Health care workers, long recognized as facing unique occupational hazards, may soon see new protections as the Occupational Safety and Health Administration (OSHA) prepares to address one of their most pressing concerns: workplace violence.

OSHA is preparing to release a proposed standard on workplace violence prevention in health care settings by December 2024, according to recent regulatory updates.

The proposed rule will likely apply to work performed in hospitals, medical centers, residential treatment centers, nursing homes, mental health centers, and private homes where health aides or social workers visit clients.

The proposed standard is expected to require health care employers to:

Develop a written workplace violence prevention policy
Train workers on that policy
Perform regular hazard assessments
Implement measures to mitigate hazards
Maintain a workplace violence incident log

Why health care?

Health care workers are five times more likely to sustain a workplace violence injury than other professions. Data from the Bureau of Labor Statistics shows hospital workers experience assaults in the workplace at a significantly higher rate (10.4 assaults per 10,000 workers) than workers in all private sector industries (2.1 per 10,000). In 2018, a staggering 73% of all nonfatal workplace violence-related injuries involved health care workers.

According to a report from the US Department of Health and Human Services, risk factors for workplace violence in health care settings can include “(1) unpredictable behaviors of patients and families who are often under emotional stress, as well as (2) organizational and systemic factors such as high-stress work environments, staff shortages, lack of organizational policies and staff training, overcrowding, long wait times, inflexible visiting hours, and lack of information.^”

A long time coming

The development comes after years of OSHA review, including a 2016 request for information and a 2023 Small Business Advocacy Review panel. OSHA aims to publish a final rule in 2025, which could take effect 30 to 60 days after publication in the Federal Register.
The agency currently uses the General Duty Clause of the Occupational Safety and Health Act to hold companies accountable for workplace violence incidents in the absence of a specific standard.

In May, OSHA cited Circles of Care Inc., an organization that operates multiple psychiatric and rehabilitation facilities, for repeated violations and failure “to provide sufficient controls to prevent the escalation of acts of aggression toward professional staff.” The organization now faces $101,397 in proposed penalties.

In July, OSHA also cited a veterans’ medical center in Arizona for failing to protect its staff. However, government employers are generally exempt from penalties.

Health care employers and social service providers are advised to review their existing workplace safety policies in anticipation of the coming standard. Begin organizing your team now, so you’re better prepared to respond to the coming standard.