Workplace violence is defined by OSHA as “any act or threat of physical violence, harassment, intimidation or other threatening disruptive behavior that occurs at the work site. It can affect and involve workers, clients, customers, and visitors. Workplace violence ranges from threats and verbal abuse to physical assaults and even homicide.” Of the nearly 25,000 workplace assaults that occurred annually from 2011 to 2013, 75% were in a healthcare setting. While this statistic is staggering, it may be a lower estimate since the American Nurses Association found that only 20 to 60 percent of violent incidents are currently reported. 

Even prior to the pandemic, the Bureau of Labor Statistics (BLS) projected a 34% growth rate in the home health and personal care aide industry from 2019 to 2029. For perspective, the average growth rate for all occupations is four percent. Currently, the novel coronavirus is fueling increased demand for home healthcare services, propelling the industry to even faster growth.

While the healthcare industry works to address this crisis and better protect healthcare workers, home care workers are faced with increased risk and unique circumstances that companies must proactively address to ensure the safety of their staff. 

Types of Healthcare Workplace Violence 

Healthcare workplace violence is a “recognized hazard in the healthcare industry” and is classified by the FBI as four different types. Within the industry, the most prevalent types of workplace violence are Type II and Type III. The table below breaks down these types and includes examples from the hospital and home health settings.

Table 1: The Four Types of Workplace Violence 

Workplace Violence TypeDescription Hospital ExampleHome Health Example
Type I Violent acts by criminals who have no other connection with the workplace, but enter to commit robbery or another crimeA nurse mugged in the hospital parking lot while walking to her car A home health aide mugged while walking to or from a client’s home
Type IIViolence directed at employees by customers, clients, patients, students, inmates, or any others for whom an organization provides servicesPatient physically or verbally threatening or assaulting a nurse administering careA home health nurse being physically, verbally or sexually threatened or attacked at a client’s home
Type IIIViolence against coworkers, supervisors or managers by a present or former employeeVerbal or emotional abuse that includes bullying between healthcare employeesVerbal or emotional abuse between home care employees 
Type IVViolence committed in the workplace by someone who doesn’t work there, but has a personal relationship with an employee – an abusive spouse or domestic partner A person with a relationship to the nurse outside of work that spills over to the workplaceA person with an existing relationship to the home care worker outside of the client’s home that spills over to the client’s home or agency workplace

Table 2: The Unique Risks in Hospital and Home Care Settings 

Hospital Healthcare RiskHome Care Risks
  • Working with people who have a history of violence of who may be delirious or under the influence of drugs
  • Lifting, moving and transporting patients
  • Working alone
  • Poor environmental design that may block vision or escape routes
  • Poor lighting in hallways or exterior areas
  • No means for emergency communication
  • Presence of firearms
  • Working in neighborhoods with high crime rates
  • Lack of training and policies for staff
  • Understaffing in general, and especially during meal times and visiting hours
  • High worker turnover
  • Inadequate security staff
  • Long wait times and overcrowded waiting rooms
  • Unrestricted public access
  • Perception that violence is tolerated and reporting incidents will have no effect
  • In addition to many of the hospital health care risk, home care workers also experience the following additional risks
  • Working alone in high risk areas with known criminal or gang-related activities
  • Some patients and patients’ relatives or people in the area threaten or assault homecare staff
  • Household risk factors for violence can include the presence of weapons in the home, illicit drug use, and family violence
  • Providing care in the home of the client creates a more uncontrolled and more highly varied environment
  • Additional household hazards and from the surrounding community including robbery, motor vehicle theft and vandalism
  • Potential unsanitary homes, temperature extremes, homes without safe drinking water or hostile pets
  • Employers are not responsible for lack of safety devices on needles purchased by patients
  • Needle sticks and other “sharps” like broken glass present a serious hazard to blood borne pathogens
  • Distractions that include pets and children increase the risk of needle stick injury
  • Attacks from dangerous or aggressive pets and animals present in the residence

Why Address Healthcare Workplace Violence 

While these lists are not comprehensive, they do illustrate the constant exposure that hospital and home care workers incur on a consistent basis. This is why it’s imperative for all stakeholders within the healthcare industry to work together to develop strategies, protocols, and a culture that reduces healthcare workplace violence. 

Not only is this a moral imperative, but healthcare companies can reduce their bottom line costs. In 2016, the American Hospital Association estimated that workplace violence cost U.S. hospitals and health systems $2.7 billion. Of that, unreimbursed medical care for victims totaled $852 million and medical care, staffing, indemnity, and other costs related to violence against hospital employees totaled $429 million. Proactively reducing workplace violence could help hospitals and health systems save up to $1.2 billion. 

Workplace violence is a complex problem for healthcare and home care systems to address. At POM, we’re building a platform to help organizations understand and implement effective programs to reduce workplace violence. Our first product, POM Safe, provides organizations with an immediate measure to address workplace violence.

POM Safe is a portable, discrete programmable alarm device that only requires a tap to activate and immediately call for help. Our device eliminates the need for employees to unlock their phone and open an app to call for help. In many situations, employees are in immediate danger and only have the ability to tap a button in the case of an emergency.