Suppose a patient had been demanding pain medication despite being told on several occasions that it was no longer needed. The patient threatens that if it doesn’t get refilled soon, someone will get hurt. What happens next?

Previously, there was no unified system in place at Brigham Health for reporting workplace safety incidents and threats of violence like this one. But now there is.

On Nov. 1, Brigham Health implemented a new Workplace Safety and Violence Prevention Policy, which provides all personnel with tools and resources, including an incident response checklist, to help guide them through immediate steps that must be taken if safety is threatened and violent events occur. The policy covers any physical assault, threatening behavior or verbal abuse that occurs in the work setting.

“We have a duty to protect our personnel from all instances of workplace violence,” said Dave Corbin, MS, CPP, CHPA, director of Police, Security and Parking at the Brigham, who co-chairs the Brigham Health Workplace Safety Committee. “In health care institutions across the country, workplace violence is a serious issue. Our team has completed a thoughtful revision of the Workplace Safety and Violence Prevention Policy and constructed it in a way so that it can be used widely at all of our Brigham Health locations.”

The policy applies to all personnel, including employees, volunteers, trainees and volunteers. It was established through the multidisciplinary Workplace Safety Committee, which includes members from the Brigham, BWFH and Brigham Health ambulatory sites. The Committee is responsible for evaluation of the policies, strategies and programs implemented by the Brigham Health Workplace Safety Committee and the efforts implemented by the Brigham Health Patients at Risk Committee.

Christi Clark Barney, MSN, RN, executive director of Patient Safety, Quality, Risk Management, Infection Control, CDI and Clinical Compliance at BWFH, stressed the importance of reporting incidents of workplace violence. The committee will use reporting data to improve safety and ensure access to needed support.

“A sense of personal respect and safety is foundational to our ability to effectively care for patients,” Barney said.

What All Employees Need to Know

An incident response checklist provides a clear timeline for action steps, clarifies incident response roles, and includes links to resources.

A “Safety/Security” reporting icon accessible via Partners Applications enables employees to directly report safety and security events related to patient care. The Workplace Safety Committee will collect data from these reports to track patterns, identify gaps in process and quantify progress in improving workplace safety.

Any employee who feels unsafe or faces an immediate security threat should call Security at 617-732-6555.

For more information and to view the policy, visit BWHPikeNotes.org.

Ambulatory S.A.F.E. Approach

Brigham Health recently launched an ambulatory S.A.F.E. (Spot a threat, Assess the risk, Formulate a safe clinical response and Evaluate the outcome) approach to care in the outpatient setting. The ambulatory S.A.F.E. approach, a complement to the inpatient version that was implemented in 2014, provides a virtual framework for all ambulatory staff to use in response to a situation with a patient or visitor that leads to a perceived and/or actual threat to personal safety. The program offers training through a series of HealthStream vignettes and activates a virtual huddle by page of key services and individuals to support the development of a plan for each S.A.F.E. response. Practice leadership and nursing leadership have been trained to activate the S.A.F.E. response in the outpatient setting to best support any staff who feel a potential threat.

For more information about ambulatory S.A.F.E., visit BWHPikeNotes.org.

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