about this important issue.

 

REMEMBER – Workplace Violence is the one threat that is PREVENTABLE!

 

                                        — Caroline Hamilton

                                                                 Caroline.r.hamilton@gmail.com

                                                                 chamilton@riskwatch.com

 


                                  www.riskwatch.com

Arming the Office – What Happens When We Let Employees Bring Guns to Work

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One of my colleagues wrote to me so passionately about the terrible gun violence he witnesses every day, that I wanted to share it with all of you.  You can call it a ‘Guest Blog’ from the Field — a Hospital Security Director in a Major U.S. City.

The gun lobby had several recent legal “wins” for the gun rights advocates in Texas, Indiana, and Tennessee.   Apparently lawmakers and gun rights advocates find it a sane and reasonable  policy to open up the workplace to armed employees.

It t is also clear that our lawmakers are not satisfied with our current national gun carnage. Currently, we shoot to death about a 100 people a day in the United States, including 25 children killed every three days.  And this tally accounts for only those killed by guns.

This doesn’t include all those I see on a daily basis who are shot, crippled, maimed and ruined by the daily shooting gallery in the USA.   In order to continue to make money and sell more guns, the gun rights advocates, and  the legislators they have paid off, corrupted and stripped of reason,  are intent on even greater carnage and human tragedy.

Every day I witness the extreme becoming mainstream, and even commonplace.  
Guns are now finding their way into the workplace, brought into churches, brought into our colleges and universities. They are brought to hospitals, and shot off over highway bridges.

The logic is totally missing.  We are already a nation awash in fear and loathing.  We hate people  we don’t know and don’t understand.  The answer to this problem is NOT to arm EVEN MORE people and have guns readily available to everyone.

Obviously, the recent horrors of Arizona and the slaughter of innocent people in a Safeway parking lot,  has already been forgotten by security professionals and criminologists.  There is no condemnation or follow up  about a terminally troubled young man and the ease in which he purchased a semi-automatic pistol and 30 shot clips.

There has been no rallying cry to address the ease in which tormented and troubled and dangerous individuals on the margins of our society can easily obtain weapons of human mass destruction.   These realities are not relevant and cannot be discussed. And in today’s political climate to even MENTION this makes one a pariah, or a “liberal”, or a “communist”.

 I have been in the Security and Prevention profession for over 35 years, so I can easily dismiss the attacks from gun rights advocates and zealots.  And in fairness,  I have found many gun rights people to be in fact reasoned and decent and willing to engage in reasoned discourse.

What troubles me, and why I wanted to write directly to YOU,  is that the vast majority of professionals in the Security profession totally bypass, ignore and in fact, minimize the reality and tragedy that is our national gun slaughter.   As a profession,  we have done nothing to challenge these trends,  or address them, or at the very least,  debate the current flood of laws designed to turn American work places into armed camps.  

And this in my view is nothing less than a tragedy.

Is Hospital Management Listening to Security Directors?

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Just finished a webinar yesterday to over 60 hospital security directors and managers and they later wrote in to say that their management listened politely to their suggestions, their budget needs, their warnings about the new violence levels — and then they said, “Thank you very much”, and went back to their paperwork.

We all know how tough it is to run a hospital, but when will the administration realize that violence in hospitals, whether it’s a distraught son, shooting his mother’s doctor in Baltimore, or a grief-stricken Chinese man running through a Shanghai hospital killing innocent bystanders with a knife — that we have a BIG PROBLEM with the increasing violence in hospitals.

The nurses know about the violence.  In a recent survey of 1000 nurses who worked in emergency departments, nurses reported that 97% experienced verbal abuse, 94% had physical threats, and 66% HAD BEEN ASSAULTED.  The saddest part of this was that 25% of the nurses said they expected abuse and violent attacks.

We need to devote some resources to this problem and not wait until 100% of nurses report assaults.  It starts with awareness that there is a problem. Tomorrow we’ll discuss the next steps.

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.

January 1st, 2011 Wake Up Call – Another Hospital Workplace Violence Incident.

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My happy 2011 celebrations were marred by another workplace violence homicide in my home state of Maryland.   I guess it’s not always ‘the most – wonderful time of the year’!

This incident brings up again the question of how to keep our hospitals and their employees, safe in the new year.  In a recent Wall Street Journal article, they brought the hospital workplace violence problem up to a management level – reporting that many doctors now say they feel unsafe at work.

In upscale Bethesda, Maryland, just a minute north of Washington DC, a 40-year old male employee of Suburban Hospital (part of the Johns Hopkins Health System since July 2009), was found dead in a non-patient area of the hospital on January 1 at 10 a.m.

Here are the details (from the Suburban Hospital press release, from January 2, 2011):

Yesterday morning, a Suburban Hospital employee was assaulted in a non-patient-care area of the hospital.  Despite the heroic efforts of the hospital’s emergency response team, attempts to resuscitate the employee were not successful.  He died at the hospital as a result of traumatic injuries sustained to his upper body.

The victim has been identified as Roosevelt Brockington, Jr.  He was 40 years old and he had been employed at Suburban Hospital since August 2006.    Mr. Brockington was a Lead Engineer in the hospital’s Plant Operations Dept,   where he was responsible for operating and maintaining the heating, ventilation and air conditioning systems.

Because of the ongoing police investigation, no further information about Mr. Brockington is being released by the hospital at this time.  Suburban Hospital is fully operational today and remains open to patients and visitors.

This incident was a little different from some of the other incidents which have been in the news lately.   First, it was not an inner-city hospital, but instead, a hospital in a very affluent area.  In fact,   Bethesda is one of the most affluent and highly educated locales in the country, placing first in FORBES list of America’s most educated small towns and eleventh on CNNMoney.com’s list of top-earning American towns.

Another difference was that it occurred in mid-morning – 10 a.m., not late at night. News reports about the incident surmised that it was not patient-related, but no one really knows at this early stage in the investigation.

 The victim, Roosevelt Brockington, Jr., was a resident of Lusby, Maryland.  For those who aren’t familiar with Lusby, it is a small town of less than 3,000 people in southern Maryland, over 70 mile commute from Bethesda. 

Having been to over twenty hospitals in 2010, I am struck by the difference between the northern east coast hospitals and the south Florida hospitals.   Many of the hospitals in south Florida have effective visitor management systems in place.  I visited a hospital in Florida just before Christmas, and they had the local choir singing carols in the background, while I took out my drivers license, had my photo taken, and received a visitor’s badge.

There seems to be a mind set in some of the northeast hospitals against trying to manage visitors.  This includes a lack of metal detectors, and a lack of visitor sign-in procedures.  I wonder if this is a cultural attitude – because many of the north east hospitals are older than their south Florida counterparts and may be more entrenched in their attitudes. 

The epidemic of workplace violence in hospitals is only starting to gain national attention since the Journal of the American Medical Association published a research paper on the increase in violence in U.S. hospitals in December 2010, and included the statistics from

The Centers for Disease Control and Prevention/National Institute for Occupational Safety and Health, summarizing Bureau of Justice Statistics data, estimate 1.7 million injuries per year due to workplace assaults, accounting for 18% of all violent crime in the United States and the rate of workplace violence in healthcare setting is about 4 times the national average.

There are a plethora of workplace violence prevention strategies that can be put in place and maybe this New Year’s Day wake up call will result in every hospital examining their Workplace Violence Prevention plans.

JOHNS HOPKINS HOSPITAL MURDER/SUICIDE IS TOO CLOSE TO HOME!

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My summer vacation is over so I jumped right back into work by doing four webinars on workplace violence in the last four days.   I have been very concerned about the trend toward violence toward healthcare and hospital workers.

Having just researched and presented on this subject two days ago, I was greatly saddened to see it AGAIN, 30 miles from my home, at the prestigious Johns Hopkins Hospital.   Local media and CNN covered it extensively because the man shot his mother’s doctor in the stomach, apparently after his mother was paralyzed as a result of spinal surgery.  He then barricaded himself into his mother’s hospital room and eventually shot and killed her and then shot himself.

With a staff of over 30,000,  this was a major incident.  I would love to calculate how much the hospital might have lost from having the staff vacate the building for at least two hours.

This incident once again opens the debate about how to ‘secure’ hospitals, or at least to have a better way to ensure the safety and security of both the staff and the patients.  Hospital administrators continue to maintain an ‘open environment’, and don’t seem to understand that this problem will continue to increase, if there is not way to better manage access in hospitals.

On the radio today, I heard that Baltimore City Council President Bernard C. “Jack” Young said that John Hopkins security is adequate and that using metal detectors would create a hazardous situation for patients entering the building.   “Why would they want metal detectors going into the hospital?” Young said. “People go to the hospital because they got shot. People wouldn’t go to the hospital because of the metal detectors. They would stay away and die rather go through metal detectors.”  He also mentioned during the same interview that the hospital has over 80 entrances.

This exact problem is raging at hospitals all over the country, because violence is dramatically increasing in healthcare.  The NIOSH study from 2004 reported that  violence in hospitals was over four times the national average for non-healthcare workplaces.  Of course, it is now 2010 and that is a long way from 2004 – AND – we have had a terrible recession raging since 2008….

The results of an Emergency Nurses Association survey released in 2009 found that more than 50% of ER nurses had experienced violence by patients on the job and more than 25% had experienced 20 or more violent incidents in the past three years. Research showed long wait times, a shortage of nurses, drug and alcohol use by patients, and treatment of psychiatric patients all contributed to violence in the ER. 

There has been only sporadic interest in this phenomenon and no standard has emerged.  For example, a NIOSH (National Institute for Occupational Safety and Health) Publication in 2004 is called Guidelines for Preventing Workplace Violence for Health Care and Social Services . OSHA Publication 3148-01R (2004). This guide describes the special considerations surrounding workplace violence in the environments of health care and social services.

After my last column on Workplace Violence issues in healthcare, I got a few angry letters from associations and organizations saying they had been working on creating standards for this – FOR THE LAST FOUR YEARS… but amazing, they have not been published.  

There is NO standard or requirement for preventing workplace violence, only the vague requirement for employers to maintain a safe workplace.   Twenty-seven states have come up with their own ‘guidelines’.  Remember – standards are Required, guidelines are only recommended.  That means if the incident happens, the management has no liability because they did not disregard a requirement.

My regular readers will remember that I recently visited a hospital that had a murder about two years ago and even two years later, it was still having a traumatic impact on the staff who witnessed the incident. 

I am a big believer in risk assessments and I think having a workplace violence assessment REQUIRED of every hospital, and having that information aggregated nationwide and studied, would be a big step that improve our knowledge of why this continues to increase, and would also point to more effective solutions to safeguarding our hospitals.

Maybe people will start to press hospitals on this issue – after all – they may end up in a hospital some day, and probably would like to be safe and secure during their visit.

Maybe the aging baby boomers will finally demand more security in their hospitals.  I hope so.

Thinking about a Model for Workplace Violence Prevention

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Since I posted my blog yesterday – I got a big reaction, which ranged from those who thought there was no need for any standards on workplace violence prevention and believes that people will should help each other.  “Work place violence cannot be stopped by legislation! Good feelings cannot be legislated!  They are stopped by a community who cares!”, one reader commented.  

Obviously, people like Omar up in Manchester, Connecticut might have been treated in a more caring manner, with as much dignity as you can give to someone stealing beer on camera, but I could not disagree more with this statement.   I’m hot on standards – and these days, more than ever, people need lots of direction on how to do their job and how to apply security-related concepts.

Have you done any hiring lately?  Some people we’ve interviewed need to have every part of their job written down for them.  There seems to be less incentive to solve a problem that is not directly in the job description.   That’s one argument for setting some kind of minimum standard for companies, to assist them in dealing with the workplace violence increase. 

Standards make life easier for everyone because you don’t have to constantly reinvent the wheel – wheels now come in standard sizes, too.   

One of the reasons it is an attractive idea to create a standardized program for WV is because it is usually totally preventable.  Many of these people leave an enormous trail of clues that they are considering something drastic – including detailed plans in writing on Facebook.   Another reader pointed out that California does have a workplace violence prevention standard.  I checked and found it here:  http://www.dir.ca.gov/dosh/dosh_publications/worksecurity.html

The Cal/OSHA policy includes this little nugget, “The demographic profile of victims of fatal workplace assaults indicate that the majority are male. However, even though the overall fatal workplace injury rate for women is substantially lower than it is for men, homicides represent the leading cause of death for women in the workplace.”  WOW.

Cal/OSHA also offers a resource guide – The Model Injury and Illness Prevention Program for Workplace Security (a nice term).     Like everything else related to security, the actual workplace violence incident is usually a slow escalation over time.  That’s exactly why it is possible to deter, or prevent it – because there are signs everywhere, and lots of coping strategies you can learn.

I worked on a project in Thailand where a manager from a big box store had been fired and humiliated.  His revenge was to call in bomb threats – FOR A YEAR.  Only when those were totally ignored did he actually bring a bomb into the facility and yes, it went off, and yes, it killed a young security guard.

But, they had ONE YEAR to take him seriously and get help for him.  Many of these incidents also have a long wind up before the actual incident is triggered.

WHY SHOULD WE CARE?  I totally buy the argument that more people are killed from industrial injuries and lightning and car accidents, than in a WV incident, but these things are usually hard to predict or detect in advance.  Think about it – the fall off the ladder, the accidental electrocution, the surprise car crash — all more random and UN-preventable.

Workplace violence IS usually preventable, in all the stages.  From the first stage when the employee starts to feel that they have been unfairly treated, right through to how to handle an insanely angry person who happens to be packing.

That’s why training is so important, because it can prepared employees to deal with an incident, and it may even help them recognize and deal with their own issues.  Here’s another note from Cal/OSHA, “The cornerstone of an effective workplace security plan is appropriate training of all employees, supervisors and managers. Employers with employees at risk for workplace violence must educate them about the risk factors associated with the various types of workplace violence and provide appropriate training in crime awareness, assault and rape prevention and defusing hostile situations. Also, employers must instruct their employees about what steps to take during an emergency incident.”

Who wants to write me and help develop a National Standard for Workplace Violence Prevention?   Let me know at caroline.r.hamilton@gmail.com.

Workplace Terror in Manchester, Connecticut

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Yesterday a tragic story unfolded in Manchester,  Connecticut.   You probably already know that nine people were killed when an employee who was being fired, came back in with his hand gun,  started shooting and, after calling his mother, killed himself. 

This incident is part of a bigger and growing trend to more workplace violence incidents – not only in companies in general, but in hospitals to an even greater degree.  The Manchester incident also illustrates again some of the basic tenets of preventing workplace violence incidents. 

Patrick Fiel, Public Safety Advisor for ADT Security, commented, “The industry standard is to not  terminate employees in open areas where other individuals may be working.   Firings are always touchy situations and should be conducted in an isolated areas, even off-site, away from the work areas.”  

“Many companies have crisis plans in place, and also conduct security risk assessments annually  to prevent this kind of incident.   A comprehensive security assessment  might have saved nine lives by setting up procedures for the termination; and additionally, by making sure employees knew what to do when he did draw his gun.” 

I have been reviewing workplace violence incidents in healthcare and find that they have skyrocketed since the recession started.   Violence against supervisors, managers and also nurses and other healthcare workers has spiked significantly.

 It is surprising to read the following statement on the osha.gov web site:

“There are currently no specific standards for workplace violence. However, this page highlights Federal Registers (rules, proposed rules, and notices) and standard interpretations (official letters of interpretation of the standards) related to workplace violence.

Section 5(a)(1) of the OSHA Act, often referred to as the General Duty Clause, requires employers to “furnish to each of his employees employment and a place of employment which are free from recognized hazards that are causing or are likely to cause death or serious physical harm to his employees”. Section 5(a)(2) requires employers to “comply with occupational safety and health standards promulgated under this Act”.”

It might be time for OSHA to develop some workplace violence prevention standards.  Many of the ones we use in our risk assessments are related to standard security safeguards – such as having a written termination policy; making sure that if  worker at one location is fired, that all other locations are notified so he can’t just go to another office and cause an incident. 

Much of the statistical data we found on the OSHA website were at least six years out of date, which makes it harder to track current trends in workplace incidents, unless you catalog the media-reported events and run an analysis on them.  The U.S. Bureau of Labor Statistics reported  “Mass shootings receive a great deal of coverage in the media, as we saw with the Orlando, Fla. office shootings in November 2009 and in the shootings at the manufacturing plant in Albuquerque, N.M. in July 2010.  Out of 421 workplace shootings recorded in 2008 (8 percent of total fatal injuries),  99 (24 percent) occurred in retail trade.  Workplace shootings in manufacturing were less common, with 17 shootings reported in 2008.  Workplace shooting events account for only a small portion of nonfatal workplace injuries.” from http://www.bls.gov/iif/.

It makes me wonder if the workplace violence statistics from 2008 until now may be such a large increase, that has been either underreported or even held from publication!

According to a report by the National Institute for Occupational Safety and Health — “State of the Sector/Healthcare and Social Assistance” — published in 2009, health care workers are more than three times as likely as workers in other industries to be injured by acts of violence.

“Health care workers are at risk for verbal, psychological and physical violence,” the report says. “Violent acts occur during interactions with patients, family, visitors, coworkers and supervisors. “Working with volatile people or people under heightened stress, long wait times for service, understaffing, patients or visitors under the influence of drugs or alcohol, access to weapons, inadequate security, and poor environmen­tal design, are among the risk factors for violence,” the report continues.

In the current economic environment, the physical security (facility) risk assessment can be used as an important tool in making sure that basic industry standards for preventing workplace violence incidents; or limiting the damage they can do – especially for making sure the staff are protected from violent incidents by their co-workers.

The security assessment can be followed by the creation of specific, detailed crisis plans that make sure people know what to do when the unthinkable happens at work.  One of the reasons that workplace violence incidents are so upsetting to all of us is because the person KNEW the people he was killing.  He probably knew their spouses and met their children at a company picnic.  It makes the violence more personal and scary, a whole different thing than falling off a ladder.   And it reminds us all that it COULD happen here!