AAOS Prioritizes Safety with New Online Toolkit Focused on Workplace Violence

According to the U.S. Department of Labor’s Bureau of Labor Statistics, healthcare workers in the United States are the most susceptible to workplace violence, exceeding all other industries combined. On June 1, 2022, orthopaedic surgeon Preston Phillips, MD, FAAOS; sports specialist Stephanie Husen, DO; receptionist Amanda Glenn; and patient William Love were killed by a disgruntled spine patient in Tulsa, Okla. AAOS President Kevin Bozic, MD, MBA, FAAOS, shared: “As a professional society that is committed to the health and welfare of our members and their patients, AAOS is deeply saddened by the tragic and senseless death of our colleague, Dr. Preston Phillips. Workplace violence is a serious issue that affects not only the safety and well-being of healthcare professionals like Dr. Phillips, but also the quality of care that we deliver to our patients. We urge all healthcare organizations to prioritize the safety of their associates and to take proactive measures to prevent workplace violence.”

AAOS leaders have responded to the increased threat of violence against its members and patients by supporting programs to protect healthcare professionals against workplace violence, including endorsing the American College of Surgeons’ firearm strategy and supporting the Safety from Violence for Healthcare Employees (SAVE) Act. The latest initiative from AAOS is a new toolkit to disseminate information on prevention of and protection from workplace violence in healthcare settings.

AAOS Workplace Violence Toolkit
On March 4, 2022, AAOS launched a Work Environment and Culture Survey to better understand the incidence of verbal abuse, threats, physical threats, and assaults among its membership, as well as to assess the safety of members’ current work environments. The survey identified that four of 10 respondents had experienced some type of workplace violence within the previous 12 months. Most (54 percent) respondents were at least moderately concerned about workplace violence and thought about it with some regularity. Nearly three-quarters (72 percent) of respondents had experienced verbal abuse, and 30 percent had experienced physical threats in the previous 12 months. One-quarter (25 percent) of physical threats and 16 percent of physical assaults involved a firearm and/or some other type of weapon. Roughly one in three respondents suggested training or education to address workplace violence.

These results propelled the work of the AAOS Committee on Healthcare Safety (formerly the Patient Safety Committee) to create a toolkit that aims to educate Academy members on violence in the healthcare field and facilitate safer workplace environments. AAOS toolkits offer resources empowering readers to learn about an issue and identify methods for addressing it. Toolkits can be used to inform and guide implementation from individuals to facilities alike.

The primary goal of the Workplace Violence Toolkit, available at aaos.org/toolkits, is to provide resources to help AAOS members improve safety from violence for both orthopaedic patients and care teams. To do this, committee members gathered information on the prevalence and types of workplace violence; warning signs; preventive measures; and steps that can be taken before, during, and after an incident. The toolkit serves as a hub of robust resources for physicians and healthcare workers, featuring relevant publications, infographics, and information statements about workplace violence and information on current AAOS advocacy efforts on these issues (Fig. 1. Table 1).

The Committee on Healthcare Safety is confident that the AAOS membership will find the toolkit useful. Educational offerings include how to recognize, screen, and assess patients for potential problems, as well as training, education, and recommendations on how to prevent workplace violence. This toolkit is an ongoing effort and will continue to be updated as appropriate.

The impact of violence on healthcare
Addressing workplace violence in the healthcare sector is particularly important because the consequences can affect healthcare workers as well as patients. According to an article published in the Annals of Medicine and Surgery in 2022, “The detrimental effects, mainly the psychological impact of workplace violence on affected healthcare employees, are one of the most critical reasons it must be handled before it escalates to higher absenteeism rates or further affects healthcare workers’ overall performance. It will have even more negative implications for the healthcare sector when staffing is already scarce, and patient loads continue to rise inexorably.” The rise in workplace violence, coupled with its effects on healthcare workers and the inevitable consequences for the entire healthcare industry, is the motivation behind the development of the Workplace Violence Toolkit.

There is a clear and immediate need for individual and organizational intervention to reduce workplace violence and enhance the overall safety of the healthcare environment. The AAOS Committee on Healthcare Safety is committed to further understanding and working toward mitigating these issues.

Jennifer Rodriguez, MBA, is a staff member at AAOS and serves as staff liaison to the Committee on Healthcare Safety.

Julie Balch Samora, MD, PhD, MPH, FAAOS, is a pediatric hand surgeon at Nationwide Children’s Hospital, where she serves as medical director of quality. She is also chair of the AAOS Committee on Healthcare Safety.

References

1. U.S. Bureau of Labor Statistics: Injuries, Illnesses, and Fatalities. Available at: https://www.bls.gov/iif/factsheets/workplace-violence-healthcare-2018.htm. Accessed June 13, 2023.
2. Lim MC, Jeffree MS, Saupin SS, Giloi N, Lukman KA: Workplace violence in healthcare settings: The risk factors, implications and collaborative preventive measures. Ann Med Surg 2022;78:103727.
3. Silver S, Li J, Marsh S, Carbone E: Pre-pandemic mental health and well-being of healthcare workers. NIOSH Science Blog. Available at: https://blogs.cdc.gov/niosh-science-blog/2022/08/29/hcw-mental-health-prepandemic/#:~:text=Findings,than%20among%20non%2Dhealthcare%20workers. Accessed April 28, 2023.
4. World Health Organization: World failing in ‘our duty of care’ to protect mental health and well-being of health and care workers, finds report on impact of COVID-19. Available at: https://www.who.int/news/item/05-10-2022-world-failing-in--our-duty-of-care--to-protect-mental-health-and-wellbeing-of-health-and-care-workers--finds-report-on-impact-of-covid-19. Accessed April 28, 2023.