Prevention Resources – Focus on Nursing Care in Hospitals
The Workplace Violence Prevention in Healthcare Leadership Table (Leadership Table) was created in August 2015 with a goal to drive a positive shift in organizational workplace violence prevention efforts. Reporting to the Leadership Table, four Working Groups were established to develop recommendations and products aiming to strengthen prevention activities, accountability, communication, and supports in the following focus areas:
- Leadership and Accountability
- Hazard Prevention and Control
- Communications and Knowledge Translation
- Indicators, Evaluation, and Reporting
A report was prepared by the Project Secretariat of the Ministry of Labour and Ministry of Health and Long-Term Care, with the guidance and advice of the Workplace Violence Prevention in Health Care Leadership Table (Leadership Table) and its Working Groups.
The recommendations and products in this report came together due to the collaborative partnerships, reinforced through the Leadership Table and its Working Groups. The Recommendations and Products referenced in the report are provided below.
Leadership and Accountability
1. Transition Teams
Create Transition Teams — sustainable groups of experts that can assist and provide advice with the implementation of Workplace Violence Prevention (WVP) tools and leading to improve a hospital’s WVP journey to excellence.
2. Workplace Safety Environmental Standard for Healthcare Workplaces
Create a Workplace Safety Environmental Standard for Healthcare Workplaces
3. Embarking on a Journey to Create Psychologically Safe and Healthy Hospitals
Develop resources and supports to help hospitals create a psychologically safe and healthy workplace based on the CSA Standard.
4. Amend OHSA to Allow Inclusion of a Designated Worker Member in Investigation
Amend the Occupational Health and Safety Act to allow a designated worker member of the JHSC to be included in workplace violence investigations under certain circumstances.
5. Amend OHS Information for Investigations
Amend the Occupational Health and Safety Act to create a requirement about the information to be provided to a worker who experienced a violent incident.
6. Healthcare Sector Plan Enhance Workplace Violence Section
Include more details on legislative compliance and requirements in the workplace violence section of the Ministry of Labour’s (MOL) health care sector plan.
7. Changes to Accreditation Canada Standard
Strengthen workplace violence language in Accreditation Canada’s Required Organizational Practice.
8. Changes to Accreditation Canada Required Organizational Practice
Strengthen workplace violence language in Accreditation Canada’s Standard.
The Sustainable Accountability Framework will be used as a guidance tool for hospitals to outline who is accountable for what in a hospital organization.
An online resource for hospitals which contains leading/good practices in six key areas.
Assessment Tool that Assists Hospitals in Identifying where they are in their WVP Journey
The assessment tool is intended to assist hospitals in self-identifying where they are in their workplace violence prevention journey. This tool is not intended to identify risks or hazards, merely to accompany the transition toolkit in providing organizations a starting point to identify any key component that they could improve upon such as policies and programs, and incident investigation/reporting.
Workplace Violence Prevention Checklist
Workers in health care facilities face significant risks of workplace violence. This Health Care Checklist is designed as a prevention tool to enable health care and community care facilities to adopt leading practices when establishing systems and practices to prevent workplace violence.
Hazard Prevention and Control
9. Adequate Risk Assessments
Amend the Ministry of Labour Policy and Procedure manual to ensure all risk assessments conducted by hospitals are adequate.
10. Promote the PSHSA Violence Aggression and Responsive Behaviour (VARB) Tools
Promote the use of all existing and future Public Service Health and Safety Association (PSHSA) Violence, Aggression and Responsive Behaviour (VARB) tools in all Ontario hospitals.
11. Additional Tools PSHSA
Ask the PSHSA, in collaboration with stakeholders, to develop additional tools to support:
- incident reporting and investigation (root cause analysis)
- code white
- patient transit (inside the facility) and transfer (outside of the facility)
- work refusal procedures
12. Future Work to be Developed by the Leadership Table
Develop specific supplementary tools through the Leadership Table in the second phase and out-years of the project.
13. Increased Supports for Patients with Aggressive or Violence Behaviour
Provide more supports for patients with known aggressive or violent behaviour within health care facilities and in the community.
14. Patient Family and Staff Input into Triggers Behaviours and Interventions
Create and implement a standard provincial form/process to engage a patient and/or family/caregiver in developing a patient’s care plan that includes safety for workers.
15. College of Nurses of Ontario CNO Standards
Work with the College of Nurses of Ontario to provide more clarity related to nurses’ right to refuse to provide care to patients in hazardous situations, where the hazard is workplace violence.
16. Workplace Violence Curriculum in Educational Settings
Require post-secondary institutions to provide students with enhanced training in workplace violence and prevention before entering the workforce.
17. Minimum Security Training Standard for Hospitals
Develop and implement a consistent minimum provincial training standard for those performing the role or function of providing security in hospitals.
Pre Risk Assessment Survey
A set of questions to be asked prior to conducting a risk assessment.
Terms of Reference for a WPV Committee
Sample document that outlines the terms of reference for a Workplace Violence Prevention Committee in a hospital.
Triggers and Care Planning
Resource to assist caregivers with identifying common patient triggers and mitigate risk of workplace violence through individualized care plans and other risk minimizing strategies.
Engaging Patients and Families in Workplace Violence Prevention and Sample Brochure
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.
The training matrix is intended to be used as a guide to assist employers in ensuring that workers are trained to prevent and react to incidents of workplace violence, and internal policies and procedures, and roles and responsibilities based on their occupation and potential exposure to risk.
Indicators, Evaluation, and Reporting
18. Reporting Systems for WVI and WV Prevention Activities
Address issues related to workplace violence incident reporting systems.
19. Workplace Violence Included in Quality Improvement Plans
Include workplace violence prevention in Quality Improvement Plans.
A Set of Organizational and Provincial Indicators
A recommended list of leading and lagging metrics to be used at the system and organizational level that can be used to measure improvement in workplace violence.
Communication and Knowledge Translation
20. Creation of Consistent Communication Protocols Between External Care Environments
Create consistent communication protocols between hospitals and external care environments to limit the risk of violence to healthcare workers and patients.
21. Preparing Hospitals for Incoming Psychiatric Examinations
Expand an existing communication protocol to prepare a health care facility to receive an incoming patient for a psychiatric assessment.
22. Public Communication About Workplace Violence Prevention in Healthcare Project
Implement a joint ministry public campaign regarding the Workplace Violence Prevention in Health Care project.
23. Publication of Convictions
Post information about all MOL fines against employers in health care under $50,000.
Communication Plan for Workplace Parties
Resource to help stakeholders within the hospital setting to improve the knowledge translation practices and communication specific to workplace violence prevention.
Communication Plan for External Stakeholders
Suggested communication/messages to stakeholders outside of the hospital setting.
Public Awareness Campaign
Marketing brief with details on designing and conducting a workplace violence awareness campaign in the public.