March 4, 2021

Exciting Developments in the Effort to Address Workplace Violence in the Emergency Department

Unfortunately, as you well know, violence in the emergency department (ED) is a common occurrence.  In fact, an ACEP survey from 2018 showed that nearly half of emergency physicians have experienced violence in the ED and 80 percent of emergency physicians said that violence in the ED was harming patient care. These trends have not improved, and we still continuously hear heart-wrenching stories about attacks or other violent episodes from emergency physicians across the country.

ACEP has made addressing violence in the ED a top advocacy priority. In 2019, ACEP and the Emergency Nurses Association (ENA) launched “No Silence on ED Violence” to support, empower, and protect those working in EDs by raising awareness of the serious dangers emergency health clinicians face every day, and by generating action among stakeholders and policymakers to ensure a violence-free workplace for emergency nurses and physicians.

Furthermore, last year, ACEP and ENA were part of an Action Team sponsored by the National Quality Forum, which included 27 experts and recognized leaders from the private and public sector committed to improving the safety of the health care workforce. I was honored to have represented ACEP on the Action Team. The Action Team was able to identify and propose ways to overcome key barriers to appropriately responding to and reporting violent incidents in health care settings and preventing future ones from occurring. The work of the Action Team culminated with the release of an issue brief (available to download here) that includes specific set of priority challenges for policymakers and other stakeholders to address.

While these efforts are good start to tackling this issue, they are by no means enough. What we truly need are national standards on workplace violence in healthcare to help ensure that all healthcare workers and patients are properly protected. ACEP has repeatedly been in touch with the Occupational Safety and Health Administration (OSHA) about the creation of such standards. However, unfortunately, OSHA’s work on these standards has been significantly delayed due to the COVID-19 pandemic.

When a regulatory agency such as OSHA seems to have moved off track from its initial goal, one way of pushing it back on course is through legislation. We are therefore happy to report that the “Workplace Violence Prevention Act for Health Care and Social Service Workers” (H.R. 1195) has just been introduced. This bipartisan legislation directs OSHA to issue standards for employers to implement workplace violence prevention plans that would protect health care and social service workers from assaults. ACEP previously supported this legislation that successfully passed the House during the last session of Congress. We along with the ENA have issued a joint press statement in support of the bill.

To make sure this important bill is enacted in this Congress, we need your help! We have created an action alert that you can use to contact your Representative to encourage him or her to support the bill and to ensure its swift passage!

Before concluding, I do want to mention that there is another important pathway for reform and progress on this issue. The Joint Commission (TJC) is currently developing new requirements for hospitals under its hospital accreditation program that specifically relate to workplace violence. These proposed requirements for hospitals include:

  • Creating a workplace violence prevention program (within each hospital) led by a designated individual and developed by a multidisciplinary team;
  • Conducting an annual work-site analysis related to its workplace violence program;
  • Establishing a process(es) for continually monitoring, internally reporting, and investigating violent episodes; and
  • Providing training, education, and resources for the prevention of workplace violence to leadership, staff, and licensed practitioners as appropriate to their roles and responsibilities.

Incorporating requirements related to workplace violence into TJC’s hospital accreditation program would be a great way to push hospitals to take more specific actions to protect healthcare workers and patients. ACEP had an opportunity to comment on these proposed requirements through an online survey, and we look forward to seeing the TJC finalize them.

As ACEP’s advocacy work continues, we want to hear from you. If you wish to share your story (even anonymously), please send it to We will keep all stories confidential unless we receive your explicit permission to share it with OSHA, TJC, Congress, or others to help with our advocacy efforts. 

Until next week, this is Jeffrey saying, enjoy reading regs with your eggs.

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