Violence against hospital employees has increased since the start of the pandemic. Recent studies indicate that 44% of nurses reported experiencing physical violence and 68% reported experiencing verbal abuse during the COVID-19 pandemic. A 2021 survey found that 63% of respondents did not feel safe at work, and 70% reported experiencing verbal assault multiple times. According to OSHA, 75% of the of the 25,000 reported workplace assaults occur in the health care and social services setting. Those unfamiliar with daily events in healthcare institutions may be shocked to learn that violent altercations are so common that most employees in the field consider them to simply be a part of the job. The high incidence of workplace violence prompted the creation of new accreditation requirements from The Joint Commission and a recent memo from The Centers for Medicare & Medicaid Services (CMS).

New and revised workplace violence prevention standards were released January 2022 and apply to all Joint Commission-accredited hospitals and critical access hospitals. The new and revised Joint Commission standards provide a framework to guide hospitals in developing effective workplace violence prevention systems, including leadership oversight, policies, and procedures, reporting systems, data collection and analysis, post-incident strategies, training, and education to decrease workplace violence.

Additionally, on November 28, 2022, The Centers for Medicare & Medicaid Services (CMS) released a Quality, Safety & Oversight (QSO) Memo on workplace violence in hospitals reviewing the regulatory requirements for Medicare certified hospitals to care for patients in a safe setting. Medicare certified hospitals are required under the Medicare Hospital Conditions of Participation (CoPs) at §482.13(c)(2) to care for patients in a safe setting. This includes the need to identify those patients at risk for intentional harm to themselves or others, as well as potential environmental safety risks for such patients. Per CMS, all hospitals are expected to implement a patient risk assessment strategy and an emergency preparedness plan accounting for these hazards.

Further, The Emergency Preparedness Conditions of Participation requires hospitals to educate and train staff to identify patients at risk of harm to self or others, develop mitigation strategies, and enact policies and procedures to protect both the workforce and patients. The Emergency Preparedness CoP at §482.15(d)(1) contains requirements for hospitals to train staff and to have policies and procedures aimed at protecting both their workforce and their patients. Under the Medicare Hospital Emergency Preparedness CoP at §482.15(a), a hospital’s emergency preparedness plan must be based on, and include, a documented, facility and community-based risk assessment, utilizing an all-hazards approach. It must also include strategies for addressing emergency events identified by the risk assessment as well as address the patient population, including, but not limited to, persons at-risk

CMS states that hospitals have the flexibility to tailor the training to the services they provide and the patient populations they serve. Additionally, CMS expects hospitals to provide education and training to all new staff initially upon orientation and whenever policies and procedures change. CMS recommends that ongoing training be performed at least every two years after initial training.

Lastly, CMS states that his memo serves as a reminder to healthcare facilities that they will continue to enforce these regulatory obligations and cite hospitals that fail to meet them. Therefore, it is imperative and the expectation of CMS that patients and staff alike work and have care in an environment that prioritizes their safety to ensure effective delivery of healthcare.

As your remarkable partner, Inspirien offers education to both help you meet these requirements and provide your staff with valuable information on issues such as:

Active Shooter
Difficult Patient
Disruptive Behaviors
Emergency Preparedness
Violence in the Workplace

These classes are offered to Inspirien insureds and the Healthcare Workers’ Compensation Fund members. For more information on how to become an Inspirien partner, email a member of our team at *Indicates class specific to Inspirien’s Medical Malpractice Insureds