John W. Hicks, OHST Texas Mutual Insurance Company Preventing Workplace Violence John W. Hicks, OHST Texas Mutual Insurance Company © 2008, 2012 Zywave, Inc. All rights reserved

Agenda Fast facts: the prevalence of workplace violence Your right to a safe workplace The warning signs of trouble and immediate signs of danger What to do in case of an incident or an emergency Post-incident analysis

Facts About Workplace Violence 2 million American employees report being victims of workplace violence each year 506 of the 4,457 total worker fatalities in 2010 were workplace homicides Homicide is the leading cause of death in the workplace for women No workplace is immune to workplace violence! *Statistics via OSHA, May 2012

Your Employer’s Responsibility OSHA states employers must take precautions to identify, minimize and prevent the risks of workplace violence. “You have a right to a safe workplace, free from recognized hazards that are likely to cause death or serious physical harm to employees.”

What Is Workplace Violence? (Note the subjective nature of 2--4) Physical Assault Threatening Behavior Verbal Abuse Harassment

Four Categories of Workplace Violence Violence by Strangers Committing Robbery Violence by Customers, Clients, or Patients Violence by Employees and/or Supervisors Violence by Domestic Partners or Relatives of Employees (new category)

External Risk Factors Include: Working alone or in small numbers Working late night/early morning Working with money Delivering passengers, goods or services Having a mobile workplace like a taxicab or police car Working in high crime areas Guarding property or possessions Contact with the public

Prevention Strategies (External Risk) Don’t work alone late at night or early morning Call for a security escort if working late Carry a cellular phone Redesign workspace to prevent entrapment Train staff in ways to diffuse violence. Place curved mirrors at hallway intersections Maintain good lighting indoors and outdoors Prepare plan for employees/customers who “act out” Control access to employee work areas.

Internal Risk Factors Include: Highly competitive sectors with intense workloads, e.g.. food processing Restructuring of an organization, e.g.. impending layoffs Ignoring warning signs from certain individuals who have a gripe with co-workers or management Allowing an ongoing feud between co-workers to go unaddressed by management Chronic verbal abuse by a supervisor towards workers Denial on the part of management regarding employee tension or favoritism towards one party Old school mentality by management that tolerates and enables supervisor abuse

Prevention Strategies (Internal Risk) Risk Assessment: Confidential survey of employees/clients designed to uncover internal risk factors, coupled with analysis of external risk factors Presentation of overall risk analysis to top management, along with supporting facts WPV training for all levels of organization Sensitivity training for high-risk employees as necessary Follow-up survey of employees to gauge impact of training

Warning Signs of Violent Behavior Take note of customers or co-workers whose: Behavior patterns change rapidly Behavior changes disrupt the facility environment Signs of stress are more elevated than normal

Warning Signs of Violent Behavior Changes in attitude Excessive absences or lateness, tardiness Changes in habits Inability to concentrate Increased personal stress A fascination with weapons or violence Sudden changes in energy History of violence Increased use of drugs or alcohol Inability to take responsibility for their actions Making inappropriate statements Social isolation Complaints of unfair treatment Overreacting to criticism Poor hygiene

Nonverbal Cues of Potential Violence Personal space violations Loud talking or yelling Shallow, rapid breathing Abusive language Avoidance of eye contact Changes in voice or tone Profuse sweating Repetitive motions, such as pacing Clenched jaw or fists Trembling or shaking Glaring, scowling or sneering

Keep in mind… These warning signs don’t always lead to violence. Warning signs could also be just normal changes in mood. However, drastic personality changes, or changes in situation, may bring out violent tendencies. Use your best judgment before reporting issues to a supervisor.

Five Categories of Escalating Behavior Confusion Frustration Blame Anger Hostility

Warning Signs of Confusion The person appears bewildered or distracted. They are unsure or uncertain of the next course of action. How would you respond to a person who is confused?

Responses to Confusion Listen Attentively to the person Ask clarifying questions Give factual Information

Warning Signs of Frustration The person is impatient and reactive The person resists information you are giving them The person may try to bait you How would you respond to a person who is frustrated?

Responses to Frustration Move the person to a quiet location Reassure them, talk to them in a calm voice Attempt to clarify their concerns

How would you respond to a person who is blaming? Warning Signs of Blame The person places responsibility on everyone else They may accuse you or hold you responsible They may find fault with others They may place blame on you How would you respond to a person who is blaming?

Responses to Blame Disengage with the person and bring a second party into the discussion Use a teamwork approach Draw the person back to the facts Show respect and concern Focus on areas of agreement to help resolve the situation

How would you respond to a person who is angry? Warning Signs of Anger The person may show a visible change in body posture Actions may include pounding fists, pointing fingers, shouting or screaming This signals VERY RISKY BEHAVIOR! How would you respond to a person who is angry?

Responses to Anger Don’t argue with the person Don’t offer solutions Prepare to evacuate the area or isolate the person Contact your supervisor and security personnel

Warning Signs of Hostility Physical actions or threats appear imminent There is immediate danger of physical harm or property damage Out-of-control behavior signals the person has crossed the line How would you respond to a hostile person?

Responses to Hostility Disengage with the person and evacuate the area Attempt to isolate the person if it can be done safely Alert your supervisor and contact security immediately

Preventing an Incident If you work with high-risk clients or those that are prone to violence, have a plan in place and take extra precaution when those individuals are on-site Know the warning signs of violent behavior Always report: Verbal or physical harassment Verbal or physical threats Assaults or other violence Any behavior that causes you to feel unsafe Your safety is the primary concern!

Responding to a Violent Incident Isolate/secure the work area Call 9-1-1 if an emergency Seek medical attention for victims Report the incident to your supervisor File an incident report If psychological trauma occurs call EAP for post-incident debriefing Give a referral to EAP to the victim

Responding to a Violent Incident Remain as calm as possible; do not scream or panic Look the person directly in the eye and talk to them to gain time and calm them down Do not provoke or argue with the potential assailant Do not try to disarm the assailant Report all incidents, even minor ones, to security and management as soon as possible

ACTIVE SHOOTER An Active Shooter is an individual actively engaged in killing or attempting to kill people in a confined and populated area In most cases, active shooters use firearms(s) and there is no pattern or method to their selection of victims. Active shooter situations are unpredictable and evolve quickly. Typically, the immediate deployment of law enforcement is required to stop the shooting and mitigate harm to victims

ACTIVE SHOOTER-RESPONSE RUN when an active shooter is in your vicinity: If there is an escape path, attempt to evacuate Evacuate whether others agree to or not Leave your belongings behind Help others escape if possible Prevent others from entering the area Call 911 when you are safe

ACTIVE SHOOTER RESPONSE HIDE If evacuation is not possible, find a place to hide: Lock and/or blockade the door Silence your cell phone Hide behind large objects Remain very quiet

ACTIVE SHOOTER RESPONSE FIGHT at last resort, and only if your life is in danger: Attempt to incapacitate the shooter Act with physical and verbal [?] aggression Improvise weapons Commit to your actions

ACTIVE SHOOTER RESPONSE How to react when law enforcement arrives: Remain calm, and follow officers’ instructions Put down any items in your hands (i.e., bags, jackets) Immediately raise hands and spread fingers Keep hands visible at all times Avoid making quick movements toward officers such as holding on to them for safety Avoid pointing, screaming and/or yelling Do not stop to ask officers for help or direction when evacuating, just proceed in the direction from which officers are entering the premises

Post-Incident Analysis If an incident occurs, learn from it: Were there warning signs that may have been missed? How did the individual enter the facility? Were they granted unauthorized access? Were authorities alerted promptly, and were clients and employees kept safe in the interim? Did employees follow the emergency action plan? Did the plan work, as intended, to keep everyone safe? What can be done, moving forward, to better discourage violence in our workplace?

The Aftermath Provide comprehensive treatment to victimized employees and those who may be traumatized by witnessing a workplace violence incident. May include: trauma-crisis counseling, critical incident stress debriefing, psychological counseling services, peer counseling, support groups. Conduct a root-cause analysis of the risk factors associated with individual violent incidents so that current response systems can be addressed and hazards can be eliminated and corrected.

REMINDERS Understand and follow WPV procedures Alert Supervisors to safety/security concerns Show up on time with the rest of the team members. Get a security escort to perimeter. What do you do off premises? Provide your ideas in training classes. You know stuff! Always report incidents.

Elements of an effective violence prevention program Management commitment and employee involvement; Worksite analysis; Hazard prevention and control; Safety and health training; and Recordkeeping and program evaluation.

Designing Your Program Buy-in from top management is critical; All levels of organization should be exposed to training; Program must be based on your type of workplace and risk profile; Conduct a systematic workplace risk assessment: Interaction with public? What are the various interface areas and sources of risk? Internal sources of stress among co-workers? Between managers and workers? Physical layout of facility: What and where are the vulnerable areas? What has been your history of WPV and the history of comparable organizations? Is there a history or accepted pattern of verbal communication that may qualify as workplace violence? Search the Web for supplemental sources, e.g. OSHA

Resources OSHA Publication 3148 - Guidelines for Preventing Workplace Violence for Health Care & Social Service Workers Workplace Violence: Prevention & Intervention Guidelines for Homeless Services Providers [Greater Cincinnati Behavioral Health Services]

Use Lessons Learned to Prevent Violence from Happening Again!