Assessing and communicating Type 2 workplace violence in healthcare

Workplace violence (WPV) in healthcare is a critical and persistent challenge affecting the safety and wellbeing of care team members across various roles, responsibilities and environments. Our report on the three pillars of care team safety underscored the risks of WPV in healthcare, while our follow-up research brief took a closer look at the different types of WPV to better understand how verbal and physical violence from patients or visitors (WPV type 2) related to acts of violence by colleagues or leaders (WPV type 3). 

Incidences of Type 2 WPV reported by leaders and bedside nurses in our past research were alarmingly high. This finding inspired our latest research report, which explores how healthcare organizations assess WPV risks by patients and visitors and how those risks are communicated to care team members.  

Many hospitals use multiple identification and communication methods to alert staff about patients or visitors who are at risk of violent behavior. Some methods include risk assessments within a patient’s electronic health record (EHR), behavioral alerts distributed via mobile communication devices and visual cues. While some of these care team safety solutions are widely adopted, there is significant variation in how they are implemented, what information they contain about the patient and risk level, and how effectively they support bedside staff, including nurses.

Our survey showed that bedside nurses and leaders generally believed risk assessments and EHR alerts improve awareness and may reduce violence, but concerns remain about alert fatigue, inconsistent use, bias and unintended impacts on quality of care. Findings suggest that healthcare organizations should focus on standardizing risk assessment and communication practices, providing actionable information to staff, regularly reviewing processes for bias and effectiveness, and investing in ongoing training. As WPV continues to increase, improving how organizations identify and communicate risk is an important component of creating safer environments for both care team members and patients.