Understanding and measuring workplace violence in healthcare: a Canadian systematic framework to address a global healthcare phenomenon.

IF 2.3 3区 医学 Q1 EMERGENCY MEDICINE BMC Emergency Medicine Pub Date : 2025-01-13 DOI:10.1186/s12873-024-01144-1
Christian Schulz-Quach, Brendan Lyver, Charlene Reynolds, Trevor Hanagan, Jennifer Haines, John Shannon, Laura Danielle Pozzobon, Yasemin Sarraf, Sam Sabbah, Sahand Ensafi, Natasha Bloomberg, Jaswanth Gorla, Brendan Singh, Lucas B Chartier, Marnie Escaf, Diana Elder, Marc Toppings, Brian Hodges, Rickinder Sethi
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Abstract

Background: Globally, healthcare institutions have seen a marked rise in workplace violence (WPV), especially since the Covid-19 pandemic began, affecting primarily acute care and emergency departments (EDs). At the University Health Network (UHN) in Toronto, Canada, WPV incidents in EDs jumped 169% from 0.43 to 1.15 events per 1000 visits (p < 0.0001). In response, UHN launched a comprehensive, systems-based quality improvement (QI) project to ameliorate WPV. This study details the development of the project's design and key takeaways, with a focus on presenting trauma-informed strategies for addressing WPV in healthcare through the lens of health systems innovation.

Methods: Our multi-intervention QI initiative was guided by the Systems Engineering Initiative for Patient Safety (SEIPS) 3.0 framework. We utilized the SEIPS 101 tools to aid in crafting each QI intervention.

Results: Using the SEIPS 3.0 framework and SEIPS 101 tools, we gained a comprehensive understanding of organizational processes, patient experiences, and the needs of HCPs and patient-facing staff at UHN. This information allowed us to identify areas for improvement and develop a large-scale QI initiative comprising 12 distinct subprojects to address WPV at UHN.

Conclusions: Our QI team successfully developed a comprehensive QI project tailored to our organization's needs. To support healthcare institutions in addressing WPV, we created a 12-step framework designed to assist in developing a systemic QI approach tailored to their unique requirements. This framework offers actionable strategies for addressing WPV in healthcare settings, derived from the successes and challenges encountered during our QI project. By applying a systems-based approach that incorporates trauma-informed strategies and fosters a culture of mutual respect, institutions can develop strategies to minimize WPV and promote a safer work environment for patients, families, staff, and HCPs.

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理解和衡量医疗保健中的工作场所暴力:加拿大解决全球医疗保健现象的系统框架。
背景:在全球范围内,特别是自2019冠状病毒病大流行开始以来,医疗机构的工作场所暴力(WPV)显著上升,主要影响到急诊科和急诊室(ed)。在加拿大多伦多的大学健康网络(UHN),急诊室的WPV事件从每1000次就诊0.43例增加到1.15例,上升了169% (p方法:我们的多干预QI倡议由患者安全系统工程倡议(SEIPS) 3.0框架指导。我们利用SEIPS 101工具来帮助制定每个QI干预措施。结果:使用SEIPS 3.0框架和SEIPS 101工具,我们全面了解了UHN的组织流程、患者体验以及HCPs和面向患者的工作人员的需求。这些信息使我们能够确定需要改进的领域,并制定一个大规模的QI计划,包括12个不同的子项目,以解决UHN的WPV问题。结论:我们的QI团队成功地开发了一个适合我们组织需要的全面的QI项目。为了支持医疗机构解决WPV问题,我们创建了一个12步框架,旨在帮助开发适合其独特需求的系统QI方法。该框架为解决卫生保健环境中的WPV问题提供了可行的策略,这些策略源于我们在QI项目期间所取得的成功和遇到的挑战。通过采用以系统为基础的方法,结合创伤知情策略和培养相互尊重的文化,机构可以制定策略,最大限度地减少WPV,并为患者、家属、工作人员和医务人员创造更安全的工作环境。
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来源期刊
BMC Emergency Medicine
BMC Emergency Medicine Medicine-Emergency Medicine
CiteScore
3.50
自引率
8.00%
发文量
178
审稿时长
29 weeks
期刊介绍: BMC Emergency Medicine is an open access, peer-reviewed journal that considers articles on all urgent and emergency aspects of medicine, in both practice and basic research. In addition, the journal covers aspects of disaster medicine and medicine in special locations, such as conflict areas and military medicine, together with articles concerning healthcare services in the emergency departments.
期刊最新文献
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