Please Note: This material, or any other material used to inform employers of compliance requirements of Oregon OSHA standards through simplification of the regulations should not be considered a substitute for any provisions of the Oregon Safe Employment Act or for any standards issued by Oregon OSHA. The information in workbook is intended for classroom use only.
There are many different approaches companies can take in developing plans to prevent workplace violence. An approach that works well in one company may not be suitable for another. This workshop outlines some broad guidelines that can help companies in developing and maintain an effective program to handle potentially violent situations.
This workshop provides you with recommendations on steps to consider in developing a workplace violence prevention program to reduce the hazards of workplace violence. These are guidelines only. Oregon OSHA does not intend to create rules specific to violence in the workplace. While not every suggestion may be appropriate for all organizations, these recommendations provide an excellent means for quickly assessing the state of an organization’s current policies and practices.
Given the information and exercises in this workshop, you will be able to:
Oregon Disabling Claims by Accident or exposure event.
2/3 of non-fatal assaults occurred in service industries.
Home Health Care
Defining violence in the workplace The nature and extent of your organization’s workplace violence program should be based on the results of the initial risk assessment. First, evaluate past incidents of violence or possible violence (they may not have been classified as “violence”). For example you may not have considered the threatening phone call from an estranged spouse to an employee a “violent incident,” but it was. It can be helpful when identifying risks in your organization to know that violence is usually classified into three categories, each type requiring different interventions and with different risk factors. Type I - Criminal Act. This type of violence involves verbal threats, threatening behavior or physical assaults by an assailant who has no legitimate business relationship to the workplace. The person enters the workplace to commit a robbery or other criminal act. Violence by strangers accounts for most of the fatalities related to workplace violence. Workplaces at risk of violence by strangers commonly include late night retail establishments and taxi cabs. Road rage is becoming more common as a possible source of Type I violence affecting workers who drive as a part of their job. Risk Factors: Type II - Recipient of Service. The person causing violence is either recipient or object of a service provided by workplace. He/she is a current or former client, passenger, or customer. Type II violence involves verbal threats, threatening behavior or physical assaults by an assailant who either receives services from or is under the custodial supervision of the affected workplace or the victim. Assailants can be current or former customers and clients such as passengers, patients, students, inmates, criminal suspects or prisoners. The workers typically provide direct services to the public, for example, municipal bus or railway drivers, health care and social service providers, teachers and sales personnel. Law enforcement personnel are also at risk of assault from individuals over whom they exert custodial supervision. Violence by customers or clients may occur on a daily basis in certain industries; they represent the majority of non-fatal injuries related to workplace violence. Risk Factors:
Type III - Employment Relationship. The person has an employment-related involvement with the workplace:
Job related — a current or former employee who is angry about a situation. Job related violence involves verbal threats, threatening behavior or physical assaults by an assailant such as a current or former employee, supervisor or manager. Any workplace can be at risk of violence by a co-worker. In committing a threat or assault, the individual may be seeking revenge for what is perceived as unfair treatment.
Non-Job related - a person who has a relationship with a current or former employee. Domestic violence erupting at work is one of the most common types of workplace violence and involves verbal threats, threatening behavior or physical assaults by an assailant who, in the workplace, confronts an individual with whom he or she has or had a personal relationship outside of work. Personal relations include a current or former spouse, lover, relative, friend or acquaintance. The assailant's actions are motivated by perceived difficulties in the relationship or by psycho-social factors that are specific to the assailant .
Which violence category do you believe to be most likely at your workplace? Give an example of this type of violence.
1. Top Management Commitment For more education on this element take courses 107, 109, 110, 112, 114 and 118
Management commitment and employee involvement are complementary and essential elements of any effective safety and health program. To ensure an effective program, management and front-line employees must work together, perhaps through a team or committee approach.
What is T op M anagement C ommitment to violence prevention?
Management commitment, including the endorsement and visible involvement of top management, provides the motivation and resources to deal effectively with workplace violence, and should include the following:
Demonstrated organizational concern for employee emotional and physical safety and health.
Equal commitment to worker safety and health and patient/client safety.
Assigned responsibility for the various aspects of the workplace violence prevention program to ensure that all managers, supervisors, and employees understand their obligations.
Appropriate allocation of authority and resources to all responsible parties.
A system of accountability for involved managers, supervisors, and employees.
A comprehensive program of medical and psychological counseling and debriefing for employees experiencing or witnessing assaults and other violent incidents.
Commitment to support and implement appropriate recommendations from safety and health committees regarding violence prevention.
A written policy indicating zero tolerance for violence in the workplace which is signed by top management.
1. Top Management Commitment For more education on this element take courses 107, 109, 110, 112, 114 and 118
What are the potential legal consequences to an employer if an employee is injured or killed as a result of Workplace Violence?
Related OR-OSHA rules
Federal & State Laws Prohibiting Sexual Harassment, Hostile Work Environment, Etc.
Premise Liability Lawsuits
Other Civil Lawsuit such as Those Resulting from Negligent Hiring Practices, Failure to Warn About a Potentially Violent Individual, etc.
Five essential components of an effective accountability system
(What things would you see in each of the listed area to tell you that an effective violence prevention system accountability system is in place?)
1. Established formal standards of behavior and performance
2. Resources provided to meet those standards
3. An effective system of measurement
4. Appropriate application of effective consequences
5. Continual evaluation of the system
OAR 437 Div 001, Rule 0765(6)(f) The safety committee shall evaluate the employer’s ac counta bility system and make recommendations to implement supervisor and employee accountability for safety and health. For more education on this element take courses 112, 114, and 119
3. Employee Involvement For more education on this element take courses 101, 107, and 111
Employee involvement and feedback enable workers to develop and express their own commitment to safety and health and provide useful information to design, implement, and evaluate the program.
Employee involvement should include the following:
Understanding and complying with the workplace violence prevention program and other safety and security measures.
Participation in an employee complaint or suggestion procedure covering safety and security concerns.
Prompt and accurate reporting of violent incidents.
Participation on safety and health committees or teams that receive reports of violent incidents or security problems, make facility inspections, and respond with recommendations for corrective strategies.
Taking part in a continuing education program that covers topics identified as necessary to address the level of violence reasonably predictable.
Choose one idea above and discuss how you would design the methods and procedures to make sure it works.
4. Hazard Identification & Control For more education on this element take courses 103, 104, 106, 120, and 202
Determining risk factors for workplace violence
The types of violence previously identified illustrate different characteristics of workplace violence and the ways violence may present itself. The significance of these types is that each involves somewhat different risk factors and means of preventing or responding to the potential violent incident.
Each risk factor only represents a potential for an increased likelihood of violence. No risk factor, or combination of risk factors, guarantees that violence will occur or that its incidence will increase. However, the presence of the risk factor, particularly if several exist, increases the likelihood that violence will occur. Ask yourself the following questions.
Do employees have contact with the public?
Does an exchange of money occur? *
Is there selling/dispensing alcohol or drugs?
Is the workplace mobile? (such as a taxicab or police cruiser)
Is there exposure to unstable or volatile persons? (such as in health care, social services or criminal justice settings)
Do employees work alone or in small numbers? *
Do employees work late at night or during early morning hours? *
Do employees work in high-crime areas. *
Do employees guard valuable property or possessions? *
Do employees work in community settings? *
Are your employees deciding on benefits, or in some other way controlling a person’s future, well-being, or freedom? (such as a government agency)
* Identified by NIOSH as risk factor for homicide (CDC/NIOSH Alert, 1993)
Describe the risk factors for violence that currently exist in your workplace.
After hazards of violence are identified through a worksite analysis, the next step is to design measures through engineering or administrative changes to control these hazards. If violence does occur, post-incidence response and analysis can be an important tool in preventing future incidents.
Engineering Controls and Workplace Adaptations
Engineering controls, for example, remove the hazard from the workplace or create a barrier between the worker and the hazard. There are countless actions an employer can take which can effectively prevent or control workplace violence, such as those identified in the following paragraphs. Like other safety hazards, workplace violence is an issue that employers can and should manage. The selection of any measure, of course, should be based upon the hazards identified in the workplace security analysis of each facility.
Assess any plans for new construction or physical changes to the facility or workplace to eliminate or reduce security hazards.
Install and regularly maintain alarm systems and other security devices, panic buttons, hand-held alarms or noise devices, cellular phones, and private channel radios where risk is apparent or may be anticipated, and arrange for a reliable response system when an alarm is triggered.
Provide metal detectors -- installed or hand-held, where appropriate -- to identify guns, knives, or other weapons, according to the recommendations of security consultants.
Use a closed-circuit video recording for high-risk areas on a 24-hour basis. Safety is a greater concern than privacy in these situations.
Place curved mirrors at hallway intersections or concealed areas.
Enclose work stations, and install deep service counters or bullet-resistant, shatter-proof glass.
Provide "safe rooms" for use during emergencies.
Establish "time-out" or seclusion areas with high ceilings without grids for patients acting out and establish separate rooms for criminal patients.
Provide waiting rooms designed to maximize comfort and minimize stress.
Ensure that counseling or patient care rooms have two exits.
Limit or control access to areas by using locking doors.
Arrange furniture to prevent entrapment of employee. In interview rooms furniture should be minimal, lightweight, without sharp comers or edges, and/or affixed to the floor. Limit the number of pictures, vases, ashtrays, or other items that can be used as weapons.
Provide lockable and secure bathrooms for employee members separate from patient-client, and visitor facilities.
Lock all unused doors to limit access, in accordance with local fire codes.
Install bright, effective lighting indoors and outdoors.
Replace burned-out lights, broken windows, and locks.
Keep automobiles, if used in the field, well-maintained. Always lock automobiles.
Administrative and Work Practice Controls
Administrative and work practice controls affect the way jobs or tasks are performed. The following examples illustrate how changes in work practices and administrative procedures can help prevent violent incidents.
State clearly to patients, clients, and employees that violence is not permitted or tolerated.
Establish liaison with local police and state prosecutors. Report all incidents of violence. Provide police with physical layouts of facilities to expedite investigations.
Require employees to report all assaults or threats a supervisor or manager (e.g., can be confidential interview). Keep log books and reports of such incidents to help in determining any necessary actions to prevent further occurrences.
Advise and assist employees, if needed, of company procedures for requesting police assistance or filing charges when assaulted.
Provide management support during emergencies. Respond promptly to all complaints.
Set up a trained response team to respond to emergencies.
Use properly trained security officers, when necessary, to deal with aggressive behavior. Follow written security procedures.
Ensure adequate and properly trained employee for restraining patients or clients.
Provide employee with identification badges, preferably without last names, to readily verify employment.
Discourage employees from carrying keys, pens, or other items that could be used as weapons.
Provide employee members with security escorts to parking areas in evening or late hours. Parking areas should be highly visible, well-lighted, and safely accessible to the building.
Use the "buddy system," especially when personal safety may be threatened. Encourage home health care providers, social service workers, and others to avoid threatening situations. employee should exercise extra care in elevators, stairwells and unfamiliar residences; immediately leave premises if there is a hazardous situation; or request police escort if needed.
Develop policies and procedures covering home health care providers, such as contracts on how visits will be conducted, the presence of others in the home during the visits, and the refusal to provide services in a clearly hazardous situation.
Establish a daily work plan for field employee to keep a designated contact person informed about workers' whereabouts throughout the workday. If an employee does not report in, the contact person should follow-up.
Develop a procedure for employees to report incidents
The primary consideration in developing a reporting procedure is to make sure that it encourages employees to report all incidents, even minor ones. Some companies use hotlines. Some arrange for a member of a team to take the calls, usually a specialist from Human Resources or Security. Other companies require employees to report incidents to their supervisor (or to any company supervisor), who in turn reports these incidents to Human Resources or Security. Credibility for any reporting system will be dependent upon whether reports are handled quickly and effectively. Word spreads quickly among employees when a report is made and nothing is done, when a report is handled improperly, or when the allegations are not treated confidentially. Therefore, before a reporting procedure is announced to employees, ensure that the staff who will be responding to reported incidents are trained and able to handle any reported incidents. The following information is useful when included in a threat incident report:
Name of the threat-maker and his/her relationship to the company and to the recipient.
Name(s) of victims or potential victims.
When and where the incident occurred.
What happened immediately prior to the incident.
The specific language of the threat.
Any physical conduct that would substantiate an intention to follow through on the threat.
How the threat-maker appeared (physically and emotionally).
Names of others who were directly involved and any actions they took. How did the incident end?
Names of witnesses.
What happened to the threat-maker after the incident.
What happened to the other employees directly involved after the incident.
Names of any supervisory staff involved and how they responded.
What event(s) triggered the incident.
Any history leading up to the incident.
The steps which have been taken to ensure that the threat will not be carried out.
Suggestions for preventing workplace violence in the future.
For more education on this element take courses 102 and 104
PRACTICE ACTIVITY Read the scenario below and complete the assignment. The incident An employee called a member of the company crisis team for advice, saying that a coworker was picking on her, and expressing fear that something serious might happen. For several weeks, she said, a coworker has been making statements such as, "You actually took credit for my work and you're spreading rumors that I'm no good. If you ever get credit for my work again, that will be the last time you take credit for anybody's work. I'll make sure of that." She also said that her computer files have been altered on several occasions and she suspects it's the same coworker. When she reported the situation to her supervisor, he tried to convince her that there was no real danger and that she's blowing things out of proportion. However, she continued to worry. She said she spoke with her union representative who suggested she contact the agency's workplace violence team. What level of investigation would you conduct in response to this incident? Would you get assistance from the EAP? Would you get the police involved? Justify your answers. _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________
Let's continue our look at the scenario. Read the “Actions to Date” and complete the assignment. An employee called a member of the company crisis team for advice, saying that a coworker was picking on her, and expressing fear that something serious might happen. For several weeks, she said, a coworker has been making statements such as, "You actually took credit for my work and you're spreading rumors that I'm no good. If you ever get credit for my work again, that will be the last time you take credit for anybody's work. I'll make sure of that." She also said that her computer files have been altered on several occasions and she suspects it's the same coworker. When she reported the situation to her supervisor, he tried to convince her that there was no real danger and that she's blowing things out of proportion. However, she continued to worry. She said she spoke with her union representative who suggested she contact the agency's workplace violence team. ACTIONS TO DATE: The agency's response plan calls for involvement of Employee Relations, Security and the Employee Assistance Program (EAP) in cases involving threats. Immediately following the report to the response team, the Security Officer contacted the female employee to assist her in filing a police report on the threat and to discuss safety measures that she should be taking. The victim was also referred to the EAP, where she received brief counseling and educational materials on handling severe stress. An investigation was immediately conducted by an investigator from the security department. In her statement, the female employee repeated what she had reported to the supervisor earlier about the threat. In his statement, the male employee stated that, on the day in question, he had been upset about what he felt were some underhanded activities by the female employee and his only recollection about the conversation was that he made a general statement like, "You'll pay," to her. He stated that this was not a threat, just an expression. The investigation showed that the employee had several previous incidents of intimidating behavior which had resulted in disciplinary actions. The employee brought in medical documentation that said he had a psychiatric disability of Post Traumatic Stress Disorder, which caused his misconduct, and he requested a reasonable accommodation. What disciplinary actions, if any, do you think the employer should take in this scenario? ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Where the supervisor possesses the relevant information regarding violent, harassing, threatening, and other disruptive behavior, the supervisor should determine the appropriate disciplinary action. The selection of an appropriate charge and related corrective action should be discussed with human resources and legal staff where appropriate. Some disciplinary actions are:
Reprimand, warning, short suspension, and alternative discipline . These lesser disciplinary actions can be used in cases where the misconduct is not serious or intervention may correct the problem behavior. They are an excellent means of dealing with problem behavior early on.
Removal, reduction-in grade, and long-term suspension. Be sure to coordinate with legal staff to ensure compliance with local, state, and federal law.
Disabilities as a Defense Against Alleged Misconduct
The Equal Employment Opportunity Commission (EEOC) has issued important guidance that specifically addresses potentially violent misconduct by employees with disabilities. Although this guidance deals specifically with psychiatric disabilities, it applies generally to other disabling medical conditions. It advises that an organization may discipline an employee with a disability who has violated a rule (written or unwritten) that is job-related and consistent with business necessity, even if the misconduct is the result of the disability, as long as the company would impose the same discipline on an employee without a disability. The guidance specifically states that nothing in the Rehabilitation Act prevents an employer from maintaining a workplace free of violence or threats of violence. For a detailed discussion of all these points, see EEOC Enforcement Guidance on the Americans with Disabilities Act and Psychiatric Disabilities, EEOC number 915.002, 3-25-97. The guidance is available on the Internet at http//www.eeoc.gov, or a copy can be obtained by calling the EEOC Publications department at (800)669-3362.
6. Education and Training For more education on this element take courses 105 and 115
Training and education ensure that all employee are aware of potential security hazards and how to protect themselves and their co-workers through established policies and procedures.
Every employee should understand the concept of ”Universal Precautions for Violence," i.e., that violence should be expected but can be avoided or mitigated through preparation. Employees should be instructed to limit physical interventions in workplace altercations whenever possible.
Employees who may face safety and security hazards should receive formal instruction on the specific hazards associated with the unit or job and facility. This includes information on the types of injuries or problems identified in the facility and the methods to control the specific hazards.
The training program should involve all employees, including supervisors and managers. New and reassigned employees should receive an initial orientation prior to being assigned their job duties. Visiting employees, such as physicians, should receive the same training as permanent employees. Qualified trainers should instruct at the level appropriate for the employee.
Topics may include Management of Assaultive Behavior; Professional Assault Response Training; Police Assault Avoidance Programs, or Personal Safety training such as awareness, avoidance, and how to prevent assaults. A combination of training maybe used depending on the severity of the risk.
Potential training topics include:
The workplace violence prevention policy.
Risk factors that cause or contribute to assaults.
Early recognition of escalating behavior or recognition of warning signs or situations that may lead to assaults.
Ways of preventing or diffusing volatile situations or aggressive behavior, and managing anger.
Information on diversity.
A standard response action plan for violent situations, including availability of assistance, response to alarm systems, and communication procedures.
Progressive behavior control methods and safe methods of restraint application or escape.
The location and operation of safety devices such as alarms systems, along with the required maintenance schedules and procedures.
Ways to protect oneself and coworkers, including use of the "buddy system."
Policies and procedures for reporting and recordkeeping.
Policies and procedures for obtaining medical care, counseling, workers' compensation, or legal assistance after a violent episode or injury.
Supervisors, Managers, and Security Personnel
Supervisors and managers should ensure that employees are not placed in assignments that compromise safety and should encourage employees to report incidents. Employees and supervisors should be trained to behave compassionately towards coworkers when an incident occurs.
They should learn how to reduce security hazards and ensure that employees receive appropriate training. Following training, supervisors and managers should be able to recognize a potentially hazardous situation and make necessary changes to reduce or eliminate the hazards.
Security personnel need specific training including the psychological components of handling aggressive and abusive individuals, types of disorders, and ways to handle aggression and defuse hostile situations.
The training program should also include an evaluation. Program evaluation may involve supervisor and/or employee interviews, testing and observing, and/or reviewing reports of behavior of individuals in threatening situations.
Using the above criteria, evaluate your company’s current Violence Prevention Program training for employees. (1=low, 10=high). Explain why you gave it that rating.
As part of their overall program, employers should evaluate their safety and security measures. Top management should review the program regularly, and with each incident, to evaluate program success. Responsible parties (managers, supervisors, and employees) should collectively reevaluate policies and procedures on a regular basis. Deficiencies should be identified and corrective action taken. An evaluation program should involve the following:
Establishing a uniform violence reporting system and regular review of reports.
Reviewing reports and minutes from employee meetings on safety and security issues.
Analyzing trends and rates in illness/injury or fatalities caused by violence relative to initial or "baseline" rates.
Measuring improvement based on lowering the frequency and severity of workplace violence.
Keeping up-to-date records of administrative and work practice changes to prevent workplace violence to evaluate their effectiveness.
Surveying employees before and after making job or worksite changes or installing security measures or new systems to determine their effectiveness.
Keeping abreast of new strategies available to deal with violence as these develop.
Surveying employees who experience hostile situations about the medical treatment they received initially and following the event.
Complying with OSHA and state requirements for recording and reporting incidents.
Requesting periodic law enforcement or outside consultant review of the worksite for recommendations on improving employee safety.
Management should share workplace violence prevention program evaluation reports with all employees. Any changes in the program should be discussed at regular meetings of the safety committee, union representatives, or other employee groups.
7. Periodic Evaluation For more education on this element take courses 110 and 116.
Case #1 Roger and Jim have worked in the same unit for several years. Although each is very accomplished in their field, they don’t get along. One example of this is, when they are involved in group discussions one (or the other) often will display his dis-interest by avoiding eye contact or by making an audible sigh. Neither one is willing to discuss their perceived differences. Roger has just had it with Jim. It just seems like everything he does (Jim) grates on Roger. Also, when things don’t go well, each tends to somehow place the fault on the other. One day after Roger arrives to work, he turns on a light switch to his area, which is also the common switch for the light source in Jim’s work space. After Roger turned on the light he was immediately chastised by Jim who said, “Hey boy! Turn off that light. I’m trying to work on this project!” To which Roger responded, “Don’t call me boy! Immediately Jim started advancing toward Roger in a threatening manner. A co-worker who overheard the exchange quickly stepped in between Roger and Jim thereby breaking up a potential physical confrontation. (It is likely that the above situation escalated over time and there were multiple opportunities for intervention prior to reaching the intensity described above. Let’s look at some different contacts involving Roger and Jim. In each scenario described on the following pages, decide what actions might have the greatest chance of de-escalating the situation? What actions might escalate the conflict? )
Escalating Behavior Confusion Scenario: Roger and Jim have worked in the same unit for several years. Although each is very accomplished in their field, they don’t get along. Today, they are involved in a group discussion. As Roger shares his ideas on a problem the group is dealing with, Jim will not make eye contact with him. He makes an audible sigh, roles his eyes and turns his back on Roger. Roger can’t understand why Jim is acting this way and describes the incident to his manager. ACTIONS Do Do Not
Escalating Behavior Frustration Scenario: Roger has just had it with Jim. It just seems like everything Jim does grates on Roger and the feelings are mutual. They are both spending an inordinate amount of time sharing their concerns about one another with other co-workers. ACTIONS Do Do Not
Escalating Behavior Blame Scenario: Jim is convinced that Roger has taken some files from his work space in order to make him look bad. Roger believes Jim has erased some files from his computer for the same reason. ACTIONS DO Do Not
Escalating Behavior Anger - Judgment call required Scenario: One day after Roger arrives to work, he turns on the light switch to his area, which is also the common switch for the light source for Jim’s work space. After Roger turned on the light he was immediately chastised by Jim who said, “Hey boy! Turn off that light. I’m trying to work on this project!” Roger shouted, “Don’t call me boy!” He then jumped out of his chair and stormed out of the work area. ACTIONS Do Do Not
Escalating Behavior Hostility - Judgment call required Scenario: One day after Roger arrives to work he turns on the light switch to his area, which is also the common switch for the light source for Jim’s work space. After Roger turned on the light he was immediately chastised by Jim who said, “Hey boy! Turn off that light. I’m trying to work on this project!” Roger responded, “Don’t call me boy!” He then jumped up from his work station, grabbed Jim by the neck and started to strangle him. Co-workers had to drag Roger off. ACTIONS Do Do Not
Personal Conduct to Minimize Violence* Follow these suggestions in your daily interactions with people to de-escalate potentially violent situations. If at any time a person’s behavior starts to escalate beyond your comfort zone, disengage. Do Project calmness, move and speak slowly, quietly and confidently. Be an empathetic listener: Encourage the person to talk and listen patiently. Focus your attention on the other person to let them know you are interested in what they have to say. Maintain a relaxed yet attentive posture and position yourself at a right angle rather than directly in front of the other person. Acknowledge the person’s feelings. Indicate that you can see he/she is upset. Ask for small, specific favors such as asking the person to move to a quieter area. Establish ground rules if unreasonable behavior persists. Calmly describe the consequences of any violent behavior. Use delaying tactics which will give the person time to calm down. For example, offer a drink of water (in a disposable cup). Be reassuring and point out choices. Break big problems into smaller, more manageable problems. Accept criticism in a positive way. When a complaint might be true, use statements like "You are probably right" or "It was my fault." If the criticism seems unwarranted, ask clarifying questions. Ask for his/her recommendations. Repeat back to him/her what you feel he/she is requesting of you. Arrange yourself so that a visitor cannot block your access to an exit.
Do Not Use styles of communication which generate hostility such as apathy, brush off, coldness, condescension, robotism, going strictly by the rules or giving the run-around. Reject all of a client’s demands from the start. Pose in challenging stances such as standing directly opposite someone, hands on hips or crossing your arms. Avoid any physical contact, finger pointing or long periods of fixed eye contact. Make sudden movements which can be seen as threatening. Notice the tone, volume and rate of your speech. Challenge, threaten, or dare the individual. Never belittle the person or make him/her feel foolish. Criticize or act impatiently toward the agitated individual. Attempt to bargain with a threatening individual. Try to make the situation seem less serious than it is. Make false statements or promises you cannot keep. Try to impart a lot of technical or complicated information when emotions are high. Take sides or agree with distortions. Invade the individual’s personal space. Make sure there is a space of three feet to six feet between you and the person. *From Combating Workplace Violence: Guidelines for Employers and Law Enforcement. International Association of Chiefs of Police. 1996. Note: Oregon OSHA is not recommending a specific response to any situation or in any way guaranteeing the effectiveness of a particular response.
ELEMENT 1 - TOP MANAGEMENT COMMITMENT VIOLENCE PREVENTION PROGRAM EVALUATION (Choose one) 5=Fully Met 3=Mostly Met 1=Partially Met 0=Not Present Audit questions ____ 1. A written violence prevention policy that sets a high priority for safety and health exists. ____ 2. A written violence prevention goal and supporting objectives exist. ____ 3. The violence prevention policy is supported by management. ____ 4. Violence prevention goals and objectives are supported by management. ____ 5. Management supports violence prevention program safety rules. ____ 6. Managers personally follow violence prevention program policies and rules. ____ 7. Managers personally intervene in the unsafe or inappropriate behavior of others. ____ 8. Managers set a visible example of violence prevention leadership. ____ 9. Managers participate in the violence prevention program training of employees.
Improve performance through measurement and consequences.
Standards Communications Resources
Measurement Consequences Application
Audit questions ____ 10. Management enforces violence prevention rules. ____ 11. Specific people or positions are identified for performance or coordination of violence prevention activities. ____ 12. Assignment of responsibility is clearly communicated. ____ 13. Individuals with assigned responsibilities have the necessary knowledge, skills, and timely information to perform their duties. ____ 14. Individuals with assigned responsibilities have the authority to perform their duties. ____ 15. Individuals with assigned responsibilities have the resources to perform their duties. ____ 16. An accountability mechanism is included with each assignment of responsibility. ____ 17. Individuals are recognized and rewarded for meeting violence prevention responsibilities. ____ 18. Individuals are disciplined for not meeting responsibilities. ____ 19. Supervisors know whether employees are meeting their violence prevention responsibilities.
Increase ownership, empowerment, opportunities for leadership
Invitation Suggestions Reports Consequences
Teams Empowerment Ownership Everyone engaged
Committees Open communications
Audit questions ____ 20. There is a process designed to involve employees in violence prevention issues. ____ 21. Employees are aware of the involvement process at the workplace. ____ 22. Employees believe the process that involves them in violence prevention is effective. ____ 23. The workplace violence prevention policy is effectively communicated to employees. ____ 24. The workplace violence prevention policy is supported by employees. ____ 25. Violence prevention goals and supporting objectives are effectively communicated to employees. ____ 26. Violence prevention goals and objectives are supported by employees. ____ 27. Employees use the hazard reporting system. ____ 28. Sata analyses of incidents of violence are reported to employees. ____ 29. Hazard control procedures are communicated to potentially affected employees. ____ 30. Employees are aware of how to obtain competent emergency medical care.
Audit questions ____ 31. A comprehensive baseline violence survey has been conducted within the past five years. ____ 32. Effective job hazard analysis (JHA) is performed, as needed. ____ 33. Effective inspections are performed regularly. ____ 34. Effective surveillance of established violence controls is conducted. ____ 35. An effective violence incident reporting system exists. ____ 36. A violence risk assessment is performed when there is a change in facilities, equipment, materials, or processes . ____ 37. Outside experts are used to identify risk factors for violence and recommend controls. ____ 38. Risk factors are eliminated or controlled promptly. ____ 39. Violence control procedures demonstrate a preference for engineering methods. ____ 40. Effective engineering controls are in place, as needed. ____ 41. Effective administrative controls are in place, as needed. ____ 42. Violence prevention rules are written. ____ 43. Personal protective equipment is effectively used as needed. ____ 44. Effective preventive and corrective maintenance is performed. ____ 45. Engineered hazard controls are well maintained. ____ 46. The organization is prepared for emergency situations resulting from violence in the workplace.
Hazard Identification Worksite Analysis Worksite analysis involves a step-by-step, commonsense look at the workplace to find existing or potential hazards for workplace violence. This entails reviewing specific procedures or operations that contribute to hazards and specific locales where hazards may develop. A "Threat Assessment Team," "Patient Assault Team," similar task force, or coordinator may assess the vulnerability to workplace violence and determine the appropriate preventive actions to be taken. Implementing the workplace violence prevention program then may be assigned to this group. The team should include representatives from senior management, operations, employee assistance, security, occupational safety and health, legal, and human resources employee. The team or coordinator can review injury and illness records and workers' compensation claims to identify patterns of assaults that could be prevented by workplace adaptation, procedural changes, or employee training. As the team or coordinator identifies appropriate controls, these should be instituted. The recommended program for worksite analysis includes, but is not limited to, analyzing and tracking records, monitoring trends and analyzing incidents, screening surveys, and analyzing workplace security. Records Analysis and Tracking This activity should include reviewing medical, safety, workers' compensation and insurance records -- including the OSHA 200 log, if required -- to pinpoint instances of workplace violence. Scan unit logs and employee and police reports of incidents or near-incidents of assaultive behavior to identify and analyze trends in assaults relative to particular departments, units, job titles, unit activities, work stations, and/or time of day. Tabulate these data to target the frequency and severity of incidents to establish a baseline for measuring improvement. Monitoring Trends and Analyzing Incidents Contacting similar local businesses, trade associations, and community and civic groups is one way to learn about their experiences with workplace violence and to help identify trends. Use several years of data, if possible, to trace trends of injuries and incidents of actual or potential workplace violence. Screening Surveys One important screening tool is to give employees a questionnaire or survey to get their ideas on the potential for violent incidents and to identify or confirm the need for improved security measures. Detailed baseline screening surveys can help pinpoint tasks that put employees at risk. Periodic surveys -- conducted at least annually or whenever operations change or incidents of workplace violence occur -- help identify new or previously unnoticed risk factors and deficiencies or failures in work practices, procedures, or controls. Also, the surveys help assess the effects of changes in the work processes. The periodic review process should also include feedback and follow-up.
Independent reviewers, such as safety and health professionals, law enforcement or security specialists, insurance safety auditors, and other qualified persons may offer advice to strengthen programs. These experts also can provide fresh perspectives to improve a violence prevention program.
Workplace Security Analysis
Periodically inspect the workplace and evaluate employee tasks to identify hazards, conditions, operations, and situations that could lead to violence.
To find areas requiring further evaluation, the team or coordinator should do the following:
Analyze incidents, including the characteristics of assailants and victims, an account of what happened before and during the incident, and the relevant details of the situation and its outcome. When possible, obtain police reports and recommendations.
Identify jobs or locations with the greatest risk of violence as well as processes and procedures that put employees at risk of assault, including how often and when.
Note high-risk factors such as types of clients or patients (e.g., psychiatric conditions or patients disoriented by drugs, alcohol, or stress); physical risk factors of the building; isolated locations/job activities; lighting problems; lack of phones and other communication devices, areas of easy, unsecured access; and areas with previous security problems. (See sample checklist for assessing hazards in Appendix B.)
Evaluate the effectiveness of existing security measures, including engineering control measures. Determine if risk factors have been reduced or eliminated, and take appropriate action.
Periodically surveying employees on workplace violence can be a valuable tool for evaluating your workplace violence prevention efforts and gathering suggestions for improving your program. Some employees may prefer not to have their names identified on a survey; making the name "optional" may increase the amount of feedback you receive.
SAMPLE Employee Survey on Workplace Violence Hazard Assessment
Name (Optional) _______________________________________________________________
Department/Unit ______________________________ Date _____________________________
Work Location (if at alternate worksite) ______________________________________________
Please assess your department/unit over the last year. Circle TRUE (T), FALSE (F) or DON’T KNOW (?). Thank you for your honest assessment.
Management Commitment and Employee Involvement
Violence/threats are not accepted as "part of the job" by managers, supervisors and/or employees.
Employees communicate information about potentially assaultive/threatening clients or visitors to appropriate staff.
Management communicates information to employees about incidents of workplace violence.
Employees feel they are treated with dignity and respect by other employees and management.
Employees are basically satisfied with their jobs.
Employees are basically satisfied with management.
Employees are basically satisfied with the organization (i.e., mission, vision, goals).
Employees generally feel "safe" when they are at work.
Employees are familiar with the department’s/unit’s violence prevention policy.
The following items serve merely as an example of what might be used or modified by employers in these industries to help prevent workplace violence.
ID Number ___________________
I. Priorities A number of factors maybe important in preventing assaults, or reducing the impact of assaults. We would like to know your views on what the most important factors are. For these questions, please use the following definition of assault: "Physical contact that results in injury." (Injury may be major or minor; e.g., mild soreness, scratches, or bruises would be included.)
1. What do you think is the most important factor contributing to assaults on employees?
A number of factors have been suggested as possibly important in determining whether assaults occur, or the impact of assaults. Please indicate which factors you think are most important. Please indicate only your top five priorities. In other words, many of the following areas maybe important, but we are interested in which are most important. Please place a "1" next to the issue that you think is the top priority, and a "2" next to the issue that you think is the next highest priority, and so forth. If you have no opinion or don't know, please check "Don't know." ____ a. Employee training in self-defense/restraint procedures ____ b. Employee interpersonal skills ____ c. Employee fitness ____ d. An effective security alarm system ____ e. Adequate numbers of personnel ____ f. Business practices (e.g., handling money) ____ g. Physical environment (e.g., noise) ____ h. Identifying customers with a history of violence
____ i. Identifying employees with potentially assaultive (e.g., agitated) behavior
____ j. Transfer of information at shift change about potentially assaultive employees ____ l. Procedures for reporting assaults to administrators ____ m. Procedures for evaluating employee who have been involved in assaults ____ n. Procedures for reporting assaults to police ____ o. Legal penalties for competent assaultive employees ____ p. Structured psychological support for assaulted employee ____ q. Timeliness of L&I processing of Worker's Compensation claims ____ r. Other _______________________________ ____ s. Don't know
ELEMENT 5 – INCIDENT / ACCIDENT INVESTIGATION Analyze incidents and accidents to fix system weaknesses Symptoms Surface cause Root cause Controls Improvements Audit questions ____ 46. Violence Incidents/Accidents are investigated for root causes. ____ 47. Investigations are conducted to improve systems. ____ 48. Investigators are trained in violence prevention procedures. ____ 49. Serious acts of violence are investigated by teams. ____ 50. Analysis and recommendations involve all interested parties.
This type of form can be used to report any threatening remark or act of physical violence against a person or property, whether experienced or observed. Individuals may be more forthcoming with information if the form is understood to be voluntary and confidential. The form also needs to identify where it should be sent after completion (for example, workplace violence prevention group or safety committee representative).
Date of Incident YearMonthDay of Week
Location of Incident (map and sketch on reverse side):
List any witnesses to the incident (name and phone).Did the assault involve a firearm? If so, describe.Did the assault involve another weapon (not a firearm)? If so, describe.Was the victim injured? If yes, please describe.
Who committed the incident (name, if known)? What is his/her status to the victim:____Stranger ____Personal Relation
What was the gender of the person(s) who committed the incident?____Male ____Female
Please check any risk factors applicable to this incident. Each company should develop and include a list of potential risk factors that may apply in its worksite.
Working with money
Working with drugs
Working in a high-crime area
Working late at night
Poor lighting outside of worksite
Other risk factor: ________________________________________________________
Other risk factor: ________________________________________________________
What steps could be taken to avoid a similar incident in the future?
(To avoid recreating trauma, sound judgment should be exercised in deciding when to request this information.)
Send completed form to:______________________________________
Threat assessment investigations Threat assessment investigations differ from administrative or criminal investigations in that the purpose of the threat assessment investigation is to provide guidance on managing the situation in a way that protects the employee. Many cases involving threatening behavior can be handled expeditiously and effectively by a supervisor with the assistance of one or more members of the company's incident response team. The security or law enforcement representative on the company's team will ordinarily assess risks, often in consultation with the Employee Assistance Program and employee relations staff, and make recommendations for appropriate strategies and security measures to protect employees. However, it may be helpful for the company's planning group to identify experts in threat assessment ahead of time, in case a situation requires more expertise than team members can provide. Gathering information. It is also a good idea to work out ahead of time who will gather which types of information on an individual who makes a threat. Multiple sources of information need to be consulted to better understand the person's behavior. In some cases, the company's incident response team can collect current and reliable information (which would include an investigative report) and then consult with a threat assessment professional to develop options for managing the situation. In other cases, the company's incident response team uses a threat assessment professional to conduct the initial investigation, assess the risks, and make recommendations for managing the situation. Administrative Investigations It is important to use an investigator who conducts the investigation in a fair and objective manner. The investigation should be conducive to developing truthful responses to issues that may surface. It must be conducted with full appreciation for the legal considerations that protect individual privacy. It is imperative that the investigation, especially the interview , create an atmosphere of candor and propriety. Use a qualified investigator. If a decision is made to conduct an administrative investigation, it is important to use a qualified and experienced professional workplace violence investigator. The company planning group should train and qualify one or more such investigators before the need for an investigator arises. Investigation and Evaluation After an incident occurs, a detailed investigation is imperative. All incidents should be investigated as soon as possible. The investigation should focus on fact-finding to prevent recurrence and not fault-finding. Employers should maintain comprehensive records of the investigation.
Immediately after an assault occurs, an employer should focus first on providing for the medical and psychological needs of all affected employees. Other immediate steps include:
Report the incident to the local police department and support law enforcement activities (for example, crime scene investigation; interviewing witnesses, victims and others).
Secure work areas where disturbances occurred.
Account for all employees and others and ensure the physical safety of those remaining in the area as soon as possible.
Provide for site security and ensure that no work area is left short-staffed while others assist the victim or help in securing the area.
Quickly assess the work area, if it was disturbed or damaged during an incident, to determine if it is safe.
Provide critical incident debriefing to victims, witnesses, and other affected employees (these conversations must be strictly confidential).
Provide accurate communication to outside agencies, media and law enforcement.
Initiate the Post Incident Trauma Plan
The post trauma plan should focus activities first on meeting the immediate medical and psychological needs of employees as necessary. Employees may also need the services of an employee assistance program or other counseling services.
Provisions for follow-up after medical and psychological treatment, medical confidentiality, and protection from discrimination must be addressed in the plan to prevent the victims of workplace violence from suffering further loss. The plan should also address ways to reduce financial losses to the company caused by absence, lost productivity, and workers’ compensation claims.
All affected employees should be included in a debriefing so that the cause of the violence and expectations can be discussed, a plan of action can be addressed, and those needing further counseling can be identified.
Improve the skills, knowledge, attitudes of everyone
Continual Skills Knowledge Attitude
Impact Everyone Consequences
Audit questions ____ 51. An organized violence prevention training program exists. ____ 52. Employees receive violence prevention training. ____ 53. Employee training covers hazards related to workplace violence. ____ 54. Employee training covers the facility safety system. ____ 55. New employee orientation includes information on violence prevention and risks. ____ 56. Violence prevention policy is understood by employees. ____ 57. Violence prevention goals and objectives are understood by employees. ____ 58. Employees periodically practice implementation of violence prevention emergency plans. ____ 59. Employees are trained in the use of violence prevention equipment. ____ 60. Supervisors receive violence prevention training. ____ 61. Supervisors are effectively trained on violence prevention. ____ 62. Supervisors are trained on all site-specific violence prevention measures and controls relevant to their needs and supervisory responsibilities. ____ 63. Supervisor training covers the supervisory aspects of their violence prevention responsibilities. ____ 64. Managers understand the organization's violence prevention system. ____ 65. Relevant violence prevention aspects are integrated into all management training.
Implement lasting positive change in all the above
Proactive Prevention Systems Conditions
Behaviors Continual Evaluation Controls
Engineering Design Purchasing Teams
Audit questions ____ 66. Workplace violence data is effectively analyzed. ____ 67. Violence prevention training is regularly evaluated. ____ 68. Post-training knowledge and skills for violence prevention are tested or evaluated. ____ 69. Incidence data is effectively analyzed. ____ 70. Hazard controls are monitored to assure continued effectiveness. ____ 71. A review of the overall violence prevention system is conducted at least annually.
One essential element that cannot be overlooked is to evaluate the violence prevention program on a scheduled basis, and immediately after an incident has occurred. If the program is not evaluated at least annually, this and other problems may never be detected.
As with any program, personnel, facilities, and issues can change within a year and updates must be maintained. Procedures may break down if they are not exercised regularly. In these instances, practice may be necessary to keep procedures effective.
After an incident, it's important to evaluate the program to see if there are any changes that should be made immediately to prevent a similar incident from occurring in the future.
Steps in the Evaluation Process
Appoint knowledgeable employees to conduct the evaluation to ensure effective results..
Conduct an initial assessment to determine what program components are in place.
Analyze the components of the violence prevention program.
Measure improvement based on lowering the frequency and severity of workplace violence.
Identify those components that require improvement.
Conduct and review the results of an employee survey.
Develop ways to improve ineffective components.
Educate, train and implement changes in the program.
Devise and update your system for measuring improvement.
Keep abreast of new strategies to deal with violence.
1. The instructor provided quality training (relevant, interesting, applicable, etc.) and was knowledgeable about occupational safety and health. 2. The instructor was able to answer questions adequately or make an appropriate referral. 3. The instructor encouraged participation. 4. Please rate the overall effectiveness of the instructor in helping you to understand your safety and health problems and needs: WE VALUE YOUR COMMENTS Management Worker Agree Disagree 1. I found the course information easy to understand and useable. 2. The information I learned today will help me reduce hazards and prevent work-related injuries and illnesses at my workplace. 3. The course materials (workbooks, overheads, slides, etc.) were helpful. 4. Please rate the overall effectiveness of this workshop in helping you to understand your safety and health problems and needs: ...Very Effective... ...Not Effective... 10 9 8 7 6 5 4 3 2 1 0 Comments: Please take the time to explain all “No” or “Not Effective” responses. ...Very Effective… ...Not Effective... 10 9 8 7 6 5 4 3 2 1 0 Comments: Please take the time to explain all “No” or “Not Effective” responses. Facility Comments: Department of Consumer and Business Services Oregon Occupational Safety and Health Division (OR-OSHA) Workshop Evaluation Workshop Title: _________________________________ Date: ______________ Instructor: ______________________
Developing an effective Violence Prevention Program OR-OSHA 120 0101 Presented by The Public Education Section Oregon Occupational Safety and Health Division (OR-OSHA)
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