By Hamad Husainy, MD, DO, FACEP
The American College of Emergency Physicians (ACEP) is actively pursuing federal regulation to strengthen protections for healthcare workers. Its recent support of H.R. 1309 is one step toward establishing safer workplaces for healthcare providers and their patients.
According to OSHA, workplace violence has been roughly four times more common in the healthcare industry than any other profession since 2002, begging the question: Why haven’t we done something about this?
The cost of increasing hospital security
When it comes to safety, the solution is more involved than installing a simple $10,000 metal detector. Additional staff would be needed to monitor that metal detector and screen patients as they enter. Then there would need to be other safeguards, like panic buttons at triage desks or second emergency exits in assessment rooms—all contributing to the overall cost.
Soon, that $10,000 project has turned into a $2 million–$3 million expense for the hospital, and with many hospitals transitioning to for-profit models, the high cost and apparent low ROI of any similar project mean plans for improving safety become tabled indefinitely.
Rethinking workplace safety
Although implementing workplace violence prevention programs can be expensive, recognizing that these changes can be profitable—and maybe even less costly—can help overcome existing mindsets to find a plan that works.
A competitive advantage
Providing better security can be a key competitive differentiator for your hospital. For example, our area has two major competing healthcare systems, so we’re always discussing ways to give our hospital an advantage. In a world where violence inside and outside of the hospital is prevalent, people want to feel safe when they come to receive care—especially during emergencies and already-stressful situations.
A retention tactic
The cost of staff turnover is high. According to a study in the Journal of Nursing Administration, the average cost of replacing a nurse is between $97,000 and $104,000—considering recruiting costs, unstaffed beds, and overtime costs accrued during the average 42 days needed to replace the nurse. When more than half of healthcare staff consider leaving their position after an incident of violence, it’s no wonder that healthcare turnover rates in 2017 were over 20%—an increase of five percentage points from 2010.
Working with ACEP’s diversity and inclusion task force, I study how well we ensure physicians across all diversities are being treated and supported. Part of supporting our staff is helping them feel safe. The better we can protect our employees, the more valued they feel and the more likely they are to stay with us.
A shared responsibility
C-suite hospital leaders can collaborate with local police departments to align standard operating procedures in better support of hospital safety. This could be as simple as building police substations closer to the hospital for a visual reminder that safety is a top priority.
ACEP’s efforts with H.R. 1309 bring Congress into the discussion, but much can be done on a local level to lobby with community leaders on ways to offset security implementation costs. This could mean receiving tax credits, or reduced insurance premiums, when certain safety standards are met.
Call to action
Improving workplace safety can start small. Simply having visible security personnel in the hospital waiting area can make a difference. Similarly, real-time notifications can alert providers when patients with a history of violence arrive—allowing security personnel to intervene. But, ultimately, these changes will need to be made.
When contemplating the cost of increasing workplace safety, I ask: Can your hospital afford to have a significant event?
Establishing a safer workplace has both a fiscal and a patient/provider satisfaction ROI that are well worth the initial time, effort, and cost investment. We just need to make the choice to put the changes into action.
Hamad Husainy is a staff physician with Helen Keller Hospital in Florence, Alabama, the founder of Sycamore, and a member of Collective Medical’s Clinical Advisory Board.