During ACEP19 in Denver, we officially announced “No Silence on ED Violence,” our new joint campaign with the Emergency Nurses Association to tackle the growing epidemic of violence against caretakers inside the emergency department. This collaborative effort is designed to support, empower, and provide the resources that emergency physicians and nurses need to improve safety at their workplace while engaging the public at large to take or support action. Share your personal stories, view resources, and learn how you can help the cause at www.stopEDviolence.org.

Preventing workplace violence in the emergency department is one of ACEP’s top priorities, and this campaign is the latest step in ACEP’s ongoing efforts to address this growing issue. It’s a complicated problem, so we are tackling the issue from various angles. Quick summaries of our ongoing efforts, resources, and updates are at www.acep.org/EDsafety.

PR: Raising Awareness

Our public relations (PR) efforts on this topic ramped up in 2018 when we conducted a survey of our membership to measure the problem across the country. The findings were powerful: Almost 50 percent of emergency physicians had been physically assaulted at work, and more than 60 percent of those incidents had occurred in the year before the survey. Nearly seven out of 10 respondents said their hospitals reported the incidents, but only 3 percent pressed charges. And violence isn’t limited to the providers either; more than 50 percent said that patients had been physically harmed during an incident. When we unveiled these results, there was widespread media coverage, raising public awareness about this problem.

Since its release in October 2018, our survey has been mentioned in 595 outlets, including CNN, The Washington Post, USA Today, Huffington Post, U.S. News & World Report, and Kaiser Health News.

As part of our continuing efforts to raise public awareness and to put a face on these statistics, ACEP’s PR team is now collecting firsthand accounts of ED violence and asking how it impacts your mental health and patient care. If you’d like to share your story, you can share on social media using #StopEDViolence or contact Maggie McGillick, ACEP’s director of public relations, at mmcgillick@acep.org.

Advocacy: Federal Legislation

In March 2019, we sent a letter of support for H.R. 1309: The Workplace Violence Prevention for Health Care and Social Service Workers Act, asking Congress to consider how emergency departments are staffed and to ensure that important provisions of the legislation are implemented appropriately. We asked for a wording clarification on the responsibility of the “covered employer” within the legislation to ensure that any new federal requirements don’t place unintentional burdens on entities (including physicians) that do not control the health care workspace.

Advocacy: State Legislation

ACEP’s State and Chapter Services Department works with chapters to support efforts to enact legislation to strengthen penalties against those who assault emergency care providers. We’re also supporting efforts to require hospitals to develop comprehensive violence prevention programs. Visit www.stopEDviolence.org to read a summary of key tenets of relevant legislation in California, Hawaii, Illinois, Nevada, Oklahoma, Oregon, South Dakota, and Utah.

Regulatory Route: Working with OSHA

While the Occupational Safety and Health Administration (OSHA) provides resources related to reducing or preventing workplace violence, it does not have an official standard in place. H.R. 1309, supported by ACEP, would require OSHA to create such a standard.

ACEP is collecting personal testimonies, surveys, and other relevant statistics to share with OSHA to make sure the standard effectively addresses health care providers’ experiences in the emergency department. If you’d like to share your stories or relevant article, research, or anecdotes to support OSHA’s efforts to create a safety standard, please send them to Jeffrey Davis, ACEP’s director of regulatory affairs, at jdavis@acep.org.

ACEP was recently invited to participate in the National Quality Partners (NQP) Action Team to Prevent Healthcare Workplace Violence. The NQP Action Team includes 27 National Quality Forum member organizations committed to action-oriented strategies to promote health care workplace safety. The NQP Action Team is a forum for discussion, collaboration, and sharing among thought leaders and experts in health care workplace violence prevention. The first kickoff meeting was held in October.

In Practice: Resources for Clinicians

While ED violence is not your fault, emergency physicians can still help prevent it. Part of our “No Silence on ED Violence” campaign is dedicated to creating more resources to help facilities mitigate ED violence and providing helpful tips for clinicians who want to be better equipped to de-escalate tense situations. Our resource library on this is expanding, and we already have related articles, videos, and CME to address workplace violence. At www.acep.org/EDsafety, you’ll find:

• ACEP policies: Protection from Violence in the ED, an ED violence fact sheet, and more
• A video of Scott Zeller, MD, demonstrating verbal de-escalation techniques as part of a simulation exercise
• Tips for how to design a safer emergency department
• A point-of-care tool to manage confusion and agitation in elderly patients (ADEPT)
• An excerpt from Critical Decisions in EM that explains how to identify, approach, and manage an agitated patient
• CME videos on how to manage an active shooter situation in the emergency department, staying calm in the midst of chaos, and more
• Relevant articles from the archives of ACEP Now and Annals of Emergency Medicine 

Ms. Grantham is ACEP communications manager.