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centra health | lynchburg

Centra cracking down on workplace violence

Centra Lynchburg General Hospital

Centra Lynchburg General Hospital as seen Aug. 10. 

From January to June, 39 Centra Health employees reported a workplace violence injury.

To reduce such incidents, the Lynchburg-based health care provider is taking steps including creating a new committee to prevent workplace violence, educating caregivers on de-escalation techniques, providing panic buttons to more caregivers to quickly signal security when needed, and enhancing security cameras and other systems.

Workplace violence is “any act or threat of physical violence, harassment, intimidation, or other threatening disruptive behavior that occurs at the work site. It ranges from threats and verbal abuse to physical assaults and even homicide. It can affect and involve employees, clients, customers, and visitors,” according to the Occupational Safety and Health Administration.

When many people hear the term “workplace violence,” they might first think of big events such as shootings. But Nathan Campbell, corporate director of security for Centra Health, said it also includes spitting, kicking and pushing. The majority of workplace violence events are centered around health care facilities and health care providers, he said.

Data from the U.S. Bureau of Labor Statistics indicates of the 20,870 private sector workers who experienced trauma from non-fatal workplace violence in 2019 resulting in missed days of work, 70% worked in health care and related fields. BLS data also shows the incidence rate of violence against health care workers rose each year from 2011 to 2018.

Meanwhile, surveys conducted by the American College of Emergency Physicians (ACEP) and the Emergency Nurses Association indicate almost half of emergency physicians report being physically assaulted at work, while about 70% of emergency nurses report being hit and kicked on the job.

Another survey conducted this year by Incredible Health found 65% of nurses surveyed reported they had been verbally or physically assaulted by a patient or a patient’s family member within the last year.

“So while you think if you come to a health care facility, you continue to receive care and everything’s good and friendly and wonderful, we actually are having a lot of incidents where our caregivers are being hit, kicked, punched, cursed at and abused,” Campbell said. “And so that obviously results in injuries, loss of work; it’s hard to recruit and retain individuals to work for us when they’re getting battered all the time.”

Centra, which has 8,000 employees, always has had safety mechanisms in place to protect its caregivers, Campbell said, but during the past several years, workplace violence has continued to increase.

The two departments where Centra sees workplace violence most are its behavioral health and emergency departments.

Campbell said behavioral health patients are being held longer and they’re getting more aggressive, which he said is a challenge within itself.

“Then outside of that, there’s just problems around society,” he said. “There’s an increase in violence just around society in general, where people have expectations and they become elevated. And I think that in a lot of cases they think that they can just kind of act however and some of it’s had to do with people that are too anxious and nervous about what’s wrong with their family.”

Campbell said some people become worried about their loved ones and are concerned about what’s happening with them and they may act in an inappropriate manner.

“So they’re very driven off of fear, concern, etc. and we try to be careful about how we watch that and monitor it and make sure we’re aware of how people act,” he said.

Ismael Gama, Centra’s vice president of behavioral health, and Shannon Miles, senior director of behavioral health, said in a joint email statement the acuity of hospital patients is ever increasing and as staff provides care, the risk for violence increases as well.

“The behavioral health staff including nurses, therapists and mental health professionals are constantly in situations that could result in physical harm. With training from Crisis Prevention Institute and other resources on de-escalation, we have reduced the number of workplace violence encounters this year,” they said in the statement. “The safety of our Caregivers and patients continues to be our top priority.”

In 2017, there were 110 workplace violence incidents reported across Centra; 199 in 2019; 196 in 2020; and 160 in 2021.

To help address such incidents, Centra has implemented a new multidisciplinary Workplace Violence Prevention Steering Committee. This committee has been tasked with identifying, preventing and responding to workplace violence events. During the past several months, the committee has developed several subcommittees focusing on Caregiver-to-Caregiver events, Complex Patients and De-escalation, and Environmental Safety.

Centra is even encouraging staff members to press charges against people who abuse them.

“We’ll actually carry them down on the magistrate’s office and will follow them through the whole process, but we want to make sure that they do feel supported by us and that we are not going to tolerate that as a health care organization,” Campbell said. “We’re here to provide a service and to help individuals in need of care but we’re not going to take abuse from people.”

Campbell said the hospital system also wants to make sure patients and visitors are safe when they are on the campus.

“So we have a multifaceted team, which has individual leaders from all throughout the organization, including home health and the hospice unit because they have a very unique perspective as opposed to our acute care facilities,” he said.

He said this committee is really driven around the prevention of workplace violence.

“We call it workplace violence prevention because while it does happen and we want to have mechanisms in place on how we manage that, we also want to make sure we’re preventing it.”

To accomplish that, Campbell said the community needs to be aware of the hospital’s zero tolerance policy on workplace violence. New signage has been placed throughout the property so patients and visitors understand expectations.

Campbell said the Centra Foundation has provided $200,000 to start education through the Crisis Prevention Institute — the vendor Centra is using for standard de-escalation and nonviolent crisis training — which will be providing education for all caregivers on de-escalation practices.

Centra is working now with caregivers to provide panic buttons that have the ability to signal the security team on a moment’s notice, Campbell said. It also is identifying people who are high risk and working to place them in electronic medical records so all caregivers are aware of the potential situation ahead of time.

Within the emergency department or behavioral health areas, the nurses and care providers have a button about the size of their name tag they can press to signal to security which room they’re in so someone can get to them quickly.

“So we’re working to scale that and spread that out throughout the organization because it’s strictly been focused on behavioral health and emergency in the past,” he said.

There’s a greeter present in the front lobby who monitors everybody that’s coming in and out of the building, he said, and camera systems and access systems also are getting enhanced.

“We expect people to act appropriately and respectful of our caregivers, because we’re here to take care of people we’re not here to be abused,” Campbell said. “So we want to make sure that people understand that when they come in here, we’re not going to tolerate that and we will cancel procedures.”

Campbell said he worked in the emergency department for 20 years before starting in the role he holds now and would go home every day with the expectation he would have gotten cursed at at least once.

“And that shouldn’t be the way our caregivers are coming to work,” he said.

“We’re here to provide a service and to help individuals in need of care but we’re not going to take abuse from people.”

Nathan Campbell, corporate director of security for Centra Health

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