An Act Requiring Health Care Facilities to Develop and Implement Programs to Prevent Workplace Violence

Joint Committee on Public Health

The Massachusetts Health & Hospital Association (MHA), on behalf of its member hospitals, health systems, physician organizations and allied healthcare providers, appreciates this opportunity to offer comments in strong support of HB1976, An Act requiring health care facilities to develop and implement programs to prevent workplace violence.

Workplace safety is a top priority for each and every hospital in Massachusetts, as healthcare professionals are part of a 24/7 system of care that can be turbulent and taxing. Hospitals share a profound commitment to ensuring the safety and wellbeing of not only our patients receiving treatment, but for caregivers and loved ones. High profile incidents have raised public awareness and discussion of violence in healthcare facilities and these occurrences remain a deep and serious concern. Our members place a high and unwavering priority on the safety of our nurses, doctors, and all those who work in our facilities.

Massachusetts hospitals have well-established, stringent policies and procedures in place to address workplace violence, with oversight from state and federal accreditation bodies and regulators. These efforts are constantly updated to reflect the latest input from safety and enforcement experts and best practices from around the nation, and these ongoing efforts – including consideration of additional tools such as those required under HB1976 – are both necessary and appropriate.

Because of the fast-paced and unpredictable nature of healthcare delivery, healthcare providers may be exposed to security risks and even violent behaviors. These caregivers deserve our protection and our hospitals are making their safety a top priority. With that in mind, HB1976 takes important steps to address the security risks that healthcare workers can face in the line of work. The legislation requires Massachusetts to develop and monitor new statewide standards for evaluating and addressing known security risks in hospitals. It then requires hospitals to: 1) implement programs based on these new standards, including employee trainings; 2) develop a written violence prevention plan in cooperation with their employees: 3) deploy an in-house crisis response team to assist employees who are victims of workplace violence; 4) adopt appropriate employment support for victims for follow-up services and legal proceedings related to incidents of workplace violence; 5) initiate regular reporting of all assaults and assaults and batteries to the Department of Public Health and local district attorneys; and 6) facilitate robust information-sharing between the healthcare and public safety communities.

Additionally, through our discussions with experts in the field, we have heard many suggestions on strategies and systems that providers can employ to improve their safety protocols. However, across all conversations, we consistently hear that one of the strongest deterrents to violence against healthcare workers requires intervention from state government: the implementation of stricter legal penalties for those who commit violent acts against caregivers. HB1976 would strengthen the penalties for assault and battery committed against healthcare providers, emergency medical technicians, and ambulance operators and attendants, granting added protection for those individuals that play a vital role in the lives of all Massachusetts residents.

MHA and our member hospitals have adopted a number of initiatives in the past year to address violence in the workplace. They include:

MHA’s Caring for the Caregiver Task Force, an initiative to improve the health, safety, and wellbeing of our hospital employees. Convened by MHA, this task force is comprised of various stakeholders from provider, practitioner, payer, and government perspectives. The group is charged with developing recommendations and best-practices for ensuring a vital healthcare workforce across all care settings. One of the four main tenets of the Task Force is a focus on healthcare workplace safety.

MHA’s Workplace Safety & Violence Prevention Workgroup, comprised of leading healthcare safety professionals in Massachusetts, developed and published MHA Security Guidance: Developing Healthcare Safety & Violence Prevention Programs within Hospitals as a resource to hospitals and health systems.

A webpage on MHA’s PatientCareLink website features resources, step-by-step guides, and best-practices that are now in use to prevent workplace violence in our hospitals. These include, but are not limited to, a workplace safety assessment, checklist, and corresponding toolkit to help implement elements of the checklist.

An MHA-sponsored day-long Healthcare Safety Summit on December 4th, 2018.

The hospital community has long-supported and developed violence prevention programs with the goal of improving current policies and procedures within healthcare facilities. Most important, however, is what MHA member hospitals are doing on an everyday basis to increase security for all concerned while also ensuring continued 24/7 access to care.

Working with the American Society for Healthcare Engineering (ASHE) and the International Association for Healthcare Security & Safety (IAHSS), hospitals throughout Massachusetts have adopted staff training programs designed to de-escalate security situations before they erupt. In addition, hospitals continue to enhance workplace injury and violence event reporting, including routine debriefing with senior management on incidents and support for employees. Hospitals have also gone to great lengths to provide a variety of security and social services to maintain a culture of safety in both clinical settings and administrative offices. These collective efforts are all aimed at continually improving hospital policies, practices, and supportive outreach in an era of constantly evolving threats.

While current policies are strong and sound, hospitals should not rest on their laurels and improvements such as the tools recommended in HB1976 should be adopted. Hospitals cannot foresee every situation that may arise in a 24–hour-a-day publicly accessible setting. No policy or set of policies is perfect, and constant vigilance is required – and that is what Massachusetts hospitals are committed to. We will continue to remain focused on the ideal that has always been in place for hospitals – to best ensure a safe and secure environment for patients, employees and their loved ones.

Thank you for the opportunity to offer testimony on this matter. If you have any questions regarding this testimony, or require further information, please contact Emily Dulong, MHA’s Senior Director of Strategy & Government Advocacy, at (781) 262-6025 or edulong@mhalink.org