BACKGROUND: Effective April 1, 2017, a comprehensive new workplace violence standard for healthcare workers (HCWs) will be enforced by the California Division of Occupational Safety and Health (Cal/OSHA). Employers will be required to establish, implement, and maintain a written workplace violence prevention plan, implement engineering controls, record all workplace violence incidents, and report the most serious injuries to Cal/OSHA within 24 hours. This standard has the potential to reduce the incidence of workplace violence injuries among HCWs through improved environmental controls, training, and analysis of incidents. Workers’ compensation claims data submitted to the California Division of Workers’ Compensation’s Workers’ Compensation Information System (WCIS) can be used for public health surveillance and evaluation of the new regulatory requirements of workplace violence. This analysis was undertaken to describe the existing scope of workplace violence injuries among HCWs in California and determine the feasibility of using workers’ compensation claims data as a public health surveillance tool.
METHODS: Using a combination of injury code and narrative description, we extracted all HCW violent injury claims (any act of violence or threat of violence that occurs at the worksite) submitted to WCIS from 2007-2014. HCWs were identified using a combination of industry and class code, employer name, and occupation description. The American Community Survey was used to calculate the number of full-time equivalents employed in the California healthcare industry for rate calculations.
RESULTS: A total of 14,124 claims met the criteria for workplace violence against HCWs from 2007-2014. Women comprised approximately 64% of all claims; over 80% of claims were classified as Type 2 violence (violence directed at employees by clients, patients, customers, students, inmates, visitors, or any others accompanying a patient). The two most common types of injuries were Contusions (30.4%) and Strains (22.7%). Approximately 27.8% of all injured HCWs worked in a hospital setting, 13.8% in a skilled nursing or intermediate care setting, and 3.3% in a specialty hospital (psychiatric or substance abuse) setting, as determined by industry code. The industry rate of workplace violence claims among HCWs was 22.5 (95% CI: 21.6, 23.5) per 10,000 full-time equivalent workers.
CONCLUSIONS: Analysis of workers’ compensation claims data is a feasible and practical method to enumerate workplace violence injuries among HCWs. As the new Workplace Violence Prevention in Healthcare standard is implemented, the use of WCIS should be considered as a method for routine surveillance of workplace violence in HCWs in California.