Responding to concerns of workers and their representatives in the health care sector, Ontario hospitals are now required to report annually incidents of workplace violence.

But how reliable will these reports actually be? This question was at the crux of a new study lead by Peter Smith, senior scientist for the Institute for Work and Health (IWH).

According to Smith, judging by our American counterparts, these reports could be highly unreliable. Two previous U.S. studies recently found considerable underreporting of violence in hospitals, with staff reporting to researchers, of the violent incidents they experienced, only between nine and 12 per cent were formally reported to the hospital system.

Of course, without an accurate understanding of sources, types and trends in workplace violence, pursuit of adequate control strategies, the reason for Ontario collecting data in the first place, will be impeded tremendously.

Thus, Smith and a team of researchers set out to survey staff employed in six Ontario hospitals. Their stated purpose was to:

• Estimate self-reported rates of different types of workplace violence in the previous 12 months (assaults, attempted assaults, and threats);
• Understand how many of these incidents were reported to the hospital system;
• Examine perceptions of workplace violence prevention activities at each hospital; and
• Know more about the incidents, their consequences, and reasons for non-reporting where applicable.

Survey responses were collected online from October of 2017 to January of 2018 from staff employed in large, urban-based, teaching hospitals. In total, approximately 1,000 staff responded.

Key findings

Of these respondents, 30 to 50 per cent reported experiencing some type of violence (e.g., physical assault, attempted assault, and threats) in the past 12 months. In 75 per cent of the cases, it was a patient(s) who committed the violence.

These incidents however were not consistently reported to hospitals. Far from it. When it came to physical assaults 45.5 per cent of respondents did not report any violent incidents, while 30.8 per cent reported only some violent incidents. Meantime, 51.6 per cent of respondents did not report attempted assaults, while 34.6 per cent reported some attempted assaults. Finally, 63.9 per cent of respondents did not report threats of violence; while 27.6 per cent reported some threats. Reasons staff provided for non-reporting included:  

• staff have become desensitized to violence as it occurs so frequently
• assault or threat was not considered serious enough to report
• worker saw no point in reporting
• there was no intent to harm
• too time consuming to fill out a report
• violence deemed part of the job
• manager knew about the incident, so the worker did not report it
• victim concerned about being blamed for the incident
• staff was discouraged from reporting the incident (it would reflect negatively on management).

Says Smith of these findings, “The numbers of workplace violence events would triple if we were successful in encouraging people to report them.”

Until such a time, Smith cautions care in the use of hospital workplace violence reports. He adds, more research with larger sample sizes is required.

Moving forward

For years, unions representing health care workers have been pressing the government to take action on workplace violence. Upon their advice and other stakeholders in the sector, the Ministry of Health and Long-Term Care and the Ministry of Labour released a report in 2017, including 23 recommendations to prevent workplace violence incidents in health care institutions. As Workers Health & Safety Centre (WHCS) reported, among these recommendations, was the recommendation for health care institutions to include workplace violence in their annual quality improvement plans and report on violent incidents. Since then, incident reporting has been made mandatory for hospitals.

Pushing for further progress, unions continue to insist on implementation and enforcement of all 23 report recommendations. Many such as the Ontario Nurses’ Association (ONA), Ontario Public Service Employees Union (OPSEU) and Canadian Union of Public Employees (CUPE) offer online resources in support of their campaigns.

For our part, WHSC offers a range of training and information resources designed to help workplace parties better prevent workplace violence, harassment and bullying and to fully comply with legal obligations.

To learn more:
Visit:    www.whsc.on.ca 
Email:  contactus@whsc.on.ca
Call:    1-888-869-7950 and ask to speak to a training services representative.