Focus on Access Management for Safety in Healthcare

Safety will influence whether your providers and staff stay or leave their jobs. As a result, healthcare access management—thoughtfully controlling visitors’ and vendors’ access to a facility—is an important strategy to protect healthcare staff and increase workforce retention while ensuring compliance.

Workplace violence in healthcare: The other epidemic

Unfortunately, workplace violence is a common, often underreported occurrence in hospitals. According to a February 2022 survey of more than 2,500 registered nurses (RNs), 65% reported being physically or verbally assaulted by a patient or patient’s family member in the last year. 

Respondents attributed the recent aggression to anger regarding hospitals' COVID-19 guidelines (52%) and frustration regarding staffing/care (47%). But widespread staffing shortages compound the problem, making it difficult for over-extended staff to respond quickly to patients. That can result in frustrated and angry patients and relatives who lash out at nurses and other frontline staff. 

In fact, healthcare workers are five times more likely to experience workplace violence than workers in other industries, according to the U.S. Bureau of Labor Statistics. Nurses, who interact with patients and their families more often than physicians and other staff, bear most of the physical and verbal abuse. Doctors are also attacked, but less often than nurses: Almost half (47%) of emergency room physicians report having been physically assaulted on the job, compared to 70% of ER nurses.

Already a widespread problem, violence toward healthcare workers increased during the pandemic as patient access rules for families and others became more stringent. 

  • In a survey of 373 hospital RNs, 44% reported experiencing physical violence and 68% reported experiencing verbal abuse between February and June 2020.
  • A September 2021 survey by the National Nurses Union (NNU) found that 31% of hospital RNs surveyed faced an increase in workplace violence. The nurses attributed the increased aggression to decreased staffing levels, changes in the patient population, and fewer visitor restrictions (after pandemic-related restrictions were relaxed).
Violence negatively impacts patient care

In March 2022, the American Hospital Association (AHA) sent a letter to the U.S. Department of Justice requesting support for legislation to protect healthcare workers from assault and intimidation. The AHA mentions the severe consequences of workplace violence on healthcare organizations. For example, workplace violence:

  • Causes physical and psychological injury for healthcare workers
  • Ties up valuable resources and can delay urgently needed care for other patients
  • Reduces patient satisfaction and employee productivity
  • Increases the potential for adverse medical events
  • Makes it more difficult for nurses, doctors, and other clinical staff to provide quality patient care 
  • Exposes health systems to regulatory compliance violations, legal trouble, and monetary fines when proper precautions are not taken 

Simply put, providers and staff cannot deliver optimal care when they are worried about their personal safety, distracted by disruptive patients and family members, or traumatized by prior violent interactions.

Impact of workplace violence on nurse satisfaction, retention

In addition to endangering frontline staff and jeopardizing patient care and satisfaction, violence in healthcare organizations takes its toll on staff morale and retention. Exposure to workplace violence can lead to:

  • Psychological distress
  • Job dissatisfaction
  • Absenteeism. The Joint Commission cites that 73% of nonfatal workplace injuries and illnesses that result in days of missed work are connected to workplace violence.
  • Higher costs and excessive staff turnover. The average cost of turnover for a bedside RN is $40,038 (ranging from $28,400 to $51,700), causing a hospital to lose $3.6 million to $6.5 million per year.

And according to a McKinsey survey of 710 frontline nurses, 32% of RNs surveyed are considering leaving their jobs. More than 60% of respondents indicated that a safe environment is an important consideration affecting their decision to stay or leave their job.

At a time when many healthcare organizations are struggling with a nursing shortage, retaining nurses and other frontline workers is essential. Healthcare leaders must protect their staff from physical and verbal abuse.

Violence prevention programs are required

To guide hospitals in developing strong programs to prevent workplace violence, The Joint Commission introduced new workplace violence prevention requirements for hospitals and critical access hospitals, effective January 1, 2022. Hospitals must:

  • Conduct an annual worksite analysis that includes investigation of workplace violence incidents and analysis of how the workplace violence prevention program’s policies/procedures, training, environmental design reflect best practices. Hospitals must take actions to alleviate or resolve the workplace violence safety and security risks uncovered during this analysis.
  • Monitor, internally report, and investigate incidents related to workplace violence
  • Train leaders, licensed practitioners, and staff to prevent, recognize, respond to, and report workplace violence, including training in de-escalation and physical and non-physical interventions  
  • Create a safety culture. A multidisciplinary team must develop the workplace violence prevention, a designated individual must lead it, and it should include:
    • Policies and procedures to prevent and respond to workplace violence
    • An incident reporting process
    • Follow up and support to victims and witnesses affected by workplace violence, including trauma and psychological counseling, if necessary
    • Reporting of workplace violence incidents to the governing body 
Proposed federal and state legislation

Passed by the House of Representatives (in April 2021) and awaiting Senate review, the Workplace Violence Prevention for Health Care and Social Service Workers Act (HR 1195) requires certain healthcare employers to develop and implement a comprehensive workplace violence prevention plan to protect healthcare workers from workplace violence. Violence prevention plans may include better reporting (to increase awareness and corrective actions) and de-escalation training, among other components.

In addition, six states recently proposed legislation to protect healthcare workers. For example, two New Jersey assembly leaders plan to introduce the Health Care Heroes Violence Prevention Act to protect healthcare workers by increasing penalties for people convicted of threats or violence against them. The act would render threats against healthcare professionals or workers a disorderly persons offense, punishable by imprisonment of up to six months and/or a fine of up to $1,000.  

Healthcare access management: Essential for workplace safety

Controlling vendor and visitor access to all areas of a facility, but especially the ED and nursing wards, protects everyone from harm. But effective facility access management also prevents gatekeepers from inappropriately denying visitors access to loved ones due to errors or mistaken identity. For example, a recent social media post discussed how one family was not allowed to say goodbye to their dying sister because the security guard confused them with another family who had been giving the staff problems all week. 

The National Association of Healthcare Access Management (NAHAM) establishes best practices and offers subject-matter expertise for healthcare staff whose responsibilities include admissions, registration, guest relations, and other associated tasks.

Managing security risk starts with knowing exactly who is in your facility and who has patient access at all times. Access management software collects vital information, making it easy for hospital staff and volunteers to ensure that only those visitors who meet your requirements (e.g., vaccination status or visitor relationship status) receive access. The system flags and denies access to visitors who pose a threat.

Your healthcare visitor management system should be simple for clerks and volunteers to use, yet robust enough to gather data for your C-suite. Effective visitor management software that ensures adherence to regulatory compliance and your visitor policy allows you to quickly check in visitors via personal ID, previous visitor search, or through manual registration.

Likewise, for vendor access management, software can be tailored to your organization’s policies and build in safety measures, such as ensuring all vendors undergo annual background checks and Office of Inspector General (OIG) compliance healthcare exclusion screening. 

symplr Access helps you navigate the complexities of facility access management to reinforce staff, patient, visitor, and vendor safety. symplr Access enables fast check-ins, typically in fewer than 30 seconds, and allows you to manage visitors simply, compliantly, and confidently.

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