As described in heartbreaking detail in Pulitzer Prize-winning journalist Raquel Rutledge recently issued exposé in the Milwaukee Journal Sentinel, the direct cost to a healthcare organization when responding to the death or injury of an employee from violence is often substantial. In addition to payment of workers’ compensation claims, liability claims for failure to provide a safe workplace for employees or even the general public frequently present (at least pre-Covid-19) in a medical facility are:
OSHA has levied considerable fines on healthcare facilities for failure to provide a safe workplace. Fines against facilities in Pennsylvania ($32,000+) and Florida ($71,000+) were assessed for making employees and patients vulnerable to injuries from punches, kicks, bites, scratches, hair or extremity pulling, and objects used as weapons by patients. A psychiatric treatment center in Massachusetts faced more than $207,000 in penalties in 2017 after OSHA accused the facility of similar failures despite a prior warning and the facility’s agreement to improve.
Although Ms. Rutledge despairs over the infrequency and relatively small amounts of more recent fines or penalties, these examples provide evidence that OSHA has legitimate enforcement power when so moved, something to be expected again as a result of the very type of reporting Ms. Rutledge does. Adding the increasingly high incidence of claims, it is fiscally responsible to act now to deter, prevent, or minimize the effects of violence than it is to pay reparations in the future, be it directly or through insurance claims and rising premiums.
Many healthcare organizations are taking what may appear to be reasonable steps to provide security for caregivers. Some organizations, for example, pay local police a nominal amount for ALICE or “Run-Hide-Fight” training. At first blush, this is a positive step, but numerous carriers have reported a surprising number of claims from the trainings themselves.
Participants have sued over psychic or emotional injuries inflicted by well-meaning officers trying to give a sense of what danger really “feels” like. Reported physical injuries include hearing loss from “blanks” shot off at close range, and bumps, bruises, sprains, or worse from practicing high stress escape attempts or hands-on take-down techniques.
Caregivers are taught to “fight” with planned improvisation, tackle and pile-on techniques, and the use of improvised weapons. This training has resulted in serious injuries, time lost from work, and a worse feeling about potential violence (especially from training) than prior to instruction. Reported settlements of $500,000 exist, and although rare, the risk-reward analysis for such potential liability simply does not merit their continuation. Thankfully, there is a far better – and safer – way today.
Training injuries are eliminated when an organization trains on Reflex Protect® hospital-safe products that stop an attacker in his or her tracks from a distance. Adopting this active measure means caregivers needn’t practice tackling an assailant – or even be near – while instead gaining confidence in the use of compassionate controlling force to protect themselves, colleagues, and patients. Workers’ compensation carriers have recently begun advocating the type of “low impact, no scare tactics” training that is made possible by the advent of the Reflex Protect non-lethal active defense solution.
Liability insurance carriers have also expressed solid support for adoption of the non-lethal active defense training and product solution. As mentioned above, potential liability arising from a failure adequately to provide a safe workplace is drastically limited by (a) having reasonably adequate policies, procedures, training, and equipment, and (b) avoiding those injuries altogether, not only to caregivers and other employees, but to bystanders and even to the subjects of the defensive action themselves. When a caregiver, staff, or security member of a medical facility team can rapidly and effectively incapacitate and control a potentially violent subject without physical contact and without any effect on bystanders or lasting harm to the subject, virtually all potential catalysts of injury from violence are effectively eliminated.
In addition to fines or workers’ comp claims, potential lawsuits may arise from the unique nature of many healthcare workplace violence events. Often, the assailant is a patient suffering delusion, fear, drug reactions or omissions, or is similarly overwhelmed by circumstances, which is where the concept of “compassionate control” is most valuable. It’s easy to see how a compassionate nurse (and even well-trained security) might find it difficult to take assertive self-defense measures against a patient in such a situation, only to find themselves compromised and in trouble. That’s when injuries can happen, not only to the caregiver, but also to the patient once security arrives and enters an ongoing fray.
They key to “compassionate control” is for the caregiver to have the confidence and comfort level to use it sooner rather than later in a potentially violent situation. Reflex Protect® is designed to provide peace of mind during the “response gap” – the period of time between the eruption of violence and the arrival of help from security or police. In an urban hospital, the response gap may only be a few minutes, whereas in a rural one it could be an hour. Regardless of the time, if the violence can be deterred or stopped – before an assault becomes a battery – then injuries are prevented. Because Reflex technology is easy and intuitive to deploy, Presidia Gel® causes no lasting harm, and Reflex Remove™ is a fast-acting antidote, caregivers trained in its use are far more comfortable and likely to use it when needed, preventing preventable injuries.
Spraying a potentially dangerous patient with a stream of Reflex Protect Presidia Gel will cause immediate involuntary eye closure, pain, and voluntary submission without the loss of bodily control, and without affecting anyone else in the vicinity. Generally, subjects simply take a knee and focus on the alleviation of this uncomfortable new condition. Once the patient is restrained and the threat of violence has passed, patent-pending Reflex Remove provides rapid neutralization, cleansing, and soothing decontamination, essentially reversing the effects of Presidia Gel in minutes. Additionally, the potential damages claims that might arise from a patient subjected to defensive measures by a potentially endangered caregiver (right or wrong) are drastically reduced when there is limited physical touching and rapid reversal of the discomforting tool or agent used in defense.
Better still, by a factor of at least 10x to date, caregivers have prevented violence from even taking place simply by brandishing Reflex Protect.
In short, this effective self-defense solution prevents injury, damage, or loss from occurring even when violence threatens.
In one of the more in-depth analyses in her article, Rutledge points out that danger lurks outside the hospital in poorly lit parking lots or garages and caregivers and employees walk to and from their cars at shift change. This is an issue Reflex Protect learned about during our earliest healthcare training sessions supporting docking stations in strategic locations around a hospital (the “fire extinguisher for violence,” as nurses nicknamed it). In response, we created the Pocket Presidia Gel®, sized to be carried in a purse, pocket, scrubs, or in-hand when headed to the parking lot or garage. It’s a timely solution for nurses and doctors making extensive rounds alone in rural hospitals at night, as well as those navigating areas outside the hospital’s doors in urban ones.
The healthcare industry is known for slow adaptation. But money matters and so does the idea of taking care. According to the logic of risk manager, liability pool participants, and claims assessors investigating these matters, premiums paid for workers’ comp and liability insurance and/or losses attributed to acts of workplace violence will undoubtedly decrease when violence preparedness training and non-lethal active defense measures are introduced.
Next up: The Indirect Economic Benefits of Safety Preparedness in Healthcare
Joe Anderson is the CEO of Reflex Protect