How leadership can help reduce health care workplace violence

Jan 16, 2023 at 10:08 pm by Staff

New free handbook charts a path for health care industry leaders to create the safe workplace employees deserve


By AlGene P. Caraulia, Vice President, Integration and Sustainability

Recently, CFNU reported more than half of nurses expressed significant concerns with workplace violence. So much so that two-thirds of nurses are considering leaving their jobs due to workplace violence issues.

In fact, according to recent surveys of nurses by Hospital IQ, 90% of respondents are considering leaving the profession in the next year and 72% said they were experiencing burnout long before the pandemic. Overall, 77% of health care workers believe workplace violence is a priority and more than two-thirds report experiencing more serious mental health issues like anxiety or depression as a result. 

Those are dedicated nurses facing very real struggles and leaving the profession to which they were called.

And now, the Center for Medicare & Medicaid Services (CMS) has provided a new memo to hospitals and health systems stating the importance of training to reducing workplace violence in the health care industry.

The question is clear.

What are you doing to reduce workplace violence?

First, recognize there is no quick fix. It is a problem that requires executive ownership and multi-departmental collaboration. One opportunity to make a long-term positive impact is with workplace violence prevention committees. Many health care organizations, especially larger systems with multiple locations and de-centralized leadership structures, have started workplace violence committees to address the problem. However, like many committees, they can be left powerless without executive endorsement or full integration into the daily lives of all employees. When this happens, change doesn’t come, violence and tension linger, and our valued health care workers continue their mass exodus out of the profession.

Whether you have a workplace violence prevention committee or have realized it’s time to start one, here are two steps you can take right now to strengthen its mandate while empowering employees to create the safe workplace they deserve. All that’s needed is the effective — and fully engaged — leadership to make it happen.

Learn and contribute to learning.

This is what we’re doing at Crisis Prevention Institute (CPI). At CPI, we believe all employees are entitled to a safe workplace. But we can’t just wish that into being. There are models, evidence-based best practices and organization-wide methods that need to be implemented to create holistic change with accountability and reporting. Therefore, we have assembled a team of health care experts to publish the first-of-its kind Workplace Violence Prevention Handbook for Health Care Professionals. This handbook is a free, on-demand digital resource providing easy-to-use recommendations and strategies to help individuals in all levels and roles of health care improve their workplace violence prevention programming to generate immediate results. Its stand-alone chapters are written to help health care leaders regardless of where they are in their workplace violence prevention journey. We developed this book with healthcare professionals who have more than 150 combined years of creating and implementing workplace safety programming. The Workplace Violence Prevention Handbook for Health Care Professionals can be downloaded at after taking a short survey focused on how workplace violence has impacted health care professionals and their organizations. That’s where the contribution to learning comes in. This survey is available for health care professionals to have their say so we uncover what is really happening to people and — crucially — what people are really doing to find solutions. We can’t apply old methods to new problems and expect results. To make change, we must first listen and understand. By collecting more data, we intend to better lead the conversations that help people bring peaceful resolution to situations that would otherwise turn to conflict so staff, patients and visitors feel safe.

 Begin de-escalation training now.

So often, we are focused on ending threats as they arise, nullifying them. But what if we took a different approach? By embracing de-escalation training, you can give your organization a direction with a clear goal — create a more peaceful working environment in a place of healing. With a commitment to training staff — all staff, at all levels — to recognize the early stages of crisis and engage in de-escalation strategies, you can move from reaction-to-violence toward prevention. De-escalation training teaches people how to work together to create meaningful personal connections that reduce the fear and anxiety that lead to violence. Pairing the Workplace Violence Prevention Handbook for Health Care Professionals with holistic training that reflects the responsibilities of every staff member based on their assessed risk will give health care organizations a clear path to the change required to de-escalate traumatic situations, and reduce risk and violence, while creating a safer workplace.

With organizations like CMS focused on continuing “to enforce the regulatory expectations that patient and staff have an environment that prioritizes their safety to ensure effective delivery of healthcare,” training your team must be a priority. In its memo, CMS states leadership must, “ensure they provide adequate training, sufficient staffing levels and ongoing assessment of patients and residents for aggressive behavior and indicators to adapt their care environments and interventions appropriately.”

Leading health systems recognize that reducing workplace violence requires more than adding metal detectors and zero-tolerance policies. Workplace violence initiatives are multi-faceted and begin with active, engaged leaders who understand that in addition to creating a safer environment of care, they are more likely to retain their talented, experienced professionals while attracting top talent in a competitive employment market.

Crisis Prevention Institute (CPI) is the world’s leading provider of evidence-based de-escalation and crisis prevention training. Since 1980, CPI has helped train more than 15 million people across the globe within service-oriented industries, helping to create a true culture of safety across workplaces. By successfully diagnosing, designing, and implementing thousands of workplace violence prevention programs, CPI helps its partners review, reassess, and reinvest in their workplace violence prevention programs with a focus on Care, Welfare, Safety and SecurityTM for everyone.

Drawing upon his expertise in organizational behavior, program design, facilitation, and implementation, Caraulia led CPI’s training department, global professional managers and instructors in North America, Europe and Asia. In 2018, he transitioned into his current role partnering with enterprises and focusing on the delivery of superior customer experiences to internal and external customers. Caraulia began his career at CPI as a professional staff instructor and has provided Nonviolent Crisis Intervention® and related training to professionals in education, health care, mental health, human service and security/law enforcement practices across the globe.


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