NORA Partnering Award 2003

Violence Prevention in Mental Healthcare Facility: Evaluation of the OSHA Guidelines

Summary

In 1996, the Occupational Safety and Health Administration (OSHA) published “Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers.” Under the National Occupational Research Agenda (NORA), representatives from industry, labor, and academia joined in a project to implement these OSHA guidelines in an in-patient mental healthcare facility in New York, and evaluate their effectiveness in preventing workplace assaults. To the best knowledge of the partners this is the first study to evaluate the effectiveness of these OSHA guidelines.

The prevention project has three main focuses: 1) Document the processes through which the OSHA violence prevention guidelines were adopted in three types of mental health facilities (adult, children, and forensic); 2) Compare assault rates and related job satisfaction for the one year before and after the start date of the implemented guidelines; and 3) Assess the costs and benefits of implementing the guidelines at the health facility.

Advisory committee groups were formed to develop and execute these guidelines in the health facility. Following an extensive worksite analysis, environmental and administrative controls were implemented in partnerships between facility management and direct care workers. The controls included alterations to the physical environment on the wards, training of direct care staff, changes in policy and procedures effecting staff/patient interactions, and experimentation with approaches to communications and teamwork among staff and across shifts. The advisory groups concluded that the collaboration between the facility management and the direct care workers was crucial for the successful implementation of these guidelines.

The effectiveness of the guidelines will be assessed with a review using the New York State Office of Mental Health’s (OMH) Occupational Injury Reporting System (ORIS). This system can provide quarterly injury, lost time, and lost times severity rates on all reported occupational injuries.

In January 2003, a meeting was held with the four intervention facility advisory groups to discuss project successes. One of the most significant successes is that workplace violence prevention is now regarded as part of the corporate culture and taken seriously. Recommendations will be made at the OMH multi-union health and safety committee to allow the transfer of the project findings to other OMH facilities.

Partner Involvement:

• New York State (NYS) Civil Service Employees Association (CSEA)
• NYS Correctional Officers and Police Benevolent Association (NYSCOPBA)
• NYS Office of Mental Health,
• NYS Public Employees Federation (PEF)
• University of Maryland, Baltimore

For more information: please contact: Jane Lipscomb (jlips001@umaryland.edu), Jonathan Rosen (jrosen@pef.org), or Janet Foley (foley@cseainc.org).