Managing and responding to violence in the medical workplace

It is a sad reality that many frontline doctors may become a victim of violence and aggression at any moment. We often care for patients and their families at stressful and traumatic points in their lives. Feelings of frustration, confusion and anger are understandably common life-and-death situations. But when this frustration leads to violence and aggression, it places patients, healthcare workers and non-clinical staff lives at risk.

Cases of violence are becoming more prevalent in public hospitals, as widespread ambulance ramping, bed block and delays caused by the logjam crisis deepen. In response to the rising threats of violence against doctors, we have developed a new position statement – Managing and responding to violence in the medical workplace. While the AMA has a suite of position statements relating to safe work environments, this is the first one to offer a comprehensive approach to violence in the medical workplace, particularly public hospitals.

The World Health Organization estimates that up to 38% of medical professionals will suffer from physical violence at some point in their careers. And Safe Work Australia regards healthcare as an industry with an elevated risk of workplace violence, with some estimates predicting up to 95% of Australian healthcare professionals have experienced the effects of physical violence and/or verbal abuse.

Doctors and healthcare staff who fall victim to workplace violence risk serious physical injury, as well as profound psychological impacts such as anxiety and decreased job satisfaction. It is also proven to have negative impacts on patient outcomes. This is why the AMA is going on the front foot, taking a leadership role to address this crisis.

Our latest position statement offers practical measures hospitals and other medical workplaces can implement to reduce the risk of violence. Some are obvious measures, like showing educational material to patients, informing them of zero-tolerance policies, making physical adjustments to include unimpeded exit points and video surveillance.

Crucially, the position statement advocates for a shift in culture and management processes to reduce the risk of violence in the workplace. It endorses recent changes to state legislation in South Australia and Queensland that place the responsibility of staff psychosocial wellbeing onto the boards of hospitals, and we encourage this change across all jurisdictions. While everyone has a role to play in ensuring safety, this change is important because it encourages a top-down, systems-based approach guided by those in medical leadership positions.

The position statement also stresses the importance of post-incident support, both immediately and longer term, and the benefits of risk audits to assess risk levels in your workplace and the appropriateness of mitigation measures.

Violence in medical workplaces remains under-reported and poorly studied, in part due to perceptions that violence is an inherent part of the job. Violence is unacceptable, and everyone deserves to be safe at work. A change of mindset is needed to embed a culture and system of reporting, monitoring and evaluation of incidents.

Governments have a huge role to play here too, and our position statement calls on them to invest in continuous monitoring and evaluation mechanisms to enable medical workplaces to report incidents with confidence.

There are major benefits in deidentified data being made available to state and federal authorities, encouraging collaboration on research relating to violence in medical workplaces and pursuing evidence-based solutions. We call for all state and territory governments to place greater protection on all medical professionals.

While our latest position statement is primarily focused on hospital settings, the principles are also applicable to other medical workplaces – such as private practices, general practice clinics and other community settings.

It is our hope that this position statement can spark long-overdue, serious discussions about violence in medical workplaces. I encourage you all to read the document and consider how you can help be part of the solution.

View or download the position statement: Managing and responding to violence in the medical workplace.