Change in Law: Hospital Action Required
To: Chief Nursing Officers, Chief Human Resources Officers, Legal Counsel, Security Officers, and
Government Affairs Staff
From: Lauren McDonald, Policy Director, Health Access | Laurenm@wsha.org | (206) 577-1821
Subject: New Requirements For Workplace Violence Prevention Planning And Training
To inform hospitals and health systems about new requirements contained in House Bill 1931, for workplace violence prevention efforts in health care settings. The legislation expands on existing workplace safety requirements and amends RCW 49.19. The legislation includes important updates to workplace violence prevention planning and training for staff.
Workplace violence prevention is a priority for Washington state hospitals. WSHA worked collaboratively with the proponents of the law to include important updates that reflect current best practices for prevention of workplace violence. WSHA’s advocacy resulted in a more refined definition of workplace violence and flexible training requirements so that hospitals can focus their efforts on areas of risk that will have a meaningful impact on preventing workplace violence for health care workers.
The new requirements for workplace violence prevention apply to “health care settings”, which include acute care hospitals licensed under RCW 70.41; home health, hospice, and home care agencies licensed under RCW 70.127; evaluation and treatment facilities pursuant to RCW 71.05.020; behavioral health programs pursuant to RCW 71.24; and ambulatory surgical facilities licensed under RCW 70.230.
- Review this bulletin and the RCW 19 within your organization to determine any resulting changes that must be made to your workplace violence prevention planning process.
- Determine how your organization will comply with the deadline in the law for workplace violence prevention training for employees, volunteers, and contracted security personnel by July 1, 2020.
Beginning January 1, 2020, health care settings must develop and implement a workplace violence prevention plan every three years. Health care settings must also review data on workplace violence incidents and any emerging issues contributing to workplace violence annually, and adjust the workplace violence prevention plan as needed based on that review.
By July 1, 2020, health care settings are required to provide training according to the workplace violence prevention plan to all applicable employees, volunteers, and contracted security personnel. The method and frequency of training may vary according to the information and strategies identified in the plan.
- Definition of Workplace Violence. The legislation updates the definition of workplace violence to provide additional specificity and to capture events that include a weapon. According to RCW 49.19.010 subsection (4) : “Workplace violence,” “violence,” or “violent act” means any physical assault or verbal threat of physical assault against an employee of a health care setting on the property of the health care setting. “Workplace violence,” “violence,” or “violent act” includes any physical assault or verbal threat of physical assault involving the use of a weapon, including a firearm as defined in RCW 9.41.010, or a common object used as a weapon, regardless of whether the use of a weapon resulted in an injury.”
- Workplace Violence Prevention Plans. Beginning January 1, 2020, health care settings must develop and implement a workplace violence prevention plan every three years. The law includes updates to the elements required to be considered in the development of a plan so that the plan addresses both security considerations and factors that may contribute to or prevent the risk of violence. Notable additions include:
- Staffing, including staffing patterns, patient classifications, and procedures to mitigate employees time spent alone working in areas at high risk for workplace violence;
- Job design, equipment, and facilities;
- Security risks associated with specific units, areas of the facility with uncontrolled access, late night or early morning shifts, and employee security in areas surrounding the facility such as employee parking areas; and
- Processes and expected interventions to provide assistance to an employee directly affected by a violent act.
For more information, see RCW 49.19.020.
- Workplace Violence Prevention Training. By July 1, 2020, health care settings are required to provide training to all applicable employees, volunteers, and contracted security personnel. The method of training, content, and how often it is delivered can vary according to the information and strategies included in the workplace violence prevention plan. Hospitals and health care entities subject to the law are required to consider several additional elements within their training compared with the previous law, based upon the duties and responsibilities of the particular employee or individual being trained. These updates ensure that guidance on topics covered in violence prevention training are current with best practices in this area.Trainings must now address the following topics, “as appropriate to the particular setting and to the duties and responsibilities of the particular employee being trained, based upon the hazards identified in the [workplace violence prevention] plan required under RCW 49.19.020”:
- The health care setting’s workplace violence prevention plan;
- General safety procedures;
- Violence predicting behaviors and factors;
- The violence escalation cycle;
- De-escalation techniques to minimize violent behavior;
- Strategies to prevent physical harm with hands-on practice or role play;
- Response team processes;
- Proper application and use of restraints, both physical and chemical restraints;
- Documentation and reporting incidents;
- The debrief process for affected employees following violent acts; and
- Resources available to employees for coping with the effects of violence.
For more information, see RCW 49.19.030.
- The Role of the Safety Committee or Workplace Violence Prevention Committee. If a health care setting subject to the new law has a safety committee pursuant to RCW 49.17.050, or workplace violence committee meeting certain standards, that committee is responsible for developing, implementing, and monitoring progress on the plan. For a workplace violence committee to oversee the plan, it must be comprised of employee-elected and employer-selected members (where the number of employee-elected members equal to or exceed the number of employer-selected members).
Health care workers in the US are nearly four times more likely than other professionals to be injured and require time away from work as a result of workplace violence (OSHA, 2015). Addressing workplace violence is a priority for WSHA, our member hospitals and regional partners.
Since 1999, hospitals in Washington state have been required to develop and implement a plan to prevent and protect employees from workplace violence. However, the previous law did not specify when the prevention plan needed to be reviewed and updated, nor did the law specify which elements were important given current workplace violence challenges.
WSHA worked with proponents of the bill to ensure that the final law supported current best practices and allowed flexibility for hospitals to train staff in ways that are responsive to the differences in risk that health care professionals face across any given facility.
WHSA continues to convene a Worker Safety Advisory Group. If interested in joining this group, please contact Ian Corbridge: IanC@wsha.org | (206) 216-2514.
- House Bill 1931: Concerning workplace violence in health care settings.
- RCW 19: Safety-Health Care Settings
- WSHA resources webpage on Workplace Violence Prevention.
- Sample Safety Committee or Workplace Violence Committee Charter, revised October 18, 2019.
- March 19, 2020 Workplace Violence Learning Collaborative. This event will provide participants best practices and tools from across Washington, Oregon and Alaska for addressing workplace violence.
WSHA’s 2019 New Law Implementation Guide
Please visit WSHA’s 2019 implementation guide online, where you will find a list of the high priority laws that WSHA is preparing resources and information on to help members implement the new laws, as well as links to resources such as this bulletin. In addition, you will find the Government Affairs team’s schedule for release of upcoming resources on other laws and additional resources for implementation.