Risk Profile: Human Resources – Workplace Violence/Disruptive Behaviour

Risk Profile: Human Resources – Workplace violence/disruptive behaviour (PDF version)

Violence against staff by patients, families, or other staff members can result in significant physical and/or psychological harm. Violence results from behavioural disturbances (e.g. agitation, stress) or illness (e.g. delirium, dementia, psychiatric conditions, overdose, head injuries). This document contains information entered by your peers in the Risk Register application to help you manage this risk.

Ranking/ratings[1]

  • Likelihood – average score 3.42
  • Impact – average score 3.83

The Risk Register allows for risks to be assessed on a five-point likelihood and impact scale, with five being the highest.

Key controls/mitigation strategies

  • Physical/environment
    • Silent alarm or panic buttons (including mobile alarms) in high risk areas
    • Magnetic locks and card access
    • Safe rooms
    • Security staff in the emergency department
    • Limited and monitored building access
    • Personal cell phones
    • Safe patient room design (e.g. weighted furniture); proximity to the nursing station
  • Policies/protocols/processes
    • Violence in the workplace policy (including zero tolerance of verbally and physically abusive behaviour towards staff)
    • Code of conduct
    • Least restraints/sedation policy
    • Code White and crisis team response
    • Standardized risk assessments, identification, incident reporting, information system flags and safety plans for patients at risk of violent behaviour
    • Crisis response drills and testing (including testing of alarms)
  • Education/training
    • Mandatory workplace violence prevention, early recognition, and response/de-escalation training
    • Inclusion of all staff, volunteers, students  and physicians in education/training
    • Non-violent crisis intervention/gentle persuasive approach training
    • Crucial conversations training

Monitoring/indicators

  • Incident/safety reports and reviews
  • Patients identified as high risk for violence (rate)
  • Education/training status (% completion)
  • Security reports
  • Occupational health and safety reports
  • Sick time
  • Staff grievances and complaints

[1] As of January 1, 2017

Note: information presented in this document has been taken from the shared repository of risks captured by HIROC subscribers participating in the Integrated Risk Management program. 

© 2017 HIROC. For quality assurance purposes.