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Violence In The

Workplace

OR-OSHA 702
0203-02
Presented by
The Public Education Section
Oregon Occupational
Safety and Health Division
(OR-OSHA)
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To advance and improve workplace safety and health for all workers in Oregon.
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This material for training use only

Welcome!
There are many different approaches companies can take in developing plans to prevent
workplace violence. An approach that works well in one company may not be suitable
for another.

This workshop provides you with recommendations on steps to consider in developing a workplace
violence prevention program to reduce the hazards of workplace violence. These are guidelines only.
Oregon OSHA does not intend to create rules specific to violence in the workplace. While not every
suggestion may be appropriate for all organizations, these recommendations provide an excellent means
for quickly assessing the state of an organization’s current policies and practices.

Objectives
1. Define workplace violence.

2. Recognize and evaluate risk factors.

Introduction - Why should we focus on “Violence In The Workplace”?

• Three workers die each day from workplace violence in the U.S.
• 1 out of 4 workers have been attacked, threatened or harassed.
• Workplace violence has been the number one workplace killer of women every year
since 1980.
• There are 1 million workplace assaults annually
• 16 million instances of workplace harassment
• $35.4 billion spent on workplace violence in 1995

Please Note: This material, or any other material used to inform employers of compliance requirements of Oregon OSHA standards
through simplification of the regulations should not be considered a substitute for any provisions of the Oregon Safe Employment Act or
for any standards issued by Oregon OSHA. The information in workbook is intended for classroom use only.

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Defining violence in the workplace


The nature and extent of your organization’s workplace violence program should be based on the
results of the initial risk assessment.
First, evaluate past incidents of violence or possible violence (they may not have been classified as
“violence”). For example you may not have considered the threatening phone call from an estranged
spouse to an employee a “violent incident,” but it was.
The following describes three categories of violence, the risk factors associated with each and a list
of preventive actions that can be taken to reduce the risk.

Type I - Criminal Act. This type of violence involves verbal threats, threatening behavior or
physical assaults by an assailant who has no legitimate business relationship to the workplace.
Risk Factors: Handle money, working alone, high crime area, valuables on site, public safety
issues, etc. (This is the number one category for homicides.)

* Training (include de-escalation techniques appropriate to your industry)


* Post signs stating cash register only contains minimal cash
* Leave a clear, unobstructed view of cash register from street
* Have a drop safe, limited access safe or comparable device
* Address adequate outside lighting
* Examine and address employee isolation factors
* Provide security personnel
* Communication method to alert police/security
* Increase police patrol in the area
* Post laws against assault, stalking or other violent acts

Type II - Recipient of Service. The person causing violence is either recipient or object of a service
provided by the workplace. He/she is a current or former client, passenger, or customer.
Risk Factors: Work alone, high crime area, drugs/alcohol, regulatory role, conflicting
expectations re: service being provided, etc. (Approximately 70% of not-fatal assaults are in this
category)

* Training (including de-escalation techniques appropriate to your industry)


* Control access to worksite (e.g., posted restricted access, locked doors)
* Examine and address employee isolation factors
* Quick communication method to alert security
* Eliminate easy access to potential weapons
* Client referral/assistance programs
* Set up worksite so employees are not trapped from exiting
* Provide security personnel
* Post laws against assault, stalking or other violent acts
* Employee reporting systems

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Type III - Employment Relationship. The person has an employment-related involvement with the
workplace:

Job related — a current or former employee who is angry about a situation.

Non-Job related - a person who has a relationship with a current or former employee. Domestic
violence erupting at work is one of the most common types of workplace violence.

Risk Factors: Atmosphere, downsizing, tolerance for violence, “good old boys”, directive
management style, domestic violence, lack of effective grievance procedure, lack of training for
supervisors in personnel issues, etc. (Represents less than 20% of the workplace homicides.

* Training (including de-escalation techniques appropriate to your industry)


* Enforced "no tolerance" policy for workplace violence
* Management strategy for layoffs
* Management policy for disciplinary actions
* Access to employee assistance program or other counseling services
* Enforced policy prohibiting weapons
* Provide security personnel
* Post laws against assault, stalking or other violent acts
* Restraining orders
* Control access to worksite
* Access to consultation with employer, employee assistance program or other counseling
program
* Reporting procedures
* Relocating within worksite where possible
* Necessary staff notification
* Provide security personnel
* Post laws against assault, stalking or other violent acts
* Policy regarding restraining orders

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1. Top Management Commitment


What is Top Management Commitment to violence
prevention?

Management commitment, including the endorsement and visible involvement of top management,
provides the motivation and resources to deal effectively with workplace violence.

Investing time, money - walking the talk

Values Leadership Integrity Character


Discipline Service Resources Selfless
Opportunity Trust Respect Pride
VIOLENCE PREVENTION PROGRAM EVALUATION
(Choose one) 5=Fully Met 3=Mostly Met 1=Partially Met 0=Not Present

Audit questions
____ 1. A written violence prevention policy that sets a high priority for safety and health exists.
____ 2. A written violence prevention goal and supporting objectives exist.
____ 3. The violence prevention policy is supported by management.
____ 4. Violence prevention goals and objectives are supported by management.
____ 5. Management supports violence prevention program safety rules.
____ 6. Managers personally follow violence prevention program policies and rules.
____ 7. Managers personally intervene in the unsafe or inappropriate behavior of others.
____ 8. Managers set a visible example of violence prevention leadership.
____ 9. Managers participate in the violence prevention program training of employees.

Potential legal consequences to an employer if an employee is injured or killed as


a result of Workplace Violence?
$ Related OR-OSHA rules
$ Federal & State Laws Prohibiting Sexual Harassment, Hostile Work Environment, Etc.
$ Premise Liability Lawsuits
$ Other Civil Lawsuit such as Those Resulting from Negligent Hiring Practices,
Failure to Warn About a Potentially Violent Individual, etc.

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2. Labor & Management Accountability


OAR 437 Div 001, Rule 0765(6)(f) The safety committee shall evaluate the employer’s accountability
system and make recommendations to implement supervisor and employee accountability for safety
and health.

Five essential components of an effective accountability system

1. Established formal standards of behavior and performance

2. Resources provided to meet those standards

3. An effective system of measurement

4. Appropriate application of effective consequences

5. Continual evaluation of the system

Improve performance through measurement and consequences.

Standards Communications Resources


Measurement Consequences Application
(Choose one) 5=Fully Met 3=Mostly Met 1=Partially Met 0=Not Present

Audit questions

____ 10. Management enforces violence prevention rules.


____ 11. Specific people or positions are identified for performance or coordination of violence
prevention activities.
____ 12. Assignment of responsibility is clearly communicated.
____ 13. Individuals with assigned responsibilities have the necessary knowledge, skills, and timely
information to perform their duties.
____ 14. Individuals with assigned responsibilities have the authority to perform their duties.
____ 15. Individuals with assigned responsibilities have the resources to perform their duties.
____ 16. An accountability mechanism is included with each assignment of responsibility.
____ 17. Individuals are recognized and rewarded for meeting violence prevention responsibilities.
____ 18. Individuals are disciplined for not meeting responsibilities.
____ 19. Supervisors know whether employees are meeting their violence prevention responsibilities.

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3. Employee Involvement
Employee involvement and feedback enable workers to develop and express their own
commitment to safety and health and provide useful information to design, implement, and
evaluate the program.

The employees should:

1. Understand and comply with the workplace violence prevention program

2. Participate in the employee suggestions procedure

3. Report violent incidents promptly and accurately

4. Participate by joining safety committees that receive reports of violent incidents, make
facility inspections, and respond with recommendations for corrective strategies.

Increase ownership, empowerment, opportunities for leadership

Invitation Suggestions Reports Consequences


Teams Empowerment Ownership Everyone engaged
Committees Open communications

(Choose one) 5=Fully Met 3=Mostly Met 1=Partially Met 0=Not Present

Audit questions

____ 20. There is a process designed to involve employees in violence prevention issues.
____ 21. Employees are aware of the involvement process at the workplace.
____ 22. Employees believe the process that involves them in violence prevention is effective.
____ 23. The workplace violence prevention policy is effectively communicated to employees.
____ 24. The workplace violence prevention policy is supported by employees.
____ 25. Violence prevention goals and supporting objectives are effectively communicated to
employees.
____ 26. Violence prevention goals and objectives are supported by employees.
____ 27. Employees use the hazard reporting system.
____ 28. Data analyses of incidents of violence are reported to employees.
____ 29. Hazard control procedures are communicated to potentially affected employees.
____ 30. Employees are aware of how to obtain competent emergency medical care.

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4. Hazard Identification & Control


Determining risk factors for workplace violence
Each risk factor only represents a potential for an increased likelihood of violence. No risk factor, or
combination of risk factors, guarantees that violence will occur or that its incidence will increase.
However, the presence of the risk factor, particularly if several exist, increases the likelihood that
violence will occur. Ask yourself the following questions.
- Do employees have contact with the public?
- Does an exchange of money occur? *
- Is there exposure to unstable or volatile persons? (such as in health care, social services or
criminal justice settings)
- Do employees work alone or in small numbers? *
- Do employees work late at night or during early morning hours? *
- Do employees work in high-crime areas. *
- Are your employees deciding on benefits, or in some other way controlling a person’s
future, well-being, or freedom? (such as a government agency)
* Identified by NIOSH as risk factor for homicide (CDC/NIOSH Alert, 1993)

Make the workplace safe through analysis and action


Observation Measurement Assessment Incidents Analysis
Accidents Inspections JHA Maintenance
(Choose one) 5=Fully Met 3=Mostly Met 1=Partially Met 0=Not Present

Audit questions

____ 31. A comprehensive baseline violence survey has been conducted within the past five years.
____ 32. Effective job hazard analysis (JHA) is performed, as needed.
____ 33. Effective inspections are performed regularly.
____ 34. Effective surveillance of established violence controls is conducted.
____ 35. An effective violence incident reporting system exists.
____ 36. A violence risk assessment is performed when there is a change in facilities, equipment,
materials, or processes .
____ 37. Outside experts are used to identify risk factors for violence and recommend controls.
____ 38. Risk factors are eliminated or controlled promptly.
____ 39. Violence control procedures demonstrate a preference for engineering methods.
____ 40. Effective engineering controls are in place, as needed.
____ 41. Effective administrative controls are in place, as needed.
____ 42. Violence prevention rules are written.
____ 43. Personal protective equipment is effectively used as needed.
____ 44. Effective preventive and corrective maintenance is performed.
____ 45. Engineered hazard controls are well maintained.
____ 46. The organization is prepared for emergency situations resulting from violence in the workplace.
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Hazard Prevention and Control


After hazards of violence are identified through a worksite analysis, the next step is to design
measures through engineering or administrative changes to control these hazards.

Engineering Controls and Workplace Adaptations


Engineering controls, for example, remove the hazard from the workplace or create a barrier between
the worker and the hazard. Here are some examples of Engineering Controls
* Install and regularly maintain alarm systems and other security devices, panic buttons,
hand-held alarms or noise devices or cellular phones, and arrange for a reliable response
system when an alarm is triggered.
* Provide metal detectors -- installed or hand-held, where appropriate
* Use a closed-circuit video recording for high-risk areas on a 24-hour basis.
* Place curved mirrors at hallway intersections or concealed areas.
* Enclose work stations, and install deep service counters or bullet-resistant, shatter-proof
glass.
* Ensure that counseling or patient care rooms have two exits.
* Limit or control access to areas by using locking doors.
* Arrange furniture to prevent entrapment of employee.
* Lock all unused doors to limit access, in accordance with local fire codes.

Administrative and Work Practice Controls


Administrative and work practice controls affect the way jobs or tasks are performed. The following
are some examples of Administrative and Work Practice Controls.
* State clearly to patients, clients, and employees that violence is not permitted or tolerated.
* Establish liaison with local police and state prosecutors.
* Require employees to report all assaults or threats to a supervisor or manager
* Provide management support during emergencies. Respond promptly to all complaints.
* Set up a trained response team to respond to emergencies.
* Ensure adequate and properly trained employee for restraining patients or clients.
* Provide employee with identification badges, preferably without last names, to readily
verify employment.
* Develop policies and procedures covering home health care providers, such as contracts on
how visits will be conducted, the presence of others in the home during the visits, and the
refusal to provide services in a clearly hazardous situation.

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5. Incident/Accident Investigation
Develop a procedure for employees to report incidents
The primary consideration in developing a reporting procedure is to make sure that it encourages
employees to report all incidents, even minor ones. The following information is useful when
included in a threat incident report:
* Name of the threat-maker and his/her relationship to the company and to the recipient.
* Name(s) of victims or potential victims.
* When and where the incident occurred.
* What happened immediately prior to the incident.
* The specific language of the threat.
* Any physical conduct that would substantiate an intention to follow through on the threat.
* How the threat-maker appeared (physically and emotionally).
* Names of others who were directly involved and any actions they took. Names of witnesses.
* What happened to the threat-maker after the incident.
* Names of any supervisory staff involved and how they responded.
* What event(s) triggered the incident.
* Suggestions for preventing workplace violence in the future.

Analyze incidents and accidents to fix system weaknesses

Symptoms Surface cause Root cause Controls Improvements

(Choose one) 5=Fully Met 3=Mostly Met 1=Partially Met 0=Not Present

Audit questions

____ 46. Violence Incidents/Accidents are investigated for root causes.


____ 47. Investigations are conducted to improve systems.
____ 48. Investigators are trained in violence prevention procedures.
____ 49. Serious acts of violence are investigated by teams.
____ 50. Analysis and recommendations involve all interested parties.

Threat assessment investigations


Threat assessment investigations differ from administrative or criminal investigations in that the
purpose of the threat assessment investigation is to provide guidance on managing the situation in a
way that protects the employee.

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6. Education and Training


Education and training ensures that all employee are aware of potential security hazards and how to
protect themselves and their co-workers through established policies and procedures.
All Employees
Every employee should understand the concept of ”Universal Precautions for Violence," i.e., that
violence should be expected but can be avoided or mitigated through preparation. Employees
should be instructed to limit physical interventions in workplace altercations whenever possible.
Employees who may face safety and security hazards should receive formal instruction on the
specific hazards associated with the unit or job and facility.
The training program should involve all employees, including supervisors and managers.
Qualified trainers should instruct at the level appropriate for the employee.
Potential training topics include:
* The workplace violence prevention policy.
* Risk factors that cause or contribute to assaults.
* Early recognition of escalating behavior or recognition of warning signs or
situations that may lead to assaults.
* Ways of preventing or diffusing volatile situations or aggressive behavior, and
managing anger.
* A standard response action plan for violent situations, including availability of
assistance, response to alarm systems, and communication procedures.

* How to deal with hostile persons.


* Progressive behavior control methods and safe methods of restraint application or escape.
* The location and operation of safety devices such as alarms systems, along with the
required maintenance schedules and procedures.
* Ways to protect oneself and coworkers, including use of the "buddy system."
* Policies and procedures for reporting and recordkeeping.
* Policies and procedures for obtaining medical care, counseling, workers' compensation, or
* legal assistance after a violent episode or injury.

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Supervisors, Managers, and Security Personnel


Supervisors and managers should ensure that employees are not placed in assignments that
compromise safety and should encourage employees to report incidents.
They should learn how to reduce security hazards and ensure that employees receive appropriate
training.
The training program should also include an evaluation. Program evaluation may involve supervisor
and/or employee interviews, testing and observing, and/or reviewing reports of behavior of
individuals in threatening situations.

Improve the skills, knowledge, attitudes of everyone

Continual Skills Knowledge Attitude


Impact Everyone Consequences
(Choose one) 5=Fully Met 3=Mostly Met 1=Partially Met 0=Not Present

Audit questions

____ 51. An organized violence prevention training program exists.


____ 52. Employees receive violence prevention training.
____ 53. Employee training covers hazards related to workplace violence.
____ 54. Employee training covers the facility safety system.
____ 55. New employee orientation includes information on violence prevention and risks.
____ 56. Violence prevention policy is understood by employees.
____ 57. Violence prevention goals and objectives are understood by employees.
____ 58. Employees periodically practice implementation of violence prevention emergency plans.
____ 59. Employees are trained in the use of violence prevention equipment.
____ 60. Supervisors receive violence prevention training.
____ 61. Supervisors are effectively trained on violence prevention.
____ 62. Supervisors are trained on all site-specific violence prevention measures and controls
relevant to their needs and supervisory responsibilities.
____ 63. Supervisor training covers the supervisory aspects of their violence prevention
responsibilities.
____ 64. Managers understand the organization's violence prevention system.
____ 65. Relevant violence prevention aspects are integrated into all management training.

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7. Periodic Evaluation
As part of their overall program, employers should evaluate their safety and security measures. Top
management should review the program regularly, and with each incident, to evaluate program
success. An evaluation program should involve the following:
* Establishing a uniform violence reporting system and regular review of reports.
* Reviewing reports and minutes from employee meetings on safety and security issues.
* Analyzing trends and rates in illness/injury or fatalities caused by violence relative to
initial or "baseline" rates.
* Measuring improvement based on lowering the frequency and severity of workplace
violence.
* Keeping up-to-date records of administrative and work practice changes to prevent
workplace violence to evaluate their effectiveness.
* Surveying employees before and after making job or worksite changes or installing
security measures or new systems to determine their effectiveness.
* Surveying employees who experience hostile situations about the medical treatment they
received initially and following the event.
* Complying with OR-OSHA and state requirements for recording and reporting incidents.
* Management should share workplace violence prevention program evaluation reports with
all employees.

Implement lasting positive change in all the above

Proactive Prevention Systems Conditions


Behaviors Continual Evaluation Controls
Engineering Design Purchasing Teams
Consequences
Audit questions

____ 66. Workplace violence data is effectively analyzed.


____ 67. Violence prevention training is regularly evaluated.
____ 68. Post-training knowledge and skills for violence prevention are tested or evaluated.
____ 69. Incidence data is effectively analyzed.
____ 70. Hazard controls are monitored to assure continued effectiveness.
____ 71. A review of the overall violence prevention system is conducted at least annually.

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Personal Conduct to Minimize Violence


Follow these suggestions in your daily interactions with people to de-escalate potentially violent
situations. If at any time a person’s behavior starts to escalate beyond your comfort zone, disengage.
Do
- Project calmness, move and speak slowly, quietly and confidently.
- Encourage the person to talk and listen patiently.
- Focus your attention on the other person to let them know you are interested.
- Maintain a relaxed yet attentive posture and position yourself at a right angle rather than
directly in front of the other person.
- Establish ground rules if unreasonable behavior persists.
- Use delaying tactics which will give the person time to calm down. For example, offer a
drink of water (in a disposable cup).
- Arrange yourself so that a visitor cannot block your access to an exit.
Do Not
- Use styles of communication which generate hostility such as apathy, brush off, coldness,
condescension, going strictly by the rules or giving the run-around.
- Reject all of a client’s demands from the start.
- Pose in challenging stances such as standing directly opposite someone, hands on hips or
crossing your arms. Avoid any physical contact, finger pointing or long periods of fixed eye
contact.
- Make sudden movements which can be seen as threatening. Notice the tone, volume and
rate of your speech.
- Challenge, threaten, or dare the individual.
- Criticize or act impatiently toward the agitated individual.
- Attempt to bargain with a threatening individual.
- Try to make the situation seem less serious than it is.
- Make false statements or promises you cannot keep.
- Take sides or agree with distortions.
- Invade the individual’s personal space. Make sure there is a space of three feet to six feet
between you and the person.
*From Combating Workplace Violence: Guidelines for Employers and Law Enforcement.
International Association of Chiefs of Police. 1996. Note: Oregon OSHA is not recommending a
specific response to any situation or in any way guaranteeing the effectiveness of a particular
response.

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Appendix

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PRACTICE ACTIVITY
Read the scenario below
The incident
An employee called a member of the company crisis team for advice, saying that a coworker was
picking on her, and expressing fear that something serious might happen. For several weeks, she said,
a coworker has been making statements such as, "You actually took credit for my work and you're
spreading rumors that I'm no good. If you ever get credit for my work again, that will be the last time
you take credit for anybody's work. I'll make sure of that." She also said that her computer files have
been altered on several occasions and she suspects it's the same coworker. When she reported the
situation to her supervisor, he tried to convince her that there was no real danger and that she's
blowing things out of proportion. However, she continued to worry. She said she spoke with her
union representative who suggested she contact the agency's workplace violence team.

(Talk to employees separately, contact other employees, referral to EAP, review historical
information if available, be aware of your own reactions, what about the supervisor’s reaction? Is
there a need for supervisor training, review of expectations, etc.? document, outcomes and actions
will vary greatly depending upon what you find out.)

ACTIONS TO DATE:
The agency's response plan calls for involvement of Employee Relations, Security and the Employee
Assistance Program (EAP) in cases involving threats. Immediately following the report to the
response team, the Security Officer contacted the female employee to assist her in filing a police
report on the threat and to discuss safety measures that she should be taking. The victim was also
referred to the EAP, where she received brief counseling and educational materials on handling
severe stress.
An investigation was immediately conducted by an investigator from the security department. In her
statement, the female employee repeated what she had reported to the supervisor earlier about the
threat. In his statement, the male employee stated that, on the day in question, he had been upset
about what he felt were some underhanded activities by the female employee and his only
recollection about the conversation was that he made a general statement like, "You'll pay," to her.
He stated that this was not a threat, just an expression. The investigation showed that the employee
had several previous incidents of intimidating behavior which had resulted in disciplinary actions.
The employee brought in medical documentation that said he had a psychiatric disability of Post
Traumatic Stress Disorder, which caused his misconduct, and he requested a reasonable
accommodation.

(Whatever your policy directs you to do. There is no requirement to accommodate violent behavior.
The next page has EEOC guideline information)

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ACCOUNTABILITY

Disciplinary Actions
Where the supervisor possesses the relevant information regarding violent, harassing, threatening,
and other disruptive behavior, the supervisor should determine the appropriate disciplinary action.
The selection of an appropriate charge and related corrective action should be discussed with human
resources and legal staff where appropriate. Some disciplinary actions are:
• Reprimand, warning, short suspension, and alternative discipline. These lesser disciplinary
actions can be used in cases where the misconduct is not serious or intervention may correct the
problem behavior. They are an excellent means of dealing with problem behavior early on.
• Removal, reduction-in grade, and long-term suspension. Be sure to coordinate with legal staff
to ensure compliance with local, state, and federal law.
Disabilities as a Defense Against Alleged Misconduct
The Equal Employment Opportunity Commission (EEOC) has issued important guidance that
specifically addresses potentially violent misconduct by employees with disabilities. Although this
guidance deals specifically with psychiatric disabilities, it applies generally to other disabling
medical conditions. It advises that an organization may discipline an employee with a disability who
has violated a rule (written or unwritten) that is job-related and consistent with business necessity,
even if the misconduct is the result of the disability, as long as the company would impose the same
discipline on an employee without a disability. The guidance specifically states that nothing in the
Rehabilitation Act prevents an employer from maintaining a workplace free of violence or threats of
violence. For a detailed discussion of all these points, see EEOC Enforcement Guidance on the
Americans with Disabilities Act and Psychiatric Disabilities, EEOC number 915.002, 3-25-97. The
guidance is available on the Internet at http//www.eeoc.gov, or a copy can be obtained by calling the
EEOC Publications department at (800)669-3362.

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ELEMENT 1 - TOP MANAGEMENT COMMITMENT


Investing time, money - walking the talk
Values Leadership Integrity Character
Discipline Service Resources Selfless
Opportunity Trust Respect Pride

VIOLENCE PREVENTION PROGRAM EVALUATION


(Choose one) 5=Fully Met 3=Mostly Met 1=Partially Met 0=Not Present

Audit questions

____ 1. A written violence prevention policy that sets a high priority for safety and health exists.
____ 2. A written violence prevention goal and supporting objectives exist.
____ 3. The violence prevention policy is supported by management.
____ 4. Violence prevention goals and objectives are supported by management.
____ 5. Management supports violence prevention program safety rules.
____ 6. Managers personally follow violence prevention program policies and rules.
____ 7. Managers personally intervene in the unsafe or inappropriate behavior of others.
____ 8. Managers set a visible example of violence prevention leadership.
____ 9. Managers participate in the violence prevention program training of employees.

ELEMENT 2 - ACCOUNTABILITY
Improve performance through measurement and consequences.

Standards Communications Resources


Measurement Consequences Application

Audit questions

____ 10. Management enforces violence prevention rules.


____ 11. Specific people or positions are identified for performance or coordination of violence prevention activities.
____ 12. Assignment of responsibility is clearly communicated.
____ 13. Individuals with assigned responsibilities have the necessary knowledge, skills, and timely information to perform
their duties.
____ 14. Individuals with assigned responsibilities have the authority to perform their duties.
____ 15. Individuals with assigned responsibilities have the resources to perform their duties.
____ 16. An accountability mechanism is included with each assignment of responsibility.
____ 17. Individuals are recognized and rewarded for meeting violence prevention responsibilities.
____ 18. Individuals are disciplined for not meeting responsibilities.
____ 19. Supervisors know whether employees are meeting their violence prevention responsibilities.

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ELEMENT 3 - EMPLOYEE INVOLVEMENT


Increase ownership, empowerment, opportunities for leadership
Invitation Suggestions Reports Consequences
Teams Empowerment Ownership Everyone engaged
Committees Open communications

Audit questions

____ 20. There is a process designed to involve employees in violence prevention issues.
____ 21. Employees are aware of the involvement process at the workplace.
____ 22. Employees believe the process that involves them in violence prevention is effective.
____ 23. The workplace violence prevention policy is effectively communicated to employees.
____ 24. The workplace violence prevention policy is supported by employees.
____ 25. Violence prevention goals and supporting objectives are effectively communicated to employees.
____ 26. Violence prevention goals and objectives are supported by employees.
____ 27. Employees use the hazard reporting system.
____ 28. Sata analyses of incidents of violence are reported to employees.
____ 29. Hazard control procedures are communicated to potentially affected employees.
____ 30. Employees are aware of how to obtain competent emergency medical care.

ELEMENT 4 – HAZARD IDENTIFICATION AND CONTROL


Make the workplace safe through analysis and action
Observation Measurement Assessment Incidents Analysis
Accidents Inspections JHA Maintenance Continual
Surveys Interviews Records Reports

Audit questions

____ 31. A comprehensive baseline violence survey has been conducted within the past five years.
____ 32. Effective job hazard analysis (JHA) is performed, as needed.
____ 33. Effective inspections are performed regularly.
____ 34. Effective surveillance of established violence controls is conducted.
____ 35. An effective violence incident reporting system exists.
____ 36. A violence risk assessment is performed when there is a change in facilities, equipment, materials, or processes .
____ 37. Outside experts are used to identify risk factors for violence and recommend controls.
____ 38. Risk factors are eliminated or controlled promptly.
____ 39. Violence control procedures demonstrate a preference for engineering methods.
____ 40. Effective engineering controls are in place, as needed.
____ 41. Effective administrative controls are in place, as needed.
____ 42. Violence prevention rules are written.
____ 43. Personal protective equipment is effectively used as needed.
____ 44. Effective preventive and corrective maintenance is performed.
____ 45. Engineered hazard controls are well maintained.
____ 46. The organization is prepared for emergency situations resulting from violence in the workplace.

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Hazard Identification
Worksite Analysis
Worksite analysis involves a step-by-step, commonsense look at the workplace to find existing or
potential hazards for workplace violence. This entails reviewing specific procedures or operations
that contribute to hazards and specific locales where hazards may develop.
A "Threat Assessment Team," "Patient Assault Team," similar task force, or coordinator may assess
the vulnerability to workplace violence and determine the appropriate preventive actions to be taken.
Implementing the workplace violence prevention program then may be assigned to this group. The
team should include representatives from senior management, operations, employee assistance,
security, occupational safety and health, legal, and human resources employee.
The team or coordinator can review injury and illness records and workers' compensation claims to
identify patterns of assaults that could be prevented by workplace adaptation, procedural changes, or
employee training. As the team or coordinator identifies appropriate controls, these should be
instituted.
The recommended program for worksite analysis includes, but is not limited to, analyzing and
tracking records, monitoring trends and analyzing incidents, screening surveys, and analyzing
workplace security.
Records Analysis and Tracking
This activity should include reviewing medical, safety, workers' compensation and insurance records
-- including the OSHA 200 log, if required -- to pinpoint instances of workplace violence. Scan unit
logs and employee and police reports of incidents or near-incidents of assaultive behavior to identify
and analyze trends in assaults relative to particular departments, units, job titles, unit activities, work
stations, and/or time of day. Tabulate these data to target the frequency and severity of incidents to
establish a baseline for measuring improvement.
Monitoring Trends and Analyzing Incidents
Contacting similar local businesses, trade associations, and community and civic groups is one way
to learn about their experiences with workplace violence and to help identify trends. Use several
years of data, if possible, to trace trends of injuries and incidents of actual or potential workplace
violence.
Screening Surveys
One important screening tool is to give employees a questionnaire or survey to get their ideas on the
potential for violent incidents and to identify or confirm the need for improved security measures.
Detailed baseline screening surveys can help pinpoint tasks that put employees at risk. Periodic
surveys -- conducted at least annually or whenever operations change or incidents of workplace
violence occur -- help identify new or previously unnoticed risk factors and deficiencies or failures in
work practices, procedures, or controls. Also, the surveys help assess the effects of changes in the
work processes. The periodic review process should also include feedback and follow-up.

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Independent reviewers, such as safety and health professionals, law enforcement or security
specialists, insurance safety auditors, and other qualified persons may offer advice to strengthen
programs. These experts also can provide fresh perspectives to improve a violence prevention
program.
Workplace Security Analysis
Periodically inspect the workplace and evaluate employee tasks to identify hazards, conditions,
operations, and situations that could lead to violence.
To find areas requiring further evaluation, the team or coordinator should do the following:
•Analyze incidents, including the characteristics of assailants and victims, an account of what
happened before and during the incident, and the relevant details of the situation and its outcome.
When possible, obtain police reports and recommendations.
•Identify jobs or locations with the greatest risk of violence as well as processes and procedures that
put employees at risk of assault, including how often and when.
•Note high-risk factors such as types of clients or patients (e.g., psychiatric conditions or patients
disoriented by drugs, alcohol, or stress); physical risk factors of the building; isolated locations/job
activities; lighting problems; lack of phones and other communication devices, areas of easy,
unsecured access; and areas with previous security problems. (See sample checklist for assessing
hazards in Appendix B.)
•Evaluate the effectiveness of existing security measures, including engineering control measures.
Determine if risk factors have been reduced or eliminated, and take appropriate action.

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Sample Employee Survey on Hazard Assessment


Periodically surveying employees on workplace violence can be a valuable tool for evaluating your workplace
violence prevention efforts and gathering suggestions for improving your program. Some employees may
prefer not to have their names identified on a survey; making the name "optional" may increase the amount of
feedback you receive.
SAMPLE
Employee Survey on
Workplace Violence Hazard Assessment
Name (Optional) _______________________________________________________________
Department/Unit ______________________________ Date _____________________________
Work Location (if at alternate worksite) ______________________________________________
Please assess your department/unit over the last year. Circle TRUE (T), FALSE (F) or DON’T KNOW (?).
Thank you for your honest assessment.
Management Commitment and Employee Involvement
•Violence/threats are not accepted as "part of the job" by managers, supervisors and/or employees.
T F Employees communicate information about potentially assaultive/threatening clients or visitors to
appropriate staff.
T F Management communicates information to employees about incidents of workplace violence.
T F Employees feel they are treated with dignity and respect by other employees and management.
T F Employees are basically satisfied with their jobs.
T F Employees are basically satisfied with management.
T F Employees are basically satisfied with the organization (i.e., mission, vision, goals).
T F Employees generally feel "safe" when they are at work.
T F Employees are familiar with the department’s/unit’s violence prevention policy.
Potential Risk Factors
T F Employees do not work in high-crime areas.
T F Employees do not work with drugs.
T F Employees do not work with cash.
T F Employees do not work with patients or clients who have a history of violent behavior or behavior
disorders.
T F Employees do not work in isolated work areas.
T F Hazard Prevention and Control
T F The department/unit has adequate lighting to, from and within the worksite.
T F The employee parking garage is secure when arriving, leaving and during changes of shift.
T F Access and freedom of movement within the workplace are restricted to those persons who have a
legitimate reason for being there.
T F Alarm systems such as panic alarm buttons, silent alarms, or personal electronic alarm systems are
being used for prompt security assistance.
T F Employees know to use security escort service after hours.
T F After hours, the building is locked down with only one access point.
T F Visitors are signed in and out.

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T F Exits are accessible and clearly marked.


T F Employees are able to locate emergency equipment such as fire alarm boxes or emergency-generator
outlets.
T F Emergency equipment is accessible and free from obstruction.
T F Employees are able to locate cellular phones, power-failure phones and/or radios for emergency
communication.
T F Employees know proper procedures if a bomb threat is announced.
T F Employee emergency call-back list is up-to-date and available.
T F Employees provide privacy to reflect sensitivity and respect for clients and visitors.
T F Employees use the "buddy system" to work together if problems arise.
T F Employees working in the field have cellular phones or other communication devices to enable them
to request aid.
T F Staffing levels are appropriate for department/unit functions.
T F Reference manuals are up-to-date and available to employees.
T F There is a grievance policy available to employees.
T F There is a Safety Committee available as a resource to staff for any hazard concern.
Training
T F Employees have received training on the company’s workplace violence prevention program.
T F Employees know how to ask for assistance by phone or by alerting other staff.
T F Employees have been trained to recognize and handle threatening, aggressive, or violent behavior.
T F Employees have been trained in verbal de-escalation techniques.
T F Employees have been trained in self-defense/restraint procedures.
Incidents and Reporting
T F This work unit/department has not experienced violent behavior and assaults or threats from strangers.
T F This work unit/department has not experienced violent behavior and assaults or threats from clients or
customers.
T F This work unit/department has not experienced violent behavior and assaults or threats from others
employed in the organization.
T F This work unit/department has not experienced domestic violence issues.
T F Employees are required to report incidents or threats of violence, regardless of injury or severity; the
reporting system is clear.
T F Medical and psychological counseling services were offered to employees who have been assaulted or
threatened.

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Employee Assault Survey


The following items serve merely as an example of what might be used or modified by
employers in these industries to help prevent workplace violence.
ID Number ___________________

I. Priorities
A number of factors maybe important in preventing assaults, or reducing the impact of assaults. We would like
to know your views on what the most important factors are. For these questions, please use the following
definition of assault: "Physical contact that results in injury." (Injury may be major or minor; e.g., mild soreness,
scratches, or bruises would be included.)
1. What do you think is the most important factor contributing to assaults on employees?

___________________________________________________________
___________________________________________________________

A number of factors have been suggested as possibly important in determining whether assaults occur, or the
impact of assaults. Please indicate which factors you think are most important. Please indicate only your top five
priorities. In other words, many of the following areas maybe important, but we are interested in which are most
important. Please place a "1" next to the issue that you think is the top priority, and a "2" next to the issue that
you think is the next highest priority, and so forth. If you have no opinion or don't know, please check "Don't
know."

___ a. Employee training in self-defense/restraint procedures

___ b. Employee interpersonal skills


___ c. Employee fitness

___ d. An effective security alarm system

___ e. Adequate numbers of personnel


___ f. Business practices (e.g., handling money)

___ g. Physical environment (e.g., noise)

___ h. Identifying customers with a history of violence

___ i. Identifying employees with potentially assaultive (e.g., agitated) behavior

___ j. Transfer of information at shift change about potentially assaultive employees

___ l. Procedures for reporting assaults to administrators

___ m. Procedures for evaluating employee who have been involved in assaults
___ n. Procedures for reporting assaults to police

___ o. Legal penalties for competent assaultive employees

___ p. Structured psychological support for assaulted employee


___ q. Timeliness of L&I processing of Worker's Compensation claims

___ r. Other _______________________________

___ s. Don't know


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ELEMENT 5 – INCIDENT / ACCIDENT INVESTIGATION

Analyze incidents and accidents to fix system weaknesses


Symptoms Surface cause Root cause Controls Improvements

Audit questions

____ 46. Violence Incidents/Accidents are investigated for root causes.


____ 47. Investigations are conducted to improve systems.
____ 48. Investigators are trained in violence prevention procedures.
____ 49. Serious acts of violence are investigated by teams.
____ 50. Analysis and recommendations involve all interested parties.

Threat assessment investigations


Threat assessment investigations differ from administrative or criminal investigations in that the purpose of the threat
assessment investigation is to provide guidance on managing the situation in a way that protects the employee.
Many cases involving threatening behavior can be handled expeditiously and effectively by a supervisor with the
assistance of one or more members of the company's incident response team. The security or law enforcement
representative on the company's team will ordinarily assess risks, often in consultation with the Employee Assistance
Program and employee relations staff, and make recommendations for appropriate strategies and security measures to
protect employees. However, it may be helpful for the company's planning group to identify experts in threat assessment
ahead of time, in case a situation requires more expertise than team members can provide. Gathering information. It is
also a good idea to work out ahead of time who will gather which types of information on an individual who makes a
threat. Multiple sources of information need to be consulted to better understand the person's behavior.
In some cases, the company's incident response team can collect current and reliable information (which would include
an investigative report) and then consult with a threat assessment professional to develop options for managing the
situation. In other cases, the company's incident response team uses a threat assessment professional to conduct the
initial investigation, assess the risks, and make recommendations for managing the situation.

Administrative Investigations
It is important to use an investigator who conducts the investigation in a fair and objective manner. The investigation
should be conducive to developing truthful responses to issues that may surface. It must be conducted with full
appreciation for the legal considerations that protect individual privacy. It is imperative that the investigation, especially
the interview, create an atmosphere of candor and propriety.

Use a qualified investigator.


If a decision is made to conduct an administrative investigation, it is important to use a qualified and experienced
professional workplace violence investigator. The company planning group should train and qualify one or more such
investigators before the need for an investigator arises.

Investigation and Evaluation


After an incident occurs, a detailed investigation is imperative. All incidents should be investigated as soon as possible.
The investigation should focus on fact-finding to prevent recurrence and not fault-finding. Employers should maintain
comprehensive records of the investigation.

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Responding & Investigating Violent Acts


Immediately after an assault occurs, an employer should focus first on providing for the medical and psychological needs
of all affected employees. Other immediate steps include:
•Report the incident to the local police department and support law enforcement activities (for example, crime scene
investigation; interviewing witnesses, victims and others).
•Secure work areas where disturbances occurred.
•Account for all employees and others and ensure the physical safety of those remaining in the area as soon as possible.
•Provide for site security and ensure that no work area is left short-staffed while others assist the victim or help in
securing the area.
•Quickly assess the work area, if it was disturbed or damaged during an incident, to determine if it is safe.
•Provide critical incident debriefing to victims, witnesses, and other affected employees (these conversations must be
strictly confidential).
•Provide accurate communication to outside agencies, media and law enforcement.

Initiate the Post Incident Trauma Plan


The post trauma plan should focus activities first on meeting the immediate medical and psychological needs of
employees as necessary. Employees may also need the services of an employee assistance program or other counseling
services.
Provisions for follow-up after medical and psychological treatment, medical confidentiality, and protection from
discrimination must be addressed in the plan to prevent the victims of workplace violence from suffering further loss. The
plan should also address ways to reduce financial losses to the company caused by absence, lost productivity, and
workers’ compensation claims.

Immediate debriefings
All affected employees should be included in a debriefing so that the cause of the violence and expectations can be
discussed, a plan of action can be addressed, and those needing further counseling can be identified.

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Sample Incident Report Form

This type of form can be used to report any threatening remark or act of physical violence against a person or property,
whether experienced or observed. Individuals may be more forthcoming with information if the form is understood to be
voluntary and confidential. The form also needs to identify where it should be sent after completion (for example,
workplace violence prevention group or safety committee representative).
Date of Incident YearMonthDay of Week
Location of Incident (map and sketch on reverse side):
Name of Victim:Gender: Male_____ Female_____
Victim Description: ____Employee Job Title__________________________________
____Client
____Visitor
Member of Labor Organization? Yes____ No____
Assigned Work Location (if employee)Supervisor:Has supervisor been notified?
Yes____ No____
Describe the incident.
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
List any witnesses to the incident (name and phone).Did the assault involve a firearm? If so, describe.Did the
assault involve another weapon (not a firearm)? If so, describe.Was the victim injured? If yes, please describe.

Who committed the incident (name, if known)? What is his/her status to the victim:____Stranger ____Personal
Relation
____Client/Patient/Customer____Co-worker ____Supervisor____Other
If other, describe:
_________________________________________________________________________
What was the gender of the person(s) who committed the incident?____Male ____Female
Please check any risk factors applicable to this incident. Each company should develop and include a list of
potential risk factors that may apply in its worksite.
•Working with money
•Working with drugs
•Working in a high-crime area
•Working late at night
•Poor lighting outside of worksite
•Other risk factor: ________________________________________________________
•Other risk factor: ________________________________________________________
What steps could be taken to avoid a similar incident in the future?
(To avoid recreating trauma, sound judgment should be exercised in deciding when to request this information.)
Send completed form to:______________________________________

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ELEMENT 6 - EDUCATION AND TRAINING


Improve the skills, knowledge, attitudes of everyone
Continual Skills Knowledge Attitude
Impact Everyone Consequences

Audit questions

____ 51. An organized violence prevention training program exists.


____ 52. Employees receive violence prevention training.
____ 53. Employee training covers hazards related to workplace violence.
____ 54. Employee training covers the facility safety system.
____ 55. New employee orientation includes information on violence prevention and risks.
____ 56. Violence prevention policy is understood by employees.
____ 57. Violence prevention goals and objectives are understood by employees.
____ 58. Employees periodically practice implementation of violence prevention emergency plans.
____ 59. Employees are trained in the use of violence prevention equipment.
____ 60. Supervisors receive violence prevention training.
____ 61. Supervisors are effectively trained on violence prevention.
____ 62. Supervisors are trained on all site-specific violence prevention measures and controls
relevant to their needs and supervisory responsibilities.
____ 63. Supervisor training covers the supervisory aspects of their violence prevention
responsibilities.
____ 64. Managers understand the organization's violence prevention system.
____ 65. Relevant violence prevention aspects are integrated into all management training.

ELEMENT 7 - PERIODIC EVALUATION


Implement lasting positive change in all the above
Proactive Prevention Systems Conditions
Behaviors Continual Evaluation Controls
Engineering Design Purchasing Teams
Communications Consequences

Audit questions

____ 66. Workplace violence data is effectively analyzed.


____ 67. Violence prevention training is regularly evaluated.
____ 68. Post-training knowledge and skills for violence prevention are tested or evaluated.
____ 69. Incidence data is effectively analyzed.
____ 70. Hazard controls are monitored to assure continued effectiveness.
____ 71. A review of the overall violence prevention system is conducted at least annually.

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Evaluation
One essential element that cannot be overlooked is to evaluate the violence prevention program on a
scheduled basis, and immediately after an incident has occurred. If the program is not evaluated at
least annually, this and other problems may never be detected.
As with any program, personnel, facilities, and issues can change within a year and updates must be
maintained. Procedures may break down if they are not exercised regularly. In these instances,
practice may be necessary to keep procedures effective.
After an incident, it's important to evaluate the program to see if there are any changes that should
be made immediately to prevent a similar incident from occurring in the future.
Steps in the Evaluation Process
• Appoint knowledgeable employees to conduct the evaluation to ensure effective results..
• Conduct an initial assessment to determine what program components are in place.
• Analyze the components of the violence prevention program.
• Measure improvement based on lowering the frequency and severity of workplace violence.
• Identify those components that require improvement.
• Conduct and review the results of an employee survey.
• Develop ways to improve ineffective components.
• Educate, train and implement changes in the program.
• Devise and update your system for measuring improvement.
• Keep abreast of new strategies to deal with violence.

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