UCSF

Background: Workplace violence in healthcare settings has been recognized globally as a major barrier to the provision of safe and effective health care services. In California, the Workplace Violence Prevention in Health Care standard (Title 8, Section 3342) requires hospitals to develop violence prevention plans and report incidents where force was used against workers to the California Occupational Safety and Health Administration (CalOSHA) through the web-based Workplace Violent Incident Reporting System for Hospitals (WVIRS). Methods: This dissertation study used data (N=27,968 incidents) reported through the WVIRS by California’s acute care and psychiatric hospitals (N=413) from July 2017-June 2020. Additionally, qualitative data from interviews and site visits were collected by the dissertation investigator from six hospitals/hospital systems during 2019-2020. Results: Analysis of the WVIRS’ first 15 months of data found that behavioral health units had 1.82 times the odds of the reported incident resulting in physical injury compared to inpatient medical units, and investor-owned facilities had 2.43 times the odds of the reported incident resulting in physical injury compared to city or county-owned facilities. From July 2017 – June 2020, hospitals reported between zero and six incidents per staffed bed. Sixteen (3.9%) out of 413 facilities reported two or more incidents per staffed bed while the rest reported fewer than two incidents. Thematic analysis of qualitative data revealed that leadership roles and reporting procedures differed between facilities, potentially impacting whether less-serious incidents ultimately appear in the WVIRS. Conclusion: The WVIRS provides important insight into the epidemiology of workplace violence in California’s hospitals and has the potential to inform future workplace violence prevention efforts.