Volume 20, Issue 2 , Pages 155-160, February 2001
Violence prevention at work:
A business perspective1
Article Outline
- Abstract
- Introduction
- Defining the problem of workplace violence
- Violence prevention policy: zero tolerance?
- Risk assessment
- Response team
- Threats: identification, assessment, and management
- Communication and training
- Legal
- Post-incident response
- Late-night retail: example of type I violence
- Health care: example of type II violence
- Domestic violence: example of type IV violence
- Conclusion
- References
- Copyright
Abstract
Introduction: The risk of workplace violence varies depending on the type and location of the business. Business managers should assess violence risk and develop a program based on the level of risk faced by their employees.
Discussion: This assessment should include: (1) a review of workplace security and identification of positions with increased risk of exposure to violence, (2) risk reduction through environmental design and employee training, (3) development of a plan and identification of professional resources to respond to incidents should they occur, and (4) communication of the employer’s commitment to providing a safe work environment for employees.
Conclusions: For most businesses, threat assessment and management comprise the cornerstone of a workplace violence–prevention program. Planning and preparation are key to workplace violence prevention.
Keywords: domestic violence, risk assessment, safety, violence, workplace
Introduction
For most businesses, a workplace violence–prevention program consists of two elements: a physically safe place for employees to work and a coherent plan to manage disruptive employees or customers. Certain businesses have increased risks based on environmental factors such as high-crime location, late-night hours, available cash, or factors intrinsic to the work situation, such as law enforcement activity or work with disturbed or agitated people. In this article, we cover the major aspects of violence prevention for business. The fact that the risks vary greatly among different types of businesses as well as for the same types of business presents a challenge. The observations in this article summarize the experiences of a number of work settings.
Many of the interventions and strategies described here have not been scientifically evaluated. Rather, we have culled them from direct experiences in prevention and management of violence in the work setting. The lack of peer-reviewed literature on this subject makes it premature to publish a definitive guide on scientifically proved strategies for preventing workplace violence. However, in recent years, some businesses directly affected by workplace violence have developed strategies for managing violence and threats of violence. The goal of this article is to describe some of these strategies and the key issues of concern for management and to provide a framework for researchers to further study these practices and issues.
According to national statistics, about 700 homicides occur at work each year and almost 80% of workplace homicides are associated with robbery.1, 2 Tragically, many employers do not consider the issue of workplace violence prevention until an employee has been killed or seriously injured. As recently as the early 1980s, few resources existed for workplace violence prevention, but in the past decade or so, some businesses have developed and shared approaches to preventing workplace violence—based more on experience and judgment than on tested theories—and these have been incorporated into a number of corporate cultures. Some of these strategies are described below.
Defining the problem of workplace violence
Workplace violence occurs on a continuum, ranging from death and homicide at one extreme, to assault, and to physical and verbal threats on the other extreme. The sources and situations that give rise to workplace violence also can be factored into subgroups. California’s branch of the Occupational Safety and Health Administration has developed an analysis of workplace violence and has identified four distinct types:3
Because threats precede most episodes of physical violence, the author views threat assessment, management, and prevention as basic to workplace violence prevention. Threats have been studied less than fatal and nonfatal assaults. Threats are generally under-reported and difficult to identify and track. Although threats can be an early indicator of more serious violence, only a small percentage of threats actually progress to more extreme acts of violence. Threats may have their own distinct typology. We do not know whether types of threats exist that can be associated with particular situations or personality types.
Workplace violence–prevention intervention must be appropriate to the likelihood and potential severity of the risk. Not all workplace environments have the same level of violence risk. For many employers, incidents occur so rarely that when they have a difficult, angry, or threatening individual, employers may not have even a framework to manage the problem comfortably and successfully. Workplace violence prevention combines anticipation and reaction. Ideally, one tries to create an environment at work in which violence does not occur, but if it does occur, a structure will be in place to handle it and to minimize the consequences.
Violence prevention policy: zero tolerance?
Security professionals often state that the most-effective position for violence prevention in the workplace is to have a policy of “zero tolerance.” Some have come to regard this to mean that a threat leads to automatic termination of employment. In this article, zero tolerance means simply that threats and physical violence at work are unacceptable, but this definition does not require specific, predetermined consequences. In some situations, for example, counseling the threatening employee is sufficient as long as the behavior does not recur. Experienced human resource professionals have found that failure to address all threats undermines employee confidence in management.
Consistent enforcement is as important as having a zero-tolerance policy. Employees look to management to see whether the policy is integral to the company or whether it is an unevenly implemented set of rules. A gap between stated policy and actual practice can lead to employee cynicism and can erode organizational functioning and well-being. Therefore, management must not only communicate the policy but must also implement it when incidents occur or safety concerns arise. Most businesses have the greatest difficulty in violence prevention in this area. Not all businesses have clearly defined which behaviors are not acceptable. When an incident occurs, the employer is not always prepared to intervene proactively.4 As a result, what may have started out as a simple case of an angry employee may progress to a more serious situation with frightened coworkers and increased risk of physical violence.
Risk assessment
Risk assessment of a work environment should include a review of past experience, neighborhood crime pattern, industry experience, specific job exposures, and work environment layout. Some specific jobs within a workplace may have greater risk of violence. Questions management may want to ask can include:
Additionally, work environment layout and security systems can have an important influence on violence:
Supervisors of hospital emergency departments, for example, have increasingly come to realize that they need a wider range of security measures, physical and behavioral, to assure employee safety.5 Similarly, employers in the food service and retail industries have found that the most effective way to prevent robbery is to make the establishment unattractive to the perpetrator with changes such as appropriate lighting, restricted access to money, or the installation of a monitoring device.6
Response team
Another component of a good violence-prevention program is the response team. This group of people can assess and manage a threatening situation, should it ever occur. People with appropriate expertise may include staff from:
Threat assessment and management require good communication among all involved. The author has found that the more separate conversations take place, the longer it takes to reach a consensus and to develop an action plan.
Part of appropriate expertise may include community resources and consultants. Threats are relatively rare in most work environments, making it difficult to establish and maintain a level of expertise within some companies. Therefore, it may be valuable to identify outside experts to call on if a situation arises.
Another responsibility of the response team is incident investigation and post-incident analysis, to review how the incident was handled and how it could be prevented in the future. After this review, assessment and recommendations should be communicated and implemented within the organization. Without this step, a business remains at risk of repeat incidents.
Threats: identification, assessment, and management
In addition to establishing a means to identify threats and high-risk situations, employers also should provide information on what employees should do if they have concerns about their safety at work. In most businesses, this is handled as one aspect of employee communication. If communication channels are poor for other areas of employee concerns, such as compensation or benefits, these channels likely will not work well for violence-prevention efforts either.
Threats are sentinel events and act as early warning signs for more serious forms of violence. In our experience, most threats never progress to violence. The challenge in threat assessment is to distinguish between idle talk and more serious intent. Nationally, we are seeing a shift in what language is acceptable at work. Just as making jokes about bombs at airports is no longer acceptable or “funny,” making threats of “going postal” at work is increasingly unacceptable. Threat assessment combines experience and intuition and is at best an imperfect science.7 Employers may feel pressure to overestimate risks, because the costs of underestimating are so high. Fortunately, the ability to predict violence in the short range has improved.8, 9
Complete information collection about the incident is key to effective threat assessment: exactly what was said, tone of voice, facial expressions observed, context of the incident, and actions and reactions. We cannot emphasize enough the importance of this. Reducing the incident to a shorthand summary often impairs threat assessment. For example, “Joe threatened Tom” may either exaggerate or downplay the risk. Without having a full picture of all the details, the risk of misjudging an incident increases as does a consequent over- or under-reaction.10 Information about any prior incidents at work, any violent episodes outside of work, access to weapons, the employee’s current psychological state, past psychiatric history, or any criminal record helps to assess a threat from a specific individual.
With threat management, one needs to recognize the importance of limit setting and of consistency.11, 12, 13, 14 Commonly, the one who threatens has received mixed messages about his or her threats. Threat management requires that the employee be told that the threats are unacceptable and consequences to making threats will occur, including job termination. By the time management becomes aware of threatening situations, a history often exists of inadequately and ineffectually dealing with threats. We have seen many examples of ignored and thereby implicitly tolerated threats. This encourages the employee to continue the behavior or to escalate the words or actions.
Many employers and workers with experience in threat management report that conflict-resolution skills are invaluable in managing situations that have the potential to progress to violence. Such skills are particularly useful in work environments such as health care and law enforcement. These work environments often have a greater frequency of cases with conflict, the intensity of conflict may be stronger, and the risk and result of violence greater. Recognizing this, some employers offer training to their employees, although more often employees learn from one another by trial and error.
Communication and training
A workplace violence–prevention policy and program is of little use if employers do not communicate it to employees. In many situations, workplace safety depends as much on employee behavior as on security systems and workplace design. For most occupations, encounters with violent or threatening people occur outside the realm of everyday experience. Employees in this category do not necessarily need to be able to solve a developing problem, but they do need access to those who have the expertise to do so. A good communication system will ensure that employees know what to do in a threatening situation.
Training is another component of workplace violence programs. Depending on the type of business and the possible risk, employers may train all employees on a zero-tolerance policy, the importance of a safe workplace, and the unacceptability of threats and how to get help. The purpose of this article is not to provide details and specifics about training but rather to identify it as an important component of violence prevention at work. For example, employees who work in late-night retail establishments are likely to need some training on how to handle money and minimize risk. Managers of health care facilities may want to provide more extensive training for certain groups at greater risk of threatening situations, such as staff who work with difficult patients, whether on a mental health unit, in a nursing home, or in an outpatient facility.
Legal
Unfortunately, some violence-prevention solutions may have serious legal implications. Legal expertise is an important resource for any workplace violence–prevention program and can help employers provide safe workplaces without creating legal problems or unduly infringing on the rights of individuals affected by prevention programs. Providing legal advice is beyond the scope of this article. Instead we seek to sensitize readers as to the importance of legal issues that may be overlooked when developing policies and practices as well as when dealing with difficult and threatening situations. These issues include negligent hiring and firing, retention, consideration of Americans with Disabilities Act of 1990 issues, and balancing the rights of the employee with the responsibility of the employer.
Post-incident response
Helping to heal all affected by a violent incident at work, including coworkers, family, and friends, is as important as prevention. Psychological and personal costs are incurred in “just getting back to work,” beyond the emotional impact of the incident, whether it was a homicide or an assault. We know that after a violent incident at work, employees can experience a roller coaster of emotions, including guilt, anger, and depression.15 Knowing what to expect and that their feelings are a normal part of the recovery will help. Studies have found that educating and supporting an employee after a traumatic incident reduces the employee’s period of disability.16 Mental health professionals report that it helps employees to review what happened with others who were present. Although most post-incident response counseling is associated with employee-on-employee (Type III) violence, it is increasingly recognized that employees who experience violence as a routine part of the job also need and benefit from support, time away from work, and counseling.
Most of this article has focused on Type III (employee-on-employee) violence, but some of the themes covered above, including risk assessment, threat management, and employee communication and training, may be appropriate for preventing other types of workplace violence. Examples of Types I, II, and IV are discussed below.
Late-night retail: example of type I violence
Of all four types, late-night retail represents one of the most-significant contributors to workplace homicide.17 Late-night retail includes businesses such as all-night convenient stores, liquor stores, gas stations, and food service establishments. Location is a key factor in determining the level of risk. Because most incidents of Type I violence are associated with robbery, businesses in neighborhoods with higher than average rates of robbery have greater risk than businesses located in areas with lower robbery rates.
A great deal of information already exists about preventing robberies: making establishments less attractive targets for robbery and making cash less accessible. Security professionals recommend changes such as modifying the design of the building, restricting areas accessible to customers, and increasing visibility around the business with landscaping changes and improved lighting. Establishments can limit the amount of available cash with measures such as locked drop safes. Informing customers of security systems in place, such as limited cash and video monitoring, also serves as a deterrent. Ideally, late-night retail employees would not have to work alone.
Health care: example of type II violence
The health care industry experiences many examples of Type II violence, in which the violence is an expression of client anger or frustration. Most violence committed against health care workers is nonfatal. Health care violence may occur when a patient is being restrained, is agitated, has received bad news, or is asked to do something he or she does not want to do. Anxious or distressed family and friends also may be a source of violence against health care professionals. In settings such as inner-city emergency departments and certain psychiatric wards where patient violence occurs regularly, this violence is often seen as part of the job. Studies have found that incidents of Type II violence are often under-reported. Employers may not investigate cases and may not take follow-up action.18, 19, 20 Many health care professionals do not receive training on how to deal with threatening patients. Training, including listening and conflict-resolution skills and teaching helpful actions and verbal responses, may increase employee awareness of potentially risky situations, although the effectiveness of training has not been well evaluated.21 Facility security makes up another important component of preventing and managing violence in health care settings and includes the layout of the facility, the use of security devices, and the role of security personnel.22, 23
Domestic violence: example of type IV violence
The problem of domestic violence is receiving increased attention. Employers often do not get involved because they perceive domestic violence as personal and not related to work. In most situations, although not all, the targeted victims are women. Domestic violence can affect the workplace directly and indirectly. Direct impact can occur when the abusive partner calls or comes to the workplace to harass, threaten, or stalk the employee, and may pose a risk to others in the workplace. Indirect impact occurs with the abused person’s increased absence and impaired work performance. The employer can help the employee deal with the problem by referring the employee to community resources and to law enforcement, and by supporting the employee’s plan to ensure her safety. This may include restricting workplace access of the abusive partner, moving the employee to another office, changing her office telephone number, giving her time for a court appearance, and helping her find a safe way to and from work.24
Conclusion
Many employers still underestimate or discount the risk of violence. Sometimes this is because violent acts are so infrequent. In other situations, the violent behavior of clients or customers occurs so frequently that employers see it as part of the job to deal with these situations. Both cases can lead to complacency. Often violent incidents at work have had early indicators that could have provided an opportunity for prevention with earlier involvement. Unfortunately, employers implement many workplace violence programs only after a violent incident challenges this complacency.
We are still learning about the environmental and personal predictors of violence and the effectiveness of environmental and personal interventions. The environmental analysis looks to geographic, industrial, and demographic patterns. This approach is most useful for understanding and reducing the incidence of Type I and Type II violence. Understanding the psychodynamics of violence can help in designing violence-prevention strategies by looking at the personal predictors and deterrents for violence. By examining the details of individual cases, we can develop a fuller picture of the precipitants of violence and better assess the level of risk, as well as the means to reduce the risk of escalating violence. Training can help employers and employees identify high-risk situations earlier and intervene more effectively. This approach is most important for Type II and Type III acts of violence.
Violence is a pervasive part of our society. Our homicide rates are higher than those of many other countries.25 We see violent acts in our schools, on our streets, in our movies, and in our closest relationships. Workplace violence, whether associated with robbery or with anger, is one more manifestation of societal violence. Ideally, if we knew how to reduce societal violence, we could lower the risk of workplace violence. Because we do not have such knowledge, workplace violence prevention must focus on what the employer and employee can do in a world where violence is a reality.
References
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- . Domestic violence—impact on the workplace (a Polaroid experience). In: Wilkinson CW editors. Violence in the workplace. Rockville, MD: Government Institutes; 1998;p. 171–201
- . In: Violence at work, 2nd ed. Geneva: International Labor Office; 2000;p. 53–54
- 1 The full text of this article is temporarily available until February 2002 via AJPM Online at www.elsevier.com/locate/ajpmonline.
PII: S0749-3797(00)00292-0
© 2001 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
Volume 20, Issue 2 , Pages 155-160, February 2001
