Building a Workplace Violence Program
5 Steps
Securing Leadership Commitment
Assessing Your Program Needs
Developing the Program Components
Implementing the Program
Evaluating the Program
Securing Leadership Commitment
Effective leadership and enhanced accountability are critical in any workplace safety program, which includes violence and harassment prevention. Leadership’s commitment to preventing workplace violence provides the necessary resources and clear directions for workers and employers to successfully implement a workplace violence and harassment prevention program and make it a priority to continually improve.
Workplace violence prevention must be a clear priority for all. It is recommended that:
- CEOs create and implement a strategic plan that places importance on the creation of a working environment free of violence for workers and patients;
- The strategic plan is shared with everyone in the working environment;
- Targets are set for reducing workplace violence;
- Achievements towards those targets are shared and monitored by the most senior committees and the HSR/HSC; and
- Members of the board of directors maintain oversight of its outcome.
Promoting a culture of safety – one that ensures the best patient care is delivered within a violence-free working environment – begins with members of the Board of Directors and senior leadership.
This is accomplished by:
- Promoting reporting of incidents/events;
- Staff who feel supported, heard, and protected when reporting hazards; and
- Staff and HSR/HSCs members who feel supported and heard by providing input into policy, measures and procedures, and training that could positively impact worker safety. Everyone, from the members of the Board of Directors to patients and families, must understand how they contribute to a violence-free workplace, and become champions to implement change.3
Securing commitment for a successful program also requires leaders to understand their overall responsibility and accountability for workplace safety.
To ensure ongoing program sustainability, organizations should integrate health, safety, and wellness into an organization’s core business through a Health and Safety Program or an organization’s OHSMS.
The Health and Safety Program/OHSMS can be utilized to motivate an organization to achieve employee health, safety, and wellness, provide quality care and embrace public safety. Successfully implemented, an HSMS will lead to a positive culture of health, safety, and wellness. The CSA standard Z1000 (Plan, Do, Check, Act) and the CCSA’s Health and Safety Program Review can identify gaps in the organization’s OHSMS and helps mitigate employee, resident, and public risks. For more information refer to the CCSA Health and Safety Toolkit.
Resources to support Step 1:
- Alberta OHS – Harassment and Violence in the Workplace. Explains what harassment and violence are and the legal obligations of employers to protect their workers.
- Alberta OHS – Harassment and Violence in the Workplace Sample Policies.
Training to support Step 1:
Assessing Your Program Needs
A strong workplace violence prevention program should include a comprehensive risk assessment and a plan to reduce those risks. Workplace violence is a hazard that all workplaces should continually strive to prevent and control.
The Alberta Occupational Health and Safety Act requires employers help prevent workplace harassment and violence and address incidents when they do occur. A risk assessment is essential to identify the specific risks of exposure to violence in particular work settings. It also helps put in place controls to prevent and minimize workplace violence. To develop a successful violence prevention program, it is essential that workers, employers, the HSC/HSR and unions participate and cooperate to identify and assess risks in the workplace.
You are encouraged to involve workers, supervisors, health and safety and/ or workplace violence prevention committees, health and safety representatives, and/or unions in this process.
Assessing the risks associated with workplace violence should include an assessment of:
- Internal documents such as:
- Employee feedback from company “suggestion boxes”;
- Security logs;
- Reports about emergencies, incidents and accidents;
- The minutes from joint health and safety committee meetings;
- Workplace inspection reports;
- Reports generated through collective agreements;
- High-level Employee Assistance Program usage reports (which do not identify individuals);
- Grievances; or,
- Workplace Compensation Board (WCB) Claims
- The organization’s physical environment;
- The work setting and clients;
- Community workplace violence issues;
- Point-of-care work practices;
- Staff perceptions.2
Developing Program Components
To ensure a comprehensive program, organizations must design a Workplace Violence Prevention Program that consists of a workplace violence prevention policy and a program that includes; reporting, response and investigation procedures; environmental control procedures; work practice and administrative control procedures.2
The Prevention, Protection, and Post-incident Response (the 3 P’s) conceptual model was adapted from risk management practices (Wiskow, 2003) that are widely accepted and used in the occupational health and safety industry.
To adequately address workplace violence aggression, and responsive behaviour, organizations should take a three-pronged, cyclical approach: Prevention, Protection, and Post-incident Response (the 3 P’s). Wherever possible, the emphasis should be on implementing measures to prevent the workplace violent event. Organizational culture may affect the success of each prong.4
Prevention involves strategies undertaken prior to an incident to deter the onset of workplace violence. Four important stages include:
1. Recognizing risks;
2. Assess existing precautions and prioritizing risk;
3. Controlling and communicating risk;
4. Evaluating and refining the action plan, i.e., R.A.C.E. information gathered in Step 2 complete the first 2 stages of Recognition and Assess. This information should be used to develop the measures and procedures to Control the hazards identified.4
Resources for “preventing” injuries may include:
Procedures to control Administrative and Work Practice hazards such as:
- Client assessment and screening
- Flagging alert Program
- Triggers and care planning
- Engaging patients and families in workplace violence prevention
Protection focuses on strategies undertaken during an incident to manage workplace violence and limit the extent of harm.
- Activities may include:
- Early identification of violent, aggressive, or responsive behaviour;
- De-escalation and diffusion techniques;
- Avoiding physical contact where possible;
- Protocols for managing individual behaviours;
- Use of coded requests for help;
- Crisis management training;
- Prompt and appropriate attention by managers;
- Mobilization of resources and security measures; and
- Keeping safety a priority.4
Resources for “protecting” workers may include:
- Policy and procedure development for Reporting of incidents.
- Security and Personal Safety Response System Programs and Tools
- Code White Response procedures
- Procedures to control Administrative and Work Practice hazards such as:
- Preparing for a meeting with a potentially violent client
- Work-related travel
- Working alone or in isolated areas
- Behavioural contracts between client and facility which outline agreed-upon behaviour, treatment and expectations
- Working in the community –CCSA Assessing Violence in the Community: A Handbook for the Workplace
- Dealing with visitors and the public
Post-incident Response strategies are undertaken after an incident has occurred to reduce long-term negative effects on the victim(s), other people involved, and the workplace following the incident.
- Suggested post-incident responses cover the following:
- Assistance and support for victims;
- Information-sharing and team debriefing;
- Reporting procedures, and workplace investigations to prevent recurrence.4
Resources for “post incident response” may include:
- Systematic Approach to Post Incident Follow Up – RCA, incident Debriefing- including steps taken to prevent a recurrence
- Victim assistance and support (Incident and treatment options such as EAP, in house resources, or peer counselling).
References:
2. PSHSA – A guide to the Development of a Workplace Violence Prevention Program: Implementing the Program in your Workplace;
4. Guidelines on Workplace Violence in the Health Sector. Comparison of major known national guidelines and strategies: United Kingdom, Australia, Swede, USA (OSHA and California) Written by Christiane Wiskow (2003) for International Labour Office, International Council of Nurses, World Health Organization, Public Services International.
Implementing the Program
To ensure all staff are aware of your Workplace Violence Prevention Program, develop a detailed plan for implementing the workplace violence prevention program that includes marketing and communication strategies.
Staff must also be trained on measures and procedures to protect themselves. Training should be mandatory and incorporated into the orientation and regular (annual) education programs. The design of the educational and training programs should reflect the specific needs of the staff. Information from the needs assessment phase of the program development strategy should be incorporated into the design of the education and training programs. All education and training programs must be evaluated in terms of employee comprehension, quality of learning, change in practice or behaviours, and organizational performance.
Evaluating the Program
An organization cannot evaluate effectiveness without measuring indicators. Measuring and evaluating your program is vital in guiding program improvement. Evaluation is a critical component of a workplace violence prevention program to determine the program’s effectiveness and highlight opportunities to enhance the program.2 The set of indicators should be comprehensive, include both leading and lagging indicators from Qualitative and Quantitative sources, and enable performance measurement and reporting at the provincial and the local level.
Goals of program evaluation:
- Create and maintain a safe working environment without the threat of violence
- Review, revise, enhance and improve program components
- Identify and implement corrective measures that may prevent subsequent violent situations
- Modify the program when insufficiencies are identified in policies, procedures, and employee training/education
Quantitative sources of information:
- Violence reporting data
- Environmental assessment data and workplace inspection reports
Qualitative sources of information:
- Data from training evaluations, staff surveys, compliance audits 2
Resources for evaluating your program:
Reference:
2. PSHSA – A guide to the Development of a Workplace Violence Prevention Program: Implementing the Program in your Workplace.
Reviewing your Current Program
Continuing Care Tools
Long Term Care and Facility Living
Community and Senior's Housing Tools
Senior's Housing, Independent Living
Ontario's PSHSA Violence and Aggression Resources Terms of Use
Accessing the PSHSA violence prevention materials for use in the Province of Alberta is with the agreement that the terms and conditions will be met under the license agreement between PSHSA and the CCSA.
The resources in the CCSA Violent and Harassment Prevention Program are aligned with the content from PSHSA violence prevention materials. These documents and resources may have references to the Ontario context and legislative requirements specific to the Province of Ontario. Though the CCSA has adapted these for use in Alberta, users of these resources are still advised to reference the Alberta OHS legislation.