Workplace Violence and Harassment Tools in LTC
Step 1: Securing Leadership Commitment
Employers have the greatest responsibility with respect to health and safety in the workplace. The employer, typically represented by senior management, is responsible to take every practicable step for the protection of a worker. They are also responsible for developing and implementing the workplace occupational health and safety program and ensuring that the Internal Responsibility System (IRS) is established, promoted, and functions successfully to continually audit, evaluate, and improve the program. Strong leadership by senior executives, managers, and supervisors is essential to setting the tone and establishing a strong safety culture.
By reviewing and following an accountability framework, the organization can work towards the same goal of preventing violence and harassment in the workplace.
According to Alberta OHS Act Part 1: Obligations of Work Site Parties:
- Employers must ensure workers are not subject to or participate in harassment or violence at the work site.
- Supervisors must ensure workers under their supervision are not subject to harassment or violence at the work site.
- Workers must refrain from causing or participating in harassment or violence.
The organization can also establish a Workplace Violence Prevention Committee as a subcommittee of the HSC to oversee the program and ensure the Workplace Violence and Harassment Prevention Plans are followed and regularly evaluated.
Leadership and Accountability Tools
Can be used as a guidance tool for organizations to outline who is accountable for certain aspects of the Violence and Harassment Prevention Program
Step 2: Assessing Your Program
Once you have secured leadership commitment and all worksite parties are aware of their responsibilities, it is essential that workers, employers, the HSC/HSR and unions participate and cooperate to identify and assess risks in the workplace.
Everyone should be involved in this process. workers, supervisors, health and safety and/ or workplace violence prevention committees, health and safety representatives, and/or unions to develop a successful workplace violence and harassment prevention program.
Assessment Tools
A tool that helps LTC homes work with their JHSCs to determine where they are in their workplace violence prevention journey and where they need to improve.
Workers in long-term care homes face significant risks of workplace violence. This checklist is designed as a prevention tool to enable healthcare and community care facilities to adopt leading practices when establishing systems and practices to prevent workplace violence. The document includes 2 parts: a checklist and an action plan.
Organizations should first assess where they stand and identify gaps in their violence and harassment prevention programs.
Contains a detailed hazard assessment designed to help long-term-care workplace identify hazards, establish their risk rating, identify controls and implement an action plan.
This toolkit includes the risk assessment tool and the detailed information on how to use it.
A series of questions employers can ask staff to help understand employees’ concerns and perceptions with respect to violence in their workplace. It is important to involve workers in the assessment process to identify their perception based on their experience and awareness. It also provides workers the opportunity to exercise their right to participate.
This tool will assist caregivers to reflect on caregiving safety measures and person-centred care strategies.
Step 3: Developing Program Components
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.
The Alberta Occupational Health and Safety Code also lists down the requirements every employer must develop and implement in their workplace harassment and violence prevention plans.
The plans must:
- include a prevention policy and prevention procedures
- be in writing and readily available for reference by workers at the work site, either in paper or electronic format.
Policies and procedures
- Policies set overall expectations that harassment and violence are not tolerated in the work environment.
- Procedures outline the methods or processes required to make the policy work on a day-to-day basis and establish a way of doing things that the employer and workers are to follow.
VARB Toolkits
The Violence, Aggression, and Responsive Behaviour (VARB) Toolkits are evidence-informed toolkits developed to help address violence against healthcare workers. Each toolkit includes prevention strategies and a variety of support materials to help enable robust workplace violence program planning and implementation. The toolkits can be used as a comprehensive resource or accessed as stand-alone resources to address an immediate priority.
The Violence Assessment Tool provides a snapshot of a client’s immediate risk of violence by identifying behaviours associated with increased risk. With this insight, healthcare teams can efficiently assess the risk, apply control interventions if needed, and improve worker safety while helping to increase quality of care.
Following extensive stakeholder consultation, the VAT was adapted from the BrØset Violence Checklist and the Dynamic Appraisal of Situational Aggression instrument for use in multiple care settings.
The VAT contains two sections:
1. Behaviours observed and history of violence and a Risk Rating Scale to determine whether the client’s risk level is low, moderate, high or imminently high
2. Action items/Interventions
The VAT should be completed at first contact with the client, and according to your organization’s policies and procedures — e.g. in acute care this might be once every shift; in long-term care, it might be between prescribed Ministry documentation such as RAI-MDS or RAI-HC. Depending on the client’s individual circumstances, further assessment may be required.
Employers, supervisors, staff — they all have a role to play in eliminating violence at work. Employers however have ultimate responsibility. They must also provide all workers at risk with information (including personal information) about a person with a history of violence. Workplaces, in turn, must adopt effective prevention strategies. One such strategy is a flagging-alert program to communicate violence-related risks to healthcare teams. By taking this kind of proactive approach to managing violent, aggressive and responsive behaviours, we can reduce the risk of harm to workers while providing patients with the best possible care.
This FLAGGING handbook provides practical tools and information that will help organizations develop a sustainable flagging-alert program.
The handbook includes:
- A Flagging overview on the purpose, benefits and types of flagging, and related legal and ethical responsibilities
- The five key steps to developing a Flagging Program
- Appendix – A Sample Flagging Policy
This toolkit is designed to help health and community organizations establish an effective PSRS. It aims to describe the PSRS, how the PSRS is a component of existing programs, processes and frameworks within an organization, and the need to consider PSRS as a system and not merely devices. The tool kit provides practical information that includes:
- Legislative requirements related to PSRS
- Definition of a PSRS and PSRS devices
- Alignment of PSRS to emergency management and a workplace violence program
- A systematic approach to developing and implementing a PSRS using Plan-Do-Check-Act
- The importance of PSRS devices, procedures and training programs
- General description of PSRS devices
- Tools to assist organizations to:
- Check legislative compliance
- Assess PSRS gaps and develop an action plan
- Assess and determine their PSRS device needs
- Evaluate selected PSRS devices
- Develop PSRS policy, procedures and training
- Create awareness
This toolkit is designed to help community and healthcare organizations, with or without designated security personnel, establish an effective security program. It aims to increase awareness and understanding of security program functions, program elements, and training requirements, many of which are based on best practices and industry-accepted standards. The toolkit provides sample tools to identify security program gaps and to develop a comprehensive and customized action plan.
The toolkit is not intended to:
- address the security of digital or personal health information
- make recommendations regarding staffing levels.
The purpose of this toolkit is to provide information and guidance to assist healthcare employers and Joint Health and Safety Committees (JHSCs) or Health and Safety Representatives (HSRs) in planning and implementing emergency control measures and procedures to effectively respond to violence which includes aggressive or responsive behaviours at the workplace.
The toolkit provides resources and information on good practices that can be incorporated into employers’ existing policies, control measures, or procedures used to create new ones where none exist.
The term “Code White” is commonly used in hospital and long-term care settings. Additional guidance and information have been provided in this document for home and community care settings to assist employers in planning and implementing emergency response measures and procedures.
The purpose of this toolkit is to be a resource for employers, supervisors, and Joint Health and Safety Committees or health and safety representatives (JHSC/HSR) in the healthcare sector to support their organizational response to work refusals. The toolkit is also a guide for workers in healthcare so they understand their right to refuse unsafe work due to workplace violence.
The toolkit provides guidance to describe:
- Work refusal challenges and sources of workplace violence
- Worker’s right to refuse unsafe work, what constitutes a work refusal
- Professional abandonment considerations
- The process and stages for refusing work and situations that may arise
- The impact of organizational culture and the Internal Responsibility System (IRS) on work refusals
- Work refusal scenarios in healthcare settings
Tools to Support the Development of the Program Components
Resource to assist caregivers with identifying common patient triggers and mitigate risk of workplace violence through individualized care plans and other risk minimizing strategies.
Resource to help patients and families understand their role in their care and ability to contribute to a safe and healthy work environment, and sample brochure for patients, family members and visitors.
Download Engaging Residents and Families in Violence Prevention
This tool will assist caregivers to reflect on caregiving safety measures and person-centred care strategies.
Implementing Your program
After determining the components of the program, an action plan should be generated in order to facilitate the implementation. Implementing the program includes communication, marketing and education. Organizations also need to create a communication plan that involves how the the whole program or its components will be implemented strategically.
Worker training
Employers must instruct workers on:
- the hazard of workplace harassment and violence
- how to recognize the signs of danger
- what to do about it
- how to report it
Tools to Support Implementation
Evaluating Your Program
Review of plans
According to Alberta OHS, the plans must be reviewed every 3 years or more often if there is an incident of harassment or violence or if the health and safety committee or representative requests a review.
The review should focus on whether the policy or procedures are current and if there are any deficiencies or gaps that need to be addressed.
Other Resources to Support Your Program
Following the CCSA Process for the Violence and Harassment Program Review, we have developed a guide to show an overview of what the process looks like.
Self-Directed Workplace Violence Program Review Guide for Employers
What's Next?
Not sure where to start? Contact the CCSA OHS Team for guidance or advice regarding your organization’s workplace violence and harassment prevention programs.
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.