Improving Type II Workplace Violence Prevention in the Outpatient Free Clinic Setting

From 2011-2013, the Bureau of Labor and Statistics reported that approximately 75% of 25,000 workplace violence (WPV) events occurred in healthcare and social service settings. Most research addressing WPV in healthcare has focused on inpatient hospital settings and there is a paucity of information for preventing violence in outpatient clinics. The purpose of this quality improvement project was to develop a WPV prevention policy, algorithm, and training program to improve the safety of clients and staff. This project also sought to assess the effectiveness of the training within a free outpatient clinic setting. The study took place at a local free outpatient mental health clinic and involved administration, licensed clinicians, students, and volunteers. WPV prevention content from peer-reviewed studies, Occupational Safety and Health Administration guidelines, and other healthcare organizations helped guide the construction of WPV prevention material. A pre-and post-training survey was administered to compare staff members' perception and knowledge regarding WPV events. Out of 32 staff members, 21 participated in the pre-training survey and 15 completed the training presentation and post-training survey. Between the pre-and post-survey data, the Wilcoxon-Mann-Whitney test identified statistically significant improvement (p <.001) in the WPV prevention training enhancing staff's knowledge about the WPV prevention policy, emergency response procedures, physical and environmental risk factors, and ways to prevent and manage WPV events. Areas that did not show statistically significant results (p =.05) include greater comfort level with managing violent events, recognizing acts of WPV, and knowledge on how to de-escalate violent situations. Though it is lacking a hands-on approach, this project has provided a WPV prevention toolkit for the local mental health outpatient clinic and the material can be used as a reference for other free outpatient clinics to develop a more interactive training program.