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Another Reminder About Emergency Planning for an Active Shooter

Washington Post shooting calendarYesterday, Dec. 2, 2015, marked the 336th day of the year and 355th mass shooting, according to the Mass Shooting Tracker, which logs incidents in which four or more people are shot. Indeed, there were two mass shootings yesterday: a smaller incident in Georgia in which a woman was killed and three men injured, and the slaughter of at least 14 people and injury of 17 at an office holiday party at San Bernadino’s Inland Regional Center, which provides social services to residents with developmental disabilities. No motive has been found thus far, but two shooters have been identified as a county employee who had attended the party and his wife.

As I wrote in the November issue of Risk Management magazine, researchers from the Harvard School of Public Health and Northeastern University found that the rate of mass shootings has tripled since 2011. According to a study released last year by the Federal Bureau of Investigation, active shooter incidents, where police arrive to a shooting in progress, are also on the rise. The FBI found that 160 of these incidents had taken place in the United States between 2000 and 2013, 70% of which occurred in either a business or educational environment. An average of 11.4 incidents occurred annually, averaging 6.4 in the first seven years studied, and 16.4 in the last seven years.

With the growing frequency and ever-increasing fatalities, risk managers clearly cannot afford to become so inured to these incidents. Rather, much like they do for other forms of crisis, from fires to tornadoes, they need to be acting now to train employees, develop emergency plans, and ensure business continuity provisions are in place.

“You have smart people leading organizations who know they need to do something, but you see them fall into a pattern of planning to have a plan, and they confuse that with taking action on the issue,” said Jay Hart, director of the Force Training Institute. “Planning to have a plan is not a plan. They need to understand that this is a leadership issue, because it is about protecting the people in the company.”

For tips on preparing for an active shooter incident, check out the Q&A with Hart from the December issue of Risk Management, and “Preparing for an Active Shooter Incident,” from the November issue. When developing a plan to respond to an active shooter crisis, make sure to:RM11.15_ff_shoot_side.630

Minimizing the Dangers for Hospital Nurses

Nurses in Emergency Room

In “Bad Medicine,” from the December issue of Risk Management magazine, Alan H. Rosenstein wrote about managing the risk of disruptive behaviors in health care settings, which he defined as “any inappropriate behavior, confrontation or conflict, ranging from verbal abuse to physical or sexual harassment, that can negatively impact patient care.
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” More than half of respondents in one survey felt these events led to medical errors and compromises in patient safety and quality of care, Rosenstein reported.

But the risks nurses face do not just come from within the staff—simply doing their jobs presents a minefield of potential danger to physical and mental health. According to the Occupational Safety and Health Administration, those who work in nursing are the most likely to face violence on the job. Over 54% of emergency room nurses report experiencing physical violence or or verbal abuse on the job, of whom 41% report they have been punched or slapped at work and almost 28% report being pushed, shoved or thrown.

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Nearly 98% of physically violent incidents against nurses are perpetrated by patients, who are also responsible for 92.

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3% of verbal abuse in the health care setting.

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Check out the infographic below for more details on the risks nurses face, and some preventative best practices to minimize risk for hospital workers:
The Dark Side of Nursing
Source: TopRNtoBSN.com

Preventing Workplace Violence

The summer of 2012 produced one of the most alarming streaks of workplace-related violence in recent memory. Among the deadliest and most-publicized events were:

  • the movie-theater rampage in Aurora, Colorado, which 12 people were killed and 58 wounded
  • the Sikh Temple shootings in Oak Creek, Wisconsin, that left seven dead, including the shooter
  • the workplace shooting near the Empire State Building, with two dead and nine wounded
  • the early-morning grocery store shooting in New Jersey, which killed three people
  • the hostage situation in an office building in Pittsburgh that ended without violence
  • the shooting at a Minnesota sign company, that killed six victims, plus the shooter

FOR A FULL LIST, SEE THE NOVEMBER ISSUE OF RISK MANAGEMENT

These tragedies all occurred within two months. The stream of headlines describing violence at various places of employment was long and horrifying, and the lives of those affected will never be the same. Is such a streak an indication of a trend towards increasing violence? Or was this an awful series of coincidences?

According to the Bureau of Labor Statistics, 4,609 people died at work in 2011, and 10% of those deaths (461) were the result of homicide.

Although the numbers may appear small compared to the size of the workforce at large, they still represent more than one death by homicide at work each day. What’s more, each death has a tragic ripple effect that extends deeply into families, businesses and communities.

These situations are often perceived to occur suddenly and without warning, but there are often signs in the months, weeks, or days leading up to the incident­­­: changes in mood, increased absenteeism, or angry outbursts. To minimize risk of a violent incident, all employees — managers, supervisors and co-workers — should be trained and empowered to report these sorts of warning signs as they occur.

Types of Workplace Violence

The headlines focusing our attention on disgruntled co-workers may actually be masking aspects of workplace violence that are not only more significant, but also preventable. For example, 39% of women who are murdered at work are victims of estranged husbands or boyfriends. In many cases, there is a history of domestic violence.

Recognizing the signs of domestic violence and providing resources for assisting victims is a vital part of providing a safe workplace.

One-third of all cases of workplace homicide involve robbery. These cases often target employees in banks, retail or transportation, where there is a known presence of cash and exposure to the public. These situations should follow OSHA guidelines for a safe workplace.

Focusing our attention on workplace homicide can also obscure the depth of the continuum of workplace violence. Almost two million U.S. workers experienced violence at work in 2011. Violence stretches from verbal threats to physical assault and homicide. The much greater extent of these varying forms of workplace violence suggests a tremendous cost to employers in categories such as lost productivity, absenteeism and employee turnover.

The Need for Training

The lower-level forms of workplace violence can often be prevented or mitigated through violence-prevention training. While no policy can eliminate the risk of violence at work altogether, a few basic steps can make employees more vigilant and better prepared to recognize and react.

  • Every workplace should have a specific and explicit policy regarding violence, including detailed plans and procedures for responding to incidents, communicating with employees, families and the media, working with law enforcement, and a capacity for critical incident stress debriefing if any type of violence was committed, threatened or observed. Each new hire should be made aware of the plan, and the plan should be practiced on a yearly basis, if not more.
  • Provide Employee Assistance Programs to assist employees in managing work- or life-related stressors to help lessen the chance of a situation turning violent.
  • Systems for mandatory referral should be made available to managers and supervisors for employees in which troublesome behaviors have been observed.
  • Transfer employees away to a safe place if a threat was made.
  • Workplace violence audits should be performed to assess threat levels for all job types and work locations.

Beyond the incidents that create headlines, workplace violence is a persistent phenomenon with an impact that extends to families, friends, co-workers and the community. Preparation and training can reduce risk and have a positive impact on the reaction and recovery of all stakeholders, helping to restore stability and productivity to the workplace.