Advancing the Delivery of Positive Practice – University Health Network (UHN)’s Journey to Eliminating Preventable Harm from Workplace Violence

Introduction: 

In healthcare, a paradigm shift in thinking is required as many healthcare workers often excuse or condone acts of violence from patients. Although few people come into a healthcare environment with intent to harm, violence is real in healthcare settings due to the nature of illness faced by certain patient populations. Prevention begins by creating a culture that supports this philosophy will inevitably reduce and eliminate harm experienced by violent acts. Designing safety systems to ensure there is an understanding of why these events occur is key to preventing future occurrences. Encouraging reporting is critical to understanding and addressing all factors that contribute to violent incidents and is an essential step in the development of effective preventative measures. 

Objective:

(1) Reduce and eliminate harm experienced from violent acts in the workplace.

(2) Encourage and improve reporting and situational awareness of workplace violence events.

(3) Build systems that support early detection and correction.

Methods:

University Health Network (UHN), Canada’s largest academic hospital system, recognized that most acts of violence are preventable within the workplace. Embarking on a strategic transformation, UHN identified safety as a core value, signifying their commitment to zero preventable harm. Safety is embedded in every aspect of the delivery of care. Transforming a culture began with an exploration beyond what happens during incidents of violence to learning why these incidents occur which lead to addressing system failures that contribute to causation; the key to preventing harm. 

Results:

UHN’s approach, unique in the healthcare industry, encourages reporting and response to near-miss events, which is critical in the development of effective preventative measures. This proactive organizational methodology to workplace violence builds systems to support early detection and correction. Building a "safety culture" where staff and patients embrace safety as a core value starts with leaders. Having a safety culture proved to be successful in reducing the harm experienced from violence. Shifting the focus on creating resilience by incorporating harm reduction and prevention strategies into daily practice enables sustainability.