California's New Healthcare Workplace Safety Laws

In December of 2016, California’s Office of Administrative Law approved a new set of regulations aimed at tackling an unfortunately growing problem: workplace violence in healthcare facilities. These new regulations went into effect back on April 1^st, 2017, and healthcare facilities are highly advised to expect visits from the California Division of Occupational Safety and Health soon in order to enforce the policy.

These new regulations require healthcare providers to have a plan for each of the four types of workplace violence that healthcare facilities are prone to:

• Type I: An individual with no relationship to the workplace enters in order to commit a criminal act. (Example: a gang member coming to a hospital to assault an injured rival gang member being treated there)
• Type II: The violent individual is a patient, resident, or visitor to a healthcare facility. (Example: a mental hospital patient has a breakdown and begins attempting to injure anyone around them)
• Type III: The violent individual has an employment relationship with the facilities, including both current and former employees.
• Type IV: The violent individual has no direct relationship with the workplace, but does have a relationship with an employee. (Example: a violent spouse seeks their partner to continue a rampage of domestic violence)

While Type IV violence is the most common in general, Types I and II are the most common throughout the healthcare industry, and state legislators saw the need to address this growing problem in order to keep workplaces safe for those who simply wish to help people. As a result, these new regulations are geared primarily towards preventing violence perpetrated by patients and their loved ones.

There are four new principal requirements for healthcare workplaces under these regulations; let’s take a closer look at them now.

Workplace Violence Prevention Plans

The first and arguably most important regulation set out by Cal/OSHA is that employers create and implement a workplace violence prevention plan. This includes putting this plan into writing for every single unit, service, and operation in a healthcare facility. This is because a healthcare facility often has different needs for different departments, based on who is treated in each department and for what reasons. For example, the emergency room will generally need a much more stringent plan due to its volatile nature than the labor and delivery department.

This workplace prevention plan is no small task, either. According to the new regulation, each Workplace Violence Prevention Plan must include 13 items, ranging from the basics like names or job titles of employees covered by that particular plan to assessment procedures to identify weaknesses in that particular plan.

Violent Incident Log

These new regulations also require all healthcare facilities to keep a detailed log of all workplace violence incidents, including what happened, how the facility responded to the incident, and how the incident was investigated by the workplace. There are eight items that must be included with every entry log, including the date, time, and department of the incident, a detailed description (including what type of force, whether a weapon was involved, if any sexual violence was perpetrated), the consequences of the incident, and who committed the violence.

Violence Prevention Training

To counter these instances of violence and prevent further attempts or violent incidents, all employees at each facility must undergo a stringent workplace violence training program. This training must cover the entire WVPP in detail, including how to recognize a potentially violent situation, strategies to avoid physical harm, how to use alarm and alert systems, shelter locations, and more.

This training should be individually tailored to the employees covered under each WVPP, and should be refreshed every year for all employees who have contact with patients and their supervisors. Specialized pre-work training should also be given for employees who will be required to respond to workplace violence alarms.

Reporting Requirements

Some healthcare facilities, including acute care, acute psychiatric hospitals, and other special hospitals with a high risk for psychological trauma or stress are required to report instances differently and with more stringent requirements, regardless of whether or not the violence resulted in an injury. All reports must be made within 72 hours, unless they result in an injury at which point they must be reported within 24 hours. All reports should keep the names of employees and patients confidential unless Cal/OSHA requests this information at a later date to assist their investigation. All supplemental information requested by Cal/OSHA should be provided within 24 hours.