Daniyal Amjad
September 8, 2023
On June 22, 2023, the Health Care Improvement Foundation’s (HCIF) Partnership for Patient Care (PPC) hosted an in-person Safety Forum workshop, “Gun Violence Prevention in the Hospital Setting”. PPC Safety Forums bring together health professionals to collaborate and share knowledge on enhancing safety in healthcare environments. Past forums have covered diverse topics, such as workplace violence, suicide prevention, root cause analysis, and best practices. This year’s focus was gun violence in hospitals, an issue that has escalated, with a rise in violence against healthcare workers since the pandemic. Between 2010 and 2020, 400 healthcare professionals lost their lives due to firearms in the workplace. This statistic emphasizes the urgency of collaboration between health systems to protect their staff and prevent such incidents.
Dr. Stanton B. Miller, Executive Director of the Jefferson Center for Injury Research & Prevention at Jefferson Health, led the keynote talk on the 23rd floor of Independence Blue Cross, overlooking the light rain that fell upon Central Philadelphia. Using a framework from the World Health Organization, he discussed the problem-solving methodology for addressing workplace violence in healthcare. Dr. Miller defined healthcare violence as any form of aggression involving staff, licensed practitioners, patients, or visitors, underscoring its pervasive nature. The magnitude of the problem became evident as he presented statistics, with 75% of 25,000 workplace assaults occurring in healthcare and social service settings. Many incidents remain underreported due to historic attitudes accepting violence as part of the job. Dr. Miller highlighted gun violence as a critical determinant, comparing it to a societal disease that affects American society deeply. “Just as individuals can suffer from PTSD… American society is suffering from PTSD” related to social issues, especially gun violence, claimed Dr. Miller. He dispelled misconceptions about the differences in violence between rural, urban, and suburban areas, urging against discriminatory assumptions.
Leadership emerged as a crucial intervention. “Leadership sets the tone, sets the culture, and needs to clearly define workplace violence,” Dr. Miller said, emphasizing the need for leadership “to be clearly dedicated to placement of systems across an organization that enables staff to report violent instances”. He emphasized the importance of fostering a culture that encourages staff to report violent instances and takes responsibility for addressing workplace violence. Developing screening tools and reporting protocols, along with coordination between databases, were also identified as effective measures. The Haddon Matrix, a tool from Injury Science and Public Health, was introduced as a key element in the implementation process. It helps measure adverse effects and identify effective interventions for specific situations. Dr. Miller highlighted the role, or lack thereof, of legislation in protecting health care workers from violence against them, highlighting the need for such interventions as incidents rise. He ended his keynote by touching on measurements, focusing on the importance of using data informing and evidence based practices.
The roundtable discussion that followed exemplified the need for interdisciplinary conversations between health systems and departments. The audience represented a diverse group of professionals from all parts of the healthcare ecosystem. Representatives from Emergency Services, Patient Quality, Public Safety, Ambulatory Services and Senior Leadership from various Health Systems across Greater Philadelphia shared their expertise, fostering a natural and impactful exchange of ideas. The event concluded with a networking session, where participants continued their discussions. One group decided to get lunch to continue the conversation, embodying the success of this in-person event and demonstrating the power of face-to-face interactions in fostering meaningful connections and promoting positive change. HCIF and PPC remain committed to initiating these essential conversations between health professionals, leading the region in enhancing safety within the health care ecosystem.