WORKPLACE VIOLENCE PROTECTION

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1 WORKPLACE VIOLENCE PROTECTION A Sample Guide Adapted for use in the Joint Workplace Violence Risk Assessment Course September 2004

2 Violence Prevention in the Workplace Table of Contents Section 1: Recognizing the Problem...1 Violence at Work - Why a Violence Prevention Program?...1 What is Violence?...1 Co-worker to Co-worker Violence...1 Who is Affected?...2 How Big is the Problem?...2 Why Are Workplace Violence Incidents Not Reported?...3 Section 2: Risk Identification...4 Why are Workers at Risk of Violence?...4 What are the Employers Responsibilities?...4 What are the Workers Responsibilities?...5 Consultation and Involvement of Committee...5 Section 3: Developing a Prevention Program...7 Step 1: Discuss the Objectives...8 Step 2: Develop Project Plan...8 Step 3: Establish Risk Assessment Team...9 Roles and Responsibilities of the Risk Assessment Team...9 Working Group Training...10 Step 4: Undertake Risk Assessment...10 When should a risk assessment be performed?...10 Gather Information:...11 Documentation that should also be considered:...11 Work Procedures...11 Inspecting the Workplace...11 Review Information From Similar Workplaces...12 Step 5: Analyze Risk Assessment Results...12 Step 6 Measures to Reduce Risk...13 A. Education and Training...14 B. Communications...15 C. Incident Response and Procedures and Work Environment Measures...15 Step 7 Implement Prevention Plan...17 Violence Prevention Policy...17 How to Write a Violence Prevention Policy...17 Step 8 Program Review...18 Sample Review of the Violence Protection Program Elements:...18 Section 4: Post Event Management...19 Post Traumatic Stress Disorder...19 Critical Incident Stress Debriefing (CISD) and Post traumatic Counseling...19 Arranging Critical Incident Stress Debriefing (CISD)...20 A sample guide adapted for use in the Joint Workplace Violence Risk Assessment course

3 Violence in the Workplace and Workers Compensation Claims...21 Prosecuting Offenders...21 References and Resources...22 Appendix A Violent Incident or Threat Report Worker Report Form...23 Appendix B Health and Safety Survey of Aggression Against Staff...25 Appendix C Violence in the Workplace Environmental Risk Assessment...31 Appendix D Risk Assessment Worksheet for Violence...36 Appendix D1 Risk Assessment Worksheet for Violence (Sample)...37 Appendix D2 Violence Rating Score...38 Appendix D3 Prevention Measures Worksheet...39 Appendix D4 Sample Risk Factors Checklist...40 Appendix E Sample Flowchart: Affected Worker Incident Follow-up...42 Appendix F Sample Policy: Workplace Violence Prevention...43 Appendix G WCB Regulations Violence in the Workplace - Definition Section Risk Assessment Section Procedures and Policies Section Instruction of Workers Section Response to Incidents Section Working Alone and in Isolation Section Refusal of Unsafe Work Section Workplace Conduct Section Prohibition Section Investigation Section Impairment by Alcohol, Drug or other Substances Section Biohazardous Materials Section Exposure Control Plan Section Education and Training Section Vaccination Section Health Protection Section Records Section...49 Appendix H References to the Criminal Code...50 Section 177 Trespassing at Night...50 Section 178 Offensive Volatile substances...50 Section 264 Criminal Harrassment...50 Section Uttering Threats...50 Section 364 Extortion...51 Section 372 False Messagess...51 Section 423 Intimidation...51 Appendix I Glossary of Terms...52 A sample guide adapted for use in the Joint Workplace Violence Risk Assessment course

4 Acknowledgements Neither workers nor employers should accept violence as an inherent part of their job. Violence is not an acceptable risk and should be treated as any other hazard in the workplace with necessary controls put in place to eliminate violent incidents. Where that is not possible, the risk of violence to workers should be minimized. Violence in the workplace has increased significantly over the last decade with Worker s Compensation claims doubling. This guide has been adapted from the BC Government and Service Workers Union, Ministry for Children and Family Development, and the Ministry of Attorney General document Workplace Violence Protection A Guide for the Protection and Regulatory Environment. Its use is to provide the participants of the Joint Workplace Violence Assessment course with sample material and is not intended to be a binding document. We thank the following persons and Ministries for their contributions in developing the original manual and written material: Project Team: Mona Sykes, Occupational Health and Safety Officer BCGEU Ray Jago, Senior Occupational Health and Safety Advisor Ministry for Children & Family Development Cheryl Fix, Manager Occupational Health and Safety Ministry for Children & Family Development Erin Van Zant, Manager Occupational Health and Safety, Ministry of Attorney General Dianne Casper, Occupational Health and Safety Advisor Public Service Employee Relations Commission Special thanks to Larry Stoffman, Director of Health and Safety, UFCW, local 1518, Mona Sykes, Occupational Health and Safety Officer, BCGEU, Ministry of Health and Workers Compensation Board for their assistance in the initial development of material in the original publication Caring Shouldn t Hurt Editing and Reformatting, and 2004 Editing for JWPVRA course: Richard Golob, Occupational Health and Safety Advisor BC Public Service Agency Mona Sykes, Occupational Health and Safety Officer BCGEU Word Processing: Marlene Speed, BCGEU Josie Masi, BC Public Service Agency A sample guide adapted for use in the Joint Workplace Violence Risk Assessment course

5 Section 1: Recognizing the Problem Violence at Work - Why a Violence Prevention Program? A violence prevention and control program includes policies and procedures for risk identification, assessment, prevention control plans, reporting and training of workers. The program covers what to do in response to incidents of violence including post-incidence procedures to assist workers. This booklet and accompanying materials provides managers, supervisors and Joint Safety & Health Committees examples that will assist in ensuring site-specific violence prevention programs are developed and implemented. Violence prevention programs work. It is often simple solutions, once implemented, that can provide workers with needed protection. We all have a right to work in a violence-free environment. Developing a violence prevention program is the first step in controlling this occupational hazard. What is Violence? The Workers' Compensation Board describes violence in the following manner: WCB Occupational Health and Safety Regulation, Section 4.27 "Violence means the attempted or actual exercise by a person, other than a worker, of any physical force so as to cause injury to a worker, and includes any threatening statement or behaviour which gives a worker reasonable cause to believe that he or she is at risk of injury. As you will note from the definition, violence is not just physical assault, but also includes near misses, verbal abuse, unwanted sexual advances, or the threat of any of these. Even if a worker is not physically injured, the stress from the fear of violence can lead to serious health problems. In reviewing Section 4.27 you will note that the regulation is applied where an employee who has been threatened has reasonable cause to believe that he or she is at risk of violence. If there is any dispute as to whether there is a risk, the worker has the right to refuse unsafe work under section 3.12 of the regulation. A threat against a worker's family that has arisen out of the course of the worker's employment is considered to be a threat against the worker for the purpose of section 4.27 of the regulation. This includes incidents that occur after hours and at other off-site locations. Co-worker to Co-worker Violence Workplace violence can be internal and can occur between employees, which includes supervisors and managers. Although a separate requirement in the Occupational Health and Safety regulation, the same violence prevention initiatives should be applied to worker violence, with the exception of an in-depth risk assessment. Worker to worker violence should be included as part of your violence prevention program. Page 1

6 The Workers' Compensation Board describes improper activity or behaviour in the following manner: WCB Occupational Health and Safety Regulation, Section 4.24(a) Includes the attempted or actual exercise by a worker towards another worker of any physical force so as to cause injury, and includes any threatening statement or behaviour, which gives a worker reasonable cause to believe he or she is at risk of injury. Who is Affected? Although random acts of violence can occur in any setting, workers who perform certain activities within a ministry or who work in specific environments, are more at risk of violence than other workers such as: workers in a correctional setting; working alone or in isolation; coming in contact with clients or family court services; carrying out enforcement or inspections; performing client services in a home environment; new workers; child protection workers; working in an outside environment; or front line workers. How big is the Problem? In BC the majority of violence incidents against workers occur as a consequence of irate clients. Co-worker to co-worker violence makes up 3.9% 1. According to the BC Workers' Compensation Board, wage loss due to acts of violence or force has increased, however, these figures on job related violence do not accurately reflect occurrence as workers may not report assaults or threats of violence. It is important that accurate reporting and records are kept on incidents on violence in the workplace, as these reports will serve as a foundation to your violence prevention initiatives. 1 Based on information provided by WCB at the time of printing Page 2

7 Why Are Workplace Violence Incidents Not Reported? The reasons for under reporting this occupational hazard includes: Past practices and workplace culture, training and employee awareness, and lack of violence prevention program development; "Part of the job" syndrome - in certain jobs, due to the nature of the client and the type of job, workers are more frequently exposed to violence, threats and verbal abuse; Note: Violence should not be accepted as part of the job; violence can be assessed and controlled. Violence in society - Violence is considered a consequence of living in a violent society, rather than working in an unsafe workplace; Fear of blame or reprisal - Workers may be afraid that they'll be held responsible for any violent act that involves a client; Lack of problem resolution - Workers often feel discouraged from reporting problems. When problems are reported, there may be inadequate investigation and insufficient resolution of problems related to violence; No serious injuries - When physical injuries are minor, or when a worker doesn't miss a day of work, the injury is not reported to the Workers Compensation Board; Not worth the effort - If workers believe nothing will be done, they feel there is no reason to file a report; and No follow-up - follow-up action is not completed or taken. The next section addresses risk identification and looks at why workers are at risk for violence. Page 3

8 Section 2: Risk Identification Why are Workers at Risk of Violence? Each incident of violence has its own set of causes. Working with clients who may be frustrated, anxious, impatient, angry, have mental illness or are under the influence of drugs or alcohol inevitably increases the potential for violence. Other factors include economic and social distress. People may lash out against whoever is closest to them -- often a worker. Assaults are often unanticipated and generally occur when workers are performing their normal work duties. Some specific factors, which commonly play a role in increasing the risk of violence, are: Improper assessment of client s potential for violence; Failure to communicate to staff which clients/inmates have a history of violence; Lack of training of workers in recognizing and defusing potentially violent situations; Failure to identify potentially hazardous situations; Ministry violence prevention programs with no local implementation plan; Lack of privacy and personal space for clients - close physical contact with clients/inmates; Organization of work and workplace design; Corporate culture, e.g. violence accepted as part of the job; and Working alone or after hours. What are the Employers Responsibilities? The WCB regulation requires employers to: Undertake a risk assessment at any place of employment in which a risk of injury to workers from violence arising out of their employment may be present; Establish policies, procedures and work environment arrangements to eliminate or minimize the risks that are identified through a risk assessment; Establish procedures for reporting, investigating and documenting incidents of violence; Inform workers who may be exposed to a risk of violence of the nature and extent of the risk; Instruct workers who may be exposed to violence, on the means of recognizing the potential for violence; and of the policies, procedures, and work environment arrangements that have been developed to eliminate or minimize the risk, including how to obtain assistance; Ensure incidents of violence are reported and investigated and that corrective measures are taken; and Ensure that workers who report an injury or adverse symptom as a result of such an incident are advised to consult a physician for treatment or referral. The employer is responsible for taking all necessary measures to protect workers from violence on the job. This includes elimination of the risk of violence and where risk cannot be eliminated, put into effect, control measures to reduce the risks. Page 4

9 The employer needs to ensure that workers are aware of the appropriate post-incident procedures and resources available to assist them. This includes the employer: Advising the worker to consult the Family Physician or physician of his/her choice following incidents of violence for treatment and referral; Provision of assistance and trauma counselling (where needed); and Employee and Family Assistance Program (EFAP). What are the Workers Responsibilities? Workers are responsible for the following activities: Provide input into the risk assessment process, as required; Follow the established policies and procedures developed by the employer to decrease the risk of violence; Report any work related violent act or threat or potentially violent act or threat against themselves, co-workers or a member of their family to their supervisor; Report any violent incident to the employer, including where they believe a risk of violence may be present; Report any activity which had the potential for creating a risk of violence; Refuse work that you believe creates an undue hazard for yourself or any other person. Section 4.31 of the regulation states incidents of violence must be reported and investigated. Employees are also responsible for reporting any new or increased risks or harmful behaviour to their supervisor and Joint Health and Safety Committee. An example of a reporting form is located in appendix A. Any violence directed to an employer or supervisor must be reported and investigated this includes worker-to-worker violence. Consultation and Involvement of Committee The employer, in consultation with the Joint Health and Safety Committee, needs to conduct ongoing assessments and develop workplace policies, systems and procedures that will protect workers from aggressive or violent behaviour. Assessments allow us to look at trends or patterns of behaviour and provide employers the ability to ensure proper security measures are implemented. An assessment examines trends of aggressive or violent behaviour and includes security considerations relating to all of the following: Physical layout; Policy and training related to appropriate responses to aggressive or violent acts; Response mechanisms (reporting, debriefing, investigations, follow-up); Appropriate client placement; Appropriate client/inmate assessment prior to interaction with workers; Staffing and personnel availability; and Page 5

10 Education and training. The Joint Health and Safety Committee (the Committee) has an important role to play in the violence prevention program. When risk assessments are first completed, they will be reviewed jointly with the Committee. Committee members must be trained in the process of hazard identification and risk assessment. Once hazards have been identified and the risks assessed, the Committee must be involved in the review of possible solutions. The Committee will make recommendations to management in the most effective and practicable solutions to the problem of violence prevention. Committee members should also be involved in the investigation of violent incidents and are responsible for proposing corrective measures. Their recommendations will be forwarded to management for review at the management safety meetings. Where the committee requests a response in writing, the employer must respond in 21 days in writing to the committee. The Committee members should be informed of all of the procedures that are in place to eliminate or minimize the risk of violence and the support systems that are in place for workers who have been victims of incidents of violence. The Workers Compensation Board requires that the Joint Health and Safety Committee members are to be consulted in the risk identification and informed of the policy, procedures and corrective actions taken by management in response to incidents. The Thirteenth Master Agreement under article Workplace Violence states: The local occupational health and safety committee or Union designated safety representative shall be consulted regarding the curriculum of training and the applicable physical and procedural measures referred to in (b). The Joint Health and Safety Committee is an important partner in the violence prevention program by providing the following: Input into the risk assessment process at the local workplace and provide input into the local Violence prevention Program, including measures to protect workers; Assist in the development of policies and workplace design changes that will reduce the risk of violence on the job; Advise regarding training needs; Determine if investigations of violent incidents or threats have taken place and participate as required; Review all reports of incidents of violence as part of the monthly meeting; Assist in the development and implementation of training programs that will reduce the risk of job violence; and Participate in regular evaluations of the Violence Prevention Program. Page 6

11 Section 3: Developing a Prevention Program A violence prevention program is part of an effective overall health and safety system. Having everyone s commitment to violence prevention is critical to the success of any health and safety initiative. The ongoing support from management, workers and the joint health and safety committee is integral to the program s success. This initiative requires open lines of communication, as communication is crucial to ensuring that workers and management clearly understand the scope of the violence prevention program and enables everyone to contribute in a meaningful manner. For those work places that do not have a violence prevention program the following steps will assist in getting the process started: ACTION STEP KEY PARTICIPANT(S) TARGET (Completion Dates) 1. Discuss the objectives of Employer a Prevention Program Local JOSH Committee or co-chairs Week 2 with workplace Other employees, as appropriate management 2. Develop Project Plan JOSH Committee Employer Week 4 3. Establish Risk Employer Assessment Team to JOSH Committee representation undertake Risk Worker rep(s) from occupational Assessment groups at workplace Weeks Undertake Risk Assessment and Identify Hazards Distribute questionnaires Gather information Inspect the workplace Review info from other similar workplaces 5. Analyze Risk Assessment Results 6. Measures to Reduce Risk a) Training and education b) Communication c) Incident Response and Reporting d) Procedures and work environment measures Risk Assessment Team Other resources may be called to assist or input such as: JOSH designate Union WCB Local Police Risk Assessment Team Others, as appropriate Risk Assessment Team Other resources that can be used: program staff Worker Info sharing and feedback Specialist Advice: contracted resources, local Police, BC Public Service Agency, WCB, Union Recommendations regarding prevention program actions should go to the JOSH Committee and then, to the employer for review and action. Week 8 Note: this target date needs to be realistic. Don t establish an unrealistic date, but at the same time, be aggressive on a due date to keep involvement and enthusiasm of participants high. Week 9 Week 12 Prioritise prevention actions and ensure areas with highest risks are addressed first Consider shorter term solutions which may change or be augmented over the longer term Be creative!! Remember many prevention measures can involve low cost or no cost activities. Those prevention recommendations that require budget planning or have ministry wide policy implications should involve appropriate ministry staff (senior management, staff resources, other affected offices/facilities) Page 7

12 ACTION STEP KEY PARTICIPANT(S) TARGET (Completion Dates) 7. Implement Prevention Plan Employer Working Group Week 13 onwards as identified in implementation planning Remember, the primary responsibility for the Prevention Plan is the Employer (local manager or other senior mgt. depending on the requirements) Other staff, depending on action items Keys: local workplace procedures training and/or education reporting 8. Program Review Employer JOSH Committee Union The JOSH Committee can help in implementation-especially where workplace inspections, communication and program review are involved 1 Year and on going What: Who: When Week 2 Action: Step 1: Discuss the Objectives Discuss the objectives of a Prevention Program with workplace management Employer Local JOSH Committee or co-chairs Other employees, as appropriate Discuss the objective of the Violence Prevention Program with senior management, supervisors, workers and the Joint Health and Safety Committee. What: Who: When Action: Develop Project Plan Step 2: Develop Project Plan JOSH Committee, Employer Week Four The employer, with assistance from the Joint Health and Safety Committee, is responsible for developing a project plan that lists tasks and accountability. It is important to ensure timelines for completing each task is documented and understood. Page 8

13 What: Who: When: Week 4-6 Action: Step 3: Establish Risk Assessment Team Establish Risk Assessment Team to Undertake Risk Assessment Employer JOSH Committee representation Worker rep(s) from occupational groups at workplace One option in facilitating the process for developing a violence prevention program is to form a violence risk assessment team (working group). Consider who should be invited to participate in the working group based on the nature of the Ministry and the expertise required for specific tasks. Making sure there is input from all levels of the workplace will assist in ensuring policies and procedures are relevant to the unique nature of the work environment and the type of hazards that workers are likely to encounter while performing various tasks. The structure and commitment of the working group is a key factor in determining the quality of the violence prevention program. Not everyone needs to be included, but you should premise your decision based on the following factors: How many employees are on site and how many should be on the team? If more than one Ministry exists at the worksite you may want to ensure representation from all Ministries. Based on the risk identification decide which classifications need to be represented, (e.g. employees who may work outside the office or alone). Ensure that both workers and the employer are represented. Ensure representation from the Joint Health and Safety committee. Roles and Responsibilities of the Risk Assessment Team The risk assessment team is responsible for developing terms of reference. Some examples of what should be included are: Establish questionnaires or review existing questionnaires and determine which questions will be utilized. Ensure that all workers participate in responding to the questions. Gather information through the questionnaires and talking to workers; Compile data and identify areas at risk. Assess the risks in these areas. Make recommendations for the control plan. Provide data and recommendation to the Joint Health and Safety Committee. Page 9

14 Working Group Training First Complete Violence Risk Assessment Training Once the working group has been formed, ensure committee members are trained and knowledgeable in understanding the scope of a violence prevention program, including the steps in undertaking a risk assessment, and analyzing the data. What: Who: When: Action: Step 4: Undertake Risk Assessment Undertake Risk Assessment Distribute questionnaires Gather information Inspect the workplace Review information from other similar workplaces Risk Assessment Team Other resources may be called to assist or input (JOSH designate, Union, WCB, Local Police) Week 8 - This target date needs to be REALISTIC, but at the same time, aggressive on a due date to keep involvement and enthusiasm of participants high. A risk assessment is a step-by-step approach to looking at the work environment and work process to identify all possible situations that could contribute to the risk of violence. A risk assessment must be specific and consider the actual work environment and conditions that are present when workers are carrying out Ministry functions. The risk assessment process relies on workers experience in various areas and applying common sense to identify the potential for violence. For example, risk factors in downtown Vancouver will vary from factors in a rural area. The risks in a correctional facility will be unique to that particular facility and dependent on many factors. Determine what violence prevention measures the employer already has in place. Identify risk factors and potentially hazardous work conditions, activities, and situations that increase the risk or contribute to the risk of violence. When should a risk assessment be performed? Risk assessments must be performed: at the start of a new operation; when policies and procedures change that may affect level of service or client changes; when the worksite changes; at any planning stages of new modes of service delivery or any changes to the work environment; and as part of an investigation when incidents of violence occur. Page 10

15 Risk assessments should be performed on an ongoing basis to ensure that the program is effective or to determine if any changes to the policies and procedures should be changed. Gather Information: Gather information of specific violent incidents through worker interview and by reviewing incident reports and any other related documentation. Obtaining input from staff and management on their experiences and workplace violence and what their views are regarding existing violence prevention measures is crucial to developing an effective violence prevention program. Ensure that individual responses are treated with confidentiality. Documentation that should also be considered: Employers current policies and procedures, including any violence prevention measures that are currently in place. Inspection reports that may have identified risk factors. Police and community reports may be beneficial in assessing risks for workers who work in the community. Viewing other Ministry s policies and procedures where similar work is performed. Health and Safety Committee reports. First aid records and past injury reports. Work Procedures The purpose of reviewing local workplace procedures is to determine which measures could minimize the risk of violence to workers. Violence prevention procedures cover but are not limited to the following: Communication procedures for interacting with clients (e.g. recognizing potential violent acts such as emotional outburst, abusive language, shouting, destruction of property). Procedures for worker response to deal with incidents of potentially aggressive clients or with incidents of violence. Backup or alarm procedures for calling for assistance (from manager, other trained workers, building security or the police). Inspecting the Workplace An environmental risk assessment should be conducted to determine the presence of hazards or workplace conditions that may place a worker at risk. This also includes workers who work outside the office. This would look at the nature of interaction, the location, time of year and time of day, plus mode of transportation and means of communication (see appendix B). Inspect all areas of the worksite, including parking lots and the perimeter of the building. Check entrances and exists to determine the presence of hazards or conditions that might place workers at risk of violent incidents. A sample checklist has been developed for your use and is contained in appendix C. Community and home situations pose greater challenges for risk assessment inspections due to changing worksites, uncontrolled environment and unpredictable clients. A pre-visit risk assessment will be useful in identifying potential risk factors and will assist in developing procedures for interaction with the client. Page 11

16 Review Information From Similar Workplaces Information can be gathered from other locations in the province for a review by the ministry. Other ministries that have similar workers will also be able to provide valuable information on the history of violence for particular classifications. What happens in one location of the province can assist in understanding trends and putting together a comprehensive violence program. The Workers Compensation Board may have information that can also be utilized. What: Who: When: Week 9 Action: Step 5: Analyze Risk Assessment Results Analyze Risk Assessment Results Risk Assessment Team, others as appropriate Once the information on risk identification and risk assessment has been completed these results are to be reviewed and evaluated as the risk factors form the basis for the development of a specific violence prevention program. In all cases the procedures and control measures should directly relate to the risk assessment. In collating the information, the team should be able to determine: how often incidents of violence have occurred and how many have been reported; the severity of the incidents, including any compensation claims, First Aid applied, and time lost; any patterns that emerge regarding the time of day, month, or certain activities which place workers at increased risk; the types of events or circumstances that precipitated the violence; if certain locations or geographic areas present greater risk of violence; which policies and procedures increase the risk of violence; which policies are in place that effectively control the risk of violence; what types of workplace arrangements increase the potential for risk; what type of incidents are most likely to occur; the frequency of violent incidents; the occupational groups and work situations which involve the greatest risk; what staff training has been conducted and was the training effective; who requires training and establish various types of training as required; what changes should be implemented regarding environmental issues; and process for assessing risks and the history of a client made available to staff prior to interaction. Page 12

17 It is important to have a process for identifying individuals and areas at greater risk of violence. Designate occupations and work situations that place workers at high risk, moderate risk, or low risk according to the following criteria: High Risk Workplace factors frequently place workers at risk, the consequences may be severe, and it is likely that the worker will be exposed to workplace violence. Moderate Risk Workplace factors place workers at risk less often the consequences may be less than severe, and it is possible that the worker will be exposed to violence. Low Risk Workers are rarely or never exposed to risk, the consequences may be minimal, and it is unlikely that the worker will be exposed to violence. Refer to appendixes D-D4 for samples of a risk assessment form. Step 6 Measures to Reduce Risk What: Measures to Reduce Risk Education and training Communication Incident response reporting and procedures and work environment measures Who: When Week 12 Action: Risk Assessment Team Other resources (program staff, and worker info sharing and feedback) Specialist Advice (Contracted resources, local police, BC Public Service Agency, WCB, Union) Recommendations regarding prevention program actions should go to the JOSH Committee and then to the employer for review and action. Prioritize prevention actions and ensure areas with highest risks are addressed first. Consider shorter-term solutions that may change or be augmented over the longer term. Be creative!! Remember many prevention measures can involve low cost or no cost activities. Those prevention recommendations that require budget planning or have ministry wide policy implications should involve appropriate ministry staff (senior management, staff resources, other affected offices/facilities). Once the risk assessment has identified the areas of concern, specific measures to eliminate the risk and, where elimination is not possible, to minimize the risk must be established. This should be done in consultation with the local Joint Health & Safety Committee. Page 13

18 A. Education and Training The employer is responsible for instructing workers regarding the risk assessment and policies and procedures to minimize the risk for violence. WCB OHS Regulation, Section 4.30 includes a requirement for employers to advise workers of the risk assessment and to instruct workers in the measures they have taken to minimize the risk. The Regulation states: Instruction of Workers Section 4.30 (1) An employer must inform workers who may be exposed to the risk of violence of the nature and extent of the risk. (2) The duty to inform workers in subsection (1) includes a duty to provide information related to the risk of violence from persons who have a history of violent behaviour and whom workers are likely to encounter in the course of their work. (3) The employer must instruct workers who may be exposed to the risk of violence in: (a) The means for recognition of the potential for violence. (b) The procedures, policies and work environment arrangements, which have been, developed to minimize or effectively control the risk to workers from violence, (c) The appropriate response to incidents of violence including how to obtain assistance, and (d) Procedures for reporting, investigating and documenting incidents of violence. Education and training needs to be specific to the risk of exposure and can include the following Recognition of occupational risks of violence, specific risks for regulatory workers, high risk locations and high risk conditions in the community; Identification of at risk violence and aggressive behaviour in clients/inmates; Recognition of potential violence situations at work and in the community; Procedures, policies and work arrangements (e.g., escape protocol) which have been developed to minimize or effectively control the risk to workers from violence; Appropriate response to incidents, including defusing hostile/aggressive behaviours, obtaining assistance and/or providing support to others affected by an incident of violence; Procedures for reporting, investigating, and documenting incidents of violence; Security and safety measures; Personal safety measures; How to obtain client information on aggressive or violent behaviour; Characteristics of aggressive and violent clients/inmates; Verbal and physical techniques to diffuse and avoid violent behaviour; Strategies to avoid violent incidents; Restraining techniques; How to obtain critical incident stress briefing; How to access Employee and Family Assistance program (EFAP); How to obtain external assistance (i.e. police response); and What to do in cases of occupational exposure to blood borne pathogens. Page 14

19 B. Communications What kinds of communication systems are in place and do they consider: How workers are checked if working alone? Does the process meet the WCB requirements? Does the process ensure that, prior to exposure, workers are informed of any potential act of violence? The identification of violent clients at each worksite must be brought to the attention of workers prior to exposure to situations, which present a potential or known risk of violence. As well, preventative or control measures must be communicated to all workers who may be exposed to that particular client. Remember to review the WCB requirements and recommend how information related to the risk is communicated regarding the following: Threats regarding another worker; Threats against a worker; Aggressive behaviour; Improper conduct; Risks that occur outside the office; and Threats against family members. C. Incident Response and Procedures and Work Environment Measures Post incident procedures are the tasks, roles, and responsibilities that outline responses to a violent incident. All incidents of violence are to be reported and recorded. A joint investigation is a good method for determining what went wrong and how similar incidents can be averted. When developing procedures, remember that the worker has been either physically or emotionally assaulted. Implemented measures should ensure that the worker is fully supported. Write and implement post exposure procedures for the following: Controlling the incident scene; Obtaining First Aid and medical aid, this may include transportation to a hospital, this is especially important where a harmful contact with blood has occurred. First aid should be provided to any person who requires it following a violent incident at work; Relief staff directly affected by a violent incident should be given the necessary time for critical incident debriefing; Reporting procedures; Establishing compensation claims; Investigating incidents (includes reviewing current policy and procedures and should include a review of any education and training requirements); Providing critical incident stress debriefing and posttraumatic counselling for employees who have suffered as a result of violence. (Workers affected by violence, whether directly or as a witness, should have made available critical incident stress debriefing); Page 15

20 Making recommendations to prevent recurrence of a similar incident and ensure the effectiveness of control measures. (Follow-up preventative actions should be implemented as soon as possible and the reasons for them should be explained to the staff); Ensuring that any blood or body fluids are appropriately cleaned-up; Legal action and providing support for staff. Note: Division 10, 172 (1) (a), Part 3 of the WC Act requires the WCB Prevention Division to be notified of any incidents that resulted in serious injury or the death of a worker. This process needs to address who is responsible for contacting police and who makes the decision on how to handle the incident. Procedures and work environment measures should include the following: Identification or flags for clients who have a history of violence or threats of violence (e.g. information about a client s previous, actual or potential for violent behaviour); Procedures for making the work location secure during or following a violent incident (e.g. locking the door, removing workers etc.); Where and when required communication and response procedures to be developed with the First Nations Band Councils; Procedures regarding client or public access to private workplaces; Check-in procedures for workers who are working alone or in isolation; First aid, hazard reduction, clean-up and repair procedures; Scheduling or other deployment arrangements, including provisions for backup assistance; How to deal with abusive clients; Procedures on work assignments; Procedures for reporting, investigating, and documenting incidents of violence; Critical Incident Stress Debriefing procedures and post traumatic counselling to workers who have been affected by workplace violence; A process for advising workers involved in a critical incident to consult with their physician; Process to ensure corrective actions are taken in response to the recommendation from the Joint Health and Safety Committee, in accordance with the WCB Regulation and WCB Act, Part III; and Ensure process and procedures are in place regarding work refusals in accordance with section Refer to appendix E for a sample flow chart Care for affected worker. Page 16

21 What: Who: When: Step 7 Implement Prevention Plan Implement Prevention Plan Violence Prevention Policy Employer Working group Other staff, depending on action items Keys: Local workplace procedures, training and/or education reporting Week 13 onwards as identified in implementation planning Action: Remember, the primary responsibility for the Prevention Plan is the Employer s (local manager or other senior mgt. depending on the requirements) The JOSH Committee can help in implementation-especially where workplace inspections, communication and program review are involved The employer is responsible for establishing procedures, policies and work environment arrangements that minimize or eliminate the risk to workers from violence on the job, taking into consideration all of the recommendations made by the Joint Health and Safety committee. The employer has a responsibility to inform employees who may be exposed to the risk of violence as to the nature and the extent of the risk. This obligation includes a duty to provide information related to the history of violence in the workplace. Violence Prevention Policy The local violence prevention policy should identify the risk that workers face and describe programs and procedures that have been developed to control those risks. The policy should also indicate who is accountable for developing, implementing and establishing the process for a regular review of the program and procedures. It should also indicate the responsibilities of managers, supervisors, and workers. The policy should incorporate standards of behaviour and a system for responding to such complaints. The policy has to be applied equally to management, employees, clients, contractors or anyone else in the organization. The policy should be communicated to all workers and should be posted or made available to workers. How to Write a Violence Prevention Policy Define what is meant by workplace violence Provide clear examples of what is unacceptable behaviour (veiled and/or explicit threats, physical assault and intimidation State the consequences of making threats or committing acts of violence State the regulatory framework, WCB, and collective agreement Distribute the policy and ensure that everyone in the Ministry is aware of the policy Refer to appendix F for a sample policy Page 17

22 What: Who: When: Action: Program Review Employer JOSH Committee Union One year and on-going Step 8 Program Review As with all programs, the local Joint Health and Safety Committee must monitor whether the Violence Plan is effective and is meeting objectives. A review should take place annually. In protection and regulatory environments, because clients and demographics change so quickly, the violence prevention program may need to be evaluated more frequently to ensure its effectiveness. This can involve checking to see what the prevention objectives were when developing the program and how do they measure up to the current violence prevention initiative? Terms of reference for the evaluation should include: who and how the review should be conducted; the authority of the review team; and who is responsible for implementing the results of the review. Sample Review of the Violence Protection Program Elements: Are workers reporting incidence of violence? Has the incidence of violence been reduced? Are workers trained in violence prevention initiatives? Do workers and management understand the policy regarding violence in the workplace? Is there an effective communication process in place? Does the check-in procedure for workers who work alone eliminate or minimize the risk? Are workers knowledgeable in the process to be used for emergency situations? Are complaints investigated jointly? Are victims given adequate support? Were police called when appropriate? Have any policies and procedures changed? A report of the findings should be submitted to the Joint Health and Safety Committee. The Committee is then responsible for making recommendations to the employer. Page 18

23 Section 4: Post Event Management Post Traumatic Stress Disorder PTSD is the way a person reacts to emotional stress or physical injury, assault or other forms of extreme stress outside of everyday experience. It can include physical pain from the assault, as well as anger, anxiety, depression, fatigue, flashbacks, nightmares and preoccupation with the event. The employee may also experience problems with their workplace, family and social relationships. Critical Incident Stress Debriefing (CISD) and Post traumatic Counseling Any violent incident particularly those that result in a worker s death or serious injury or in a traumatic life threatening situation, can cause workers to experience strong emotional, cognitive (memory, problems solving or decision making abilities), behavioural and physical reactions. Some of the incidents that can precipitate posttraumatic stress are: assault causing harm; a death threat; a fire, causing injury or severe damage; a bomb threat; witnessing a violent event; a hostage incident; firing a weapon, or a threat of a weapon threat to family member. The purpose of a CISD is to reduce any harmful effects of the incident and to try to prevent the emergence of post-traumatic stress disorder, an often-disabling psychiatric condition. Qualified professional counsellors provide CIS debriefings. Typically, they last from one to three hours and include workers present at the scene of the incident. Usually a CISD is conducted within 72 hours after the incident. The objectives of CISD are: To lessen the impact of violent incidents on the workers who have been exposed to them; To accelerate and support recovery from the violent incident before more harmful stress reactions occur that may damage work performance, careers, health and family/personal relationships; and To identify follow-up actions and interventions for a worker as required. Page 19

24 Arranging Critical Incident Stress Debriefing (CISD) If there is a need to provide a CISD to a specific situation you can contact: 1. The local manager or other designated ministry official; 2. BC Public Service Agency, Client Services, Occupational Health and Safety, and 3. BC Public Service Agency, Occupational Health Programs. In situations where only one employee is affected by the incident or additional support is required following the event, employees can access the Employee and Family Assistance Program (EFAP). EFAP is a program of confidential assistance in the resolution of personal problems. For more brochures contact your ministry EFAP Coordinator, the BC Pubic Service Agency, or check the BC Public Service Agency web site at Call Toll Free The number is answered 24 hours per day, every day of the year Page 20

25 Workers Compensation Claims Violence in the Workplace and Workers Compensation Claims Workers injured or disabled, caused by any work related activity, are entitled to medical assistance and wage loss compensation from the Workers Compensation Board. Workers who suffer from a violent incident at work are not differentiated from those who suffer a more familiar type of accident or injury. Since 1995, the legislation in British Columbia has been amended to ensure that any worker who suffers from a violence related incident at work is potentially eligible for Workers Compensation benefits. It is important, for any worker who experiences a violent incident at work, to immediately file an Incident Report with their employer and their union representative. This worker should also request an application form for both Workers Compensation benefits and for benefits under the Criminal Injuries Act. If workers claim for medical and/or wage loss benefits is accepted, the worker can then apply for benefits for compensation due to related pain and suffering under the Criminal Injuries Act. If they were eligible for these benefits, these would be in addition to normal wage loss benefits. It is also important to know that should a worker s claim for wage loss benefits be denied as a Workers Compensation claim, the entire claim could be reviewed under the Criminal Injuries Act which may include wage loss benefits. Even if the worker believes she or he suffered no physical injury as a result of the incident, some workers may suffer symptoms of post-traumatic stress due to the incident. We have discussed critical incident stress debriefing and other counseling programs earlier in this workbook. It should be stressed here, however, that workers should seek out and obtain counseling assistance on the advice of their physician and follow the prescribed treatment program. Claims for post-traumatic stress may be accepted by the Workers Compensation Board for treatment and wage loss benefits. Assistance with filing a claim can be obtained from your supervisor, Human Resources personnel, WCB Claims staff and your local union representative. Prosecuting Offenders The employer should assist the assaulted worker in any legal actions that she/he undertakes against the offender. If the employer decides not to press charges, the employer should provide a written explanation to the union and to the worker of its decision. Page 21

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