Toolkit: Preventing Violence in the Healthcare Setting
Among the litany of challenges facing healthcare professionals today, the rise in incidents of workplace violence is surely one of the worst – and seemingly, one of the most intractable. According to the U.S. Bureau of Labor Statistics, healthcare and social services workers are five times more likely than other workers to experience workplace violence,1 and as many as 38% of healthcare professionals across the world report experiencing physical violence at some point in their careers.2
As physicians and clinicians cope with this difficult reality, ISMIE remains committed to providing guidance and support. Unfortunately, there is no one-size-fits-all solution to preventing and/or defusing violence in the healthcare setting. Instead, strategies must be carefully designed to meet the needs of healthcare professionals, patients, and staff at any given medical practice or facility.
When developing your violence prevention strategies, it’s essential to consider the following:
- Complex medicolegal issues: Patients who pose a threat to you, your staff, or other patients and visitors may need to be dismissed from your practice or facility. However, when ending the physician/clinician-patient relationship the treating clinician should follow certain steps in order to avoid allegations of patient abandonment. While many states offer somewhat more leeway in situations where the patient has been aggressive or violent, dismissing patients is never without risk. As such, it’s critical to understand and follow the laws regarding the dismissal of patients in the state(s) where you practice.
- Potential unintended consequences: It can be difficult to predict the full spectrum of consequences that can result from a given change in protocols. For example, enhancing security at medical practices/facilities might seem like a surefire and “no downside” strategy for reducing violence. However, recent research shows that calls to hospital security disproportionately affect Black patients and family members, which in turn could affect clinician-patient trust, patients’ perceptions of whether they are receiving equitable care, and so on. Given the potential for one change to negatively impact another area of operations or practice, it’s incredibly important to keep a close eye on all process improvement efforts to ensure that they are having the desired effect.
It is ISMIE’s goal to provide practical, actionable resources to help healthcare professionals design the workplace violence plans that best fit their own practice or facility. In this toolkit, you’ll find industry news, printable templates, quick guides and a variety of resources for you to use as you see fit.
Industry news:

Insights from Duke Raleigh Hospital
In this short podcast from the American Hospital Association, president of Duke Raleigh Hospital, Barbara Griffith, MD, shares how her organization has found success in addressing workplace violence.
Listen nowTemplates & quick guides:
- “No violence tolerated” poster: Consider customizing and hanging
this poster in your practice or facility to emphasize that violence is unacceptable.
- Code of conduct Consulting this sample code of conduct from the American Society for Healthcare Risk Management (ASHRM) may be a good place to start when creating similar guidelines for the patients who visit your practice or facility.
- Printable quick guide: Recognizing the warning signs (ISMIE login required)
- Printable quick guide: De-escalation strategies (ISMIE login required)
ISMIE resources:
- Resource: Risk manager Q&A
- Resource: Workplace violence
For Illinois physicians:
External resources:
- American Hospital Association: Building a Safe Workplace and Community handout
- American Hospital Association: Building a Safe Workplace and Community: Mitigating the Risk of Violence
- American Hospital Association: Boardroom Brief: How Boards Contribute to a Safe Workplace and Community
- American Hospital Association: Protecting Heath Care Workers from Being Targets of Violence Podcast
- American Hospital Association: Utilizing Multidisciplinary Teams to Reduce Violence at Inova Health
- Crisis & Trauma Resource Institute: Crisis Response Checklist
- Crisis Prevention Institute: Top 10 De-escalation Tips
- The Joint Commission: Workplace Violence Prevention Compendium of Resources
For questions and support regarding the prevention of violence in the healthcare setting, contact our Risk Management team at [email protected] or 800-782-4767 x3300.
Last updated Jan. 2, 2025
1 Injuries, illnesses and fatalities. U.S. Bureau of Labor Statistics. Accessed November 17, 2023. https://www.bls.gov/iif/factsheets/workplace-violence-healthcare-2018.htm#:~:text=The%20health%20care%20and%20social,workers%20has%20increased%20since%202011.
2 Preventing violence against health works. World Health Organization. Accessed November 17, 2023. https://www.who.int/activities/preventing-violence-against-health-workers.