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5. 5 Preventing and Managing Workplace Violence in Healthcare: Ontario’s Violence Prevention Partnership Tina Dunlop, RN, MsN CUPE Injured Worker Advocacy and Health & Safety Conference Ottawa, Ontario September 10, 2015

6. 2009 NON-PROFIT ASSOCIATION FUNDED PARTNER OF THE Ministry of Labour WE PROVIDE OCCUPATIONAL SAFETY Training Resources Consulting & WE WORK WITH 1.67 + MILLION WORKERS 10,000 + ORGANIZATIONS Education Healthcare Emergency Services Government First Nations ONTARIO’S PUBLIC & BROADER PUBLIC SECTORS: ESTABLISHED IN HEALTH Who We Are

7. Workplace Violence  Physical force that causes or could cause physical injury;  An attempt to exercise physical force that could cause physical injury;  A statement or behaviour that it is reasonable to interpret as a threat to exercise physical force that could cause physical injury to the worker.

8. Violence in Healthcare PSHSA Injury Type (LT) Injury Claims Total MSD Other1594 Falls1208 MSD Client Handling1135 Exposures932 Contact with/Struck by670 Workplace Violence639 Not Classified221 MVI155 Machinery63 Transportation20 Fires and Explosions2 Grand Total6639

9. Types of Workplace Violence Type I (Criminal Intent) Type II (Client to Worker) Type III (Worker to worker) Type IV (Domestic Violence) 9

10. Project Overview 10

11. Project Purpose Engages key stakeholders Focus on client-on-staff violence Develop toolkits that are:  Practical  Scalable  Consensus-based 11

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13. Project Framework 13 Protection Post-incident Response Prevention

14. Strategies undertaken prior an incident to deter onset of workplace violence Important steps include:  Recognizing risks  Analyzing precautions and prioritizing risks  Controlling and communicating risk  Evaluating and refining the action plan 14

15. Protection Strategies undertaken during an incident to manage workplace violence and extent of harm Activities include:  Early identification of violent/responsive behaviour  De-escalation and diffusion techniques  Use of coded requests for help  Mobilization of resources and security measures  Keeping safety a priority 15

16. Post-Incident Response Strategies undertaken after an incident has occurred reduce long-term negative effects Suggested responses include:  Assistance and support for victims  Information sharing and team debriefing  Reporting and recording procedures  Incident investigations to prevent recurrence 16

17. 17 Literature Review Jurisdictional Scan Focus Group Confirm Priority Areas Design Toolkit Marketing Strategy Research & Evaluation Plan Toolkit Pilot Implementation Knowledge Translation Education Phase 1: Discovery Phase 2: Design Phase 3: Delivery Steering Committee Leadership Working Group Expertise Project Phases

18. Phase 1 Discovery 18

19. Phase 1 Discovery – Approach Environmental Lighting entrances and exits using security hardware and other engineering controls. Organizational and Administrative Developing programs, policies, and work practices to promote a safe working environment. Behavioural/interpersonal Training staff to anticipate, recognize, and respond to conflict and actual violence in the workplace.  Literature Review  Reviewed 35 intervention studies (MEDLINE & Oud Proceedings 2012)  Studies were organized by category of intervention (Merchant & Lundell, 2011).  Jurisdictional Scan  Focus Groups n = 3 n = 15 (includes interventions in another category) n = 17 19

20. Digital Campaign Type Targeting DemographicsMetrics Programmatic Display & Retargeting Healthcare workers Families of clients 2,120,521 Impressions 7,172 Clicks 0.34% CTR Point of Interest / Mobile: Hospitals Medical buildings Doctors offices Health care facilities Treatment and Rehabilitation facilities Related Points of Interest 492,400 Impressions 2,082 Clicks 0.42% CTR LinkedIn Health Care Industry - Executives Mid-level management Supervisors Medical specialists 488,822 Impressions 972 Clicks 0.20% CTR STRATEGY Increase awareness about health and safety issues in Ontario among healthcare workers Educate people about PSHSA risk preventive services and measures Marketing Campaign

21. Phase 2 Design 21

22. Priority Areas 1.Organizational Risk Assessment 2.Individual Client Risk Assessment 3.Flagging 4.Security 5.Personal Safety Response System 22

23. Organizational Risk Assessment Pre-assessment checklist Organizational workplace violence risk assessment tool Acute care Long-term care Multidisciplinary team At least once a year; more frequently when there’s changes 23

24. Individual Client Risk Assessment Violence assessment tool Recommended controls Sample policy Acute care Long-term care Emergency services Community care Healthcare provider or manager/supervisor First contact and according to organization’s policies and procedures 24 WHAT:Snapshot of a client’s immediate risk of violence. WHERE:Acute care, long-term care and emergency services (EMS). WHO:Healthcare provider or manager/supervisor. WHEN:First contact and according to organization’s policies and procedures.

25. Flagging Handbook Sample policy Privacy fast fact Acute care All staff Potential for violence 25

26. Security 9 tools Acute care Long-term care Community care Security personnel Those responsible for security Once a year; more frequently when circumstances change 26

27. Personal Safety Response System Decision guide Device list Policy template Training guidelines Action plan template Acute care Long-term care Community care Multidisciplinary team Once a year; more frequently when circumstances change 27

28. Phase 3 Delivery 28

29. Research and Evaluation 29

30. Next Steps Toolkit revisions Toolkit ready for full implementation and posting on PSHSA website 30

31. 31 Henrietta Van hulle, Executive Director, Health & Community Services hvanhulle@pshsa.ca 519 688 6221 Era Mae Ferron, Project Lead eferron@pshsa.ca 416-708-5618 Tina Dunlop, Project Coordinator, Consultant tdunlop@pshsa.ca 519-890-9012

32. Posters – Free to Download 32

33. Handbooks – free to download 33

34. The following resources may be purchased from our website: www.pshsa.ca Workplace Violence Prevention Series 34

35. Workplace Violence Prevention DVD 35

36. Workplace Bullying Fast Fact Additional Fast Facts Workplace Violence: OHSA Domestic Violence Working Alone 36

37. Your gateway to: Best Practices Tips & Tools Resources Free Downloads Research & Publications Upcoming Healthcare Events and more! HealthyWorkEnvironments.ca 37

38. Questions 38

39. PSHSA.ca @PSHSAca Public Services Health & Safety Association on LinkedIn youtube.com/PSHSA 416-250-2131 (toll free: 1-877-250-7444) 39