Engaged Leadership to Prevent Healthcare Workplace Violence

Introduction: Workplace Violence in Healthcare

Workplace violence can be prevented by creating a workplace environment and organizational culture that prevents the problem, protects employees, and pursues strategies for change. The presence of official policies or codes of ethics in the workplace is not enough on its own. Those policies must also be strictly enforced so that all employees as well as patients feel safe and supported. The United States Department of Labor and OSHA (2016) define workplace violence as "any act or threat of physical violence, harassment, intimidation, or other threatening disruptive behavior that occurs at the work site." Moreover, the Department of Labor (2016) reports that almost 20% of the 11,370 reported incidents in one year occurred in nursing and residential care facilities. Healthcare workers are five times more likely to experience assault or violence than workers in any other sector (Thompson, 2015).

Henry and Ginn (2014) claim that these incidences cannot be tolerated, and that effective leadership styles and strategies are the most important and effective tools in preventing workplace violence in the healthcare sector. Effective leadership will determine the need for changes in human resources, as well as administrative efforts including risk assessments and total quality management.

Engaged Leadership as the Core Strategy

The most effective leadership style to address concerns of workplace violence is engaged leadership because there is "a direct connection between engaged leadership, workplace security and organizational success" (Whitmore, 2012, p. 1). An engaged leader cares about both patients and employees in meaningful ways, taking all concerns and complaints seriously. Moreover, an engaged leader cares about the organization itself and is committed to creating an organizational culture free from violence and where violence is not tolerated.

Preventing violence might entail deep changes to organizational policy and procedures, including shifts in scheduling, in hiring and employee training practices, and in treatment delivery. As Trotto (2014) points out, patient violence against healthcare workers can be triggered by long wait times in emergency rooms, when patients are suffering and their pain is taken out on employees. Minimizing wait times or better addressing the needs of patients who have long waits would be one way of reducing the potential for violent outbursts. Similarly, violence occurs in situations involving psychiatric patients who are not being properly cared for (Trotto, 2014). Administrators and human resources management can work harder to train employees in how to identify patients who may potentially become violent. Finally, patients who are known to be violent can be handled in ways that reduce the potential for violent behavior. Each of these changes to organizational procedure starts at the level of leadership and management, creating a safer workplace environment.

Prevention Through Holistic and Evidence-Based Practice

Simply increasing penalties for violence in the healthcare environment is not enough (Henry & Ginn, 2014). Leaders in healthcare need to focus attention on prevention. To do so, an engaged leader would solicit input from employees to determine the needs specific to the organization and its patient population. Evidence-based practice can inform new policies and procedures. As Henry and Ginn (2014) point out, engaged leaders attack the problem of workplace violence holistically through the use of diverse tactics such as risk assessments, total quality management, training, and the development of written plans of action.

The strength of the engaged leadership style is that all employees take part in the decision-making process and feel comfortable reporting incidents that would otherwise be ignored or dismissed as simply part of the job (Thompson, 2015). By engaging with employees, leaders can dramatically shift the organizational culture within a relatively short time frame to reduce incidences of violence and improve responses to violence.

Conclusion: Zero Tolerance and Long-Term Organizational Change

Ultimately, a zero-tolerance attitude toward violence is the core objective. Healthcare leaders must take the step of becoming actively engaged in their organizations, committed to doing whatever it takes to prevent and address workplace violence, whether against patients or employees. An engaged leadership style provides a long-term vision of organizational change. That change requires additional robust training for employees, including security staff. Moreover, the organizational change may entail legal counsel in times of trouble.

Engaged leaders provide education and outreach to employees, helping them take advantage of assistance programs. Finally, an engaged leader is open to learning about new strategies that can prevent workplace violence — such as changing the environmental design of the organization or the policies and procedures governing care (Henry & Ginn, 2014). As research on workplace violence continues to evolve, engaged leadership in healthcare must remain adaptive, taking into account the multifaceted nature of preventing and responding to violence in all its forms.