3076 Findings from the first year of California’s Workplace Violence Prevention in Healthcare standard (Title 8, Section 3342)

Abstract

OBJECTIVES/SPECIFIC AIMS: This research project aims to: 1) describe the incidents of workplace violence that have been reported to CalOSHA through the Workplace Violent Incident Reporting System for Hospitals; 2) determine if there are any relationships between the types of violent incidents reported and the unit or hospital where the event occurred; 3) describe what mitigation strategies facility representatives report having utilized immediately following a violent incident, such as changes to practice or involvement of law enforcement. METHODS/STUDY POPULATION: Reports submitted to CalOSHA pursuant to the Workplace Violent Incident Reporting System for Hospitals are considered public record and are available through the state’s Public Records Act (PRA) mandate. Records from 7/1/17 – 9/30/18 were obtained through the CalOSHA PRA request process. Descriptive statistics and correlations were calculated using Stata. RESULTS/ANTICIPATED RESULTS: Records reporting 11,116 individual events of violence were analyzed. These results do not include reports submitted by the five California State Hospitals, a group of facilities which treated nearly 13,000 patients in 2017, many of whom have a psychiatric diagnosis and are undergoing treatment mandated by judicial decision. For each record, 111 variables were reported, including description of the event itself, characteristics of the workers involved, factors which may have triggered the event, and what measures were taken to mitigate the situation during and after the incident. All events identified an aggressor; 10,357 (93%) described this individual as a patient. 11,048 reports had a unit or hospital location listed to describe where the incident occurred. Of these, 9393 (84.5%) were inpatient, behavioral health, or surgical units. A physical injury was reported in 3672 events (33%) and stress/psychological impairment was reported in 536 (5%) of the incidents. Police officers were deployed to the scene following the incident in 1122 (10%) of reported events, resulting in arrest of the perpetrator in 402 (3.6%) of the reported incidents. DISCUSSION/SIGNIFICANCE OF IMPACT: While the impulse to address the high prevalence of workplace violence towards healthcare providers has led to deserved attention from policy makers, safety regulators, and healthcare unions, plans for ensuring that new initiatives are achieving their desired effect for workers have yet to fully materialize. An ongoing concern is that incidents are known to be under-reported through official mechanisms, leading to challenges in determining the scope of the problem itself and evaluating the efficacy of interventions to address it. CalOSHA’s new reporting requirement and online interface provides a new channel for improving validity of prevalence data, as early findings indicate that less serious events are being reported through the system. In addition, information describing how hospital leaders report responding to incidents in their immediate aftermath will provide needed insight into what additional efforts are needed to support victims of violence given the unique challenges present in the healthcare industry.