We can do a better job of protecting our coworkers and ourselves. It first requires an understanding of the breadth of health care WPV; it’s an issue at every facility. EDs and psychiatric units are statistically the most violent health care settings. Medical students and EM residents have a right to be informed about their risk of harm and how to best handle high-risk situations. And more federal oversight may not be popular, but OSHA has promised to revamp its regulatory and punishment processes. It’s time for states to enact laws and health care systems and individual EDs to adopt strategies for improvement.

Dr. Phillips is a board-certified emergency medicine specialist and full-time academic faculty member at Beth Israel Deaconess Medical Center (BIDMC) in Boston and an instructor at Harvard Medical School. He is the director of the Counterterrorism Medicine program in the BIDMC Disaster Medicine Fellowship and is the alternate councillor for the ACEP Tactical Medicine Section.

References

1. Phillips JP. Workplace violence against health care workers in the United States. N Engl J Med. 2016;374(17):1661-1669. doi:10.1056/NEJMra1501998.
2. Behnam M, Tillotson RD, Davis SM, et al. Violence in the emergency department: a national survey of emergency medicine residents and attending physicians. J Emerg Med. 2011;40(5):565-579. doi:10.1016/j.jemermed.2009.11.007.
3. Workplace Safety and Health: Additional Efforts Needed to Help Protect Health Care Workers From Workplace Violence. U.S. Government Accountability Office website. Available at: http://www.gao.gov/products/GAO-16-11. Accessed June 13, 2016.
4. Administration OSHA. Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers.[PDF] U.S. OSHA, 3148-01R 2015.
5. Violence: Occupational Hazards in Hospitals. Atlanta: National Institute for Occupational Safety and Health, April 2002. CDC website. Avaliable at: http://www.cdc.gov/niosh/docs/2002-101. Accessed June 13, 2016.
6. Findorff MJ, McGovern PM, Wall M, et al. Risk factors for work related violence in a health care organization. Inj Prev. 2004;10(5):296-302. doi:10.1136/ip.2003.004747.