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Workplace Violence

Workplace Violence Quick Links

  1. Reporting Workplace Violence
  2. Education and Training
  3. Code Gray – Combative Person
  4. Code Silver- Hostage/Weapon/Active Shooter 
  5. WPV Resources

Definition of Workplace Violence

Workplace violence is any act of violence or threat of violence that occurs at the work site. Workplace violence does not include lawful acts of self-defense or defense of others.

Workplace violence is further defined as: 

  • The threat of physical force against an employee that results in or has a high likelihood of resulting in injury, psychological trauma, or stress, regardless of whether the employee sustains an injury;
  • The use of physical force against an employee that results in or has a high likelihood of resulting in injury, psychological trauma, or stress, regardless of whether the employee sustains an injury;
  • Any incident involving the threat or use of a firearm or other dangerous weapon, including the use of common objects as weapons, regardless of whether the employee sustains an injury.

Mission and Policy Statement

The mission of the Workplace Violence Prevention Program is to provide a safe, caring, and healthy environment for employees, patients, medical staff, students, and visitors.

We recognize that workplace violence cannot be completely prevented, however, our goal is to minimize the risk of harm from workplace violence. Accordingly, LLUH holds a “zero tolerance” policy and will not tolerate any acts of violence, threats of violence, injury, or mental harm on LLUH property. 

Several documents outline our policy and approach with regard to workplace violence:

Reporting Workplace Violence

Immediate Assistance

To receive immediate assistance and support during or after a workplace violence incident, please contact Security and notify your management.

Submit an Electronic Event Report (EER)

All incidents of Workplace Violence should be reported as soon as possible after experiencing or witnessing an event. Even if the Workplace Violence was a result of the patient’s condition, report all workplace violence.

Submit an Electronic Event Reporting (EER) form using the appropriate link and selecting Workplace Violence from the option list:

These links may also be found on One Portal, under Frequently Used Links.

Cal/OSHA Title 8, CCR section 3342 and SB1299 require all general acute care hospitals and psychiatric hospitals to report to Cal/OSHA all acts of physical workplace violence. This requires Environmental Health & Safety to review and begin investigation of workplace violence within 24/72 hours of notification of an incident of workplace violence.

Education and Training

De-escalating Workplace Aggression

Loma Linda University Health utilizes the Crisis Prevention Institute’s (CPI) industry leading De-escalating Workplace Aggression (aka Managing Assaultive Behavior) program for didactic and hands-on skills training.

The De-escalating Workplace Aggression course emphasizes non-violence crisis intervention designed to educate staff on how to recognize signs of potentially violent situations.

This course is provided in two parts:

  • Part I – Didactic: Trains staff in general and personal safety measures, aggression and violence predicting factors, the assault cycle, characteristics of aggressive and violent patients and victims, and verbal intervention and de-escalation.
  • Part II – Skills/Hands-on: Staff learn how to use nonviolent physical interventions safely to protect oneself and others from danger. Proper physical safety, restraint, and individual and team control techniques are emphasized. This course follows the Nonviolent Crisis Intervention model, which offers practical application to the humanistic concerns of providing Care, Welfare, Safety and Security of all involved.

Selecting the Right Workplace Violence Training

Different levels Workplace Violence training are required for employees depending on their role and type of interaction others.

Use the following matrix to help guide you to the right course.

Audience
Course Name and Description

All LLUH Employees
(required annually)

Required annually of all employees; automatically registered with course found under “My Requirements” in OWL.

BLUE Book

Initial workplace violence training explaining the following:  the plan, how to recognize the potential for violence, strategies to avoid harm, how to recognize alarms, role of security, how to report WPV, resources available to employees.

Course length: 30 minutes

All Hospital Employees
(required one-time)

All Clinical Employees
(required annually)

Course is also available to faculty and students.

Workplace Violence at LLUH (eLearning) (COMP1704)

Builds on knowledge learned from the BLUE Book WPV Module and provides a more in-depth exploration of the workplace violence plan, how to recognize the potential for violence, strategies to avoid harm, how to recognize alarms, role of security, how to report WPV, resources available to employees.

Course length: 30 minutes

Charge Nurses, Clinical Educators, House Supervisors, Patient Sitters
(required one-time)

Additional groups and/or individuals may be chosen to receive this training as needed.

De-escalating Workplace Aggression, Part 1
(CE1301)

Non-violence crisis intervention including: general and personal safety measures, aggression and violence predicting factors, the assault cycle, characteristics of aggressive and violence patients and victims, verbal intervention and de-escalation.

Course length: Four Hours

Special note: This is an interactive online course.

De-escalating Workplace Aggression, Part 2
(COMP2376)

Physical maneuvers to defuse and prevent violent behavior, strategies to prevent physical harm, appropriate use and risks of physical restraints. 

The class provides an opportunity to practices physical safety intervention skills. 

Course length: Two Hours

Pre-requisite: Part 1 (CE1301)

Emergency Services, Urgent Care, SSN and Security Employees
(required annually)

De-escalating Workplace Violence Aggression, Flex Part 1
(COMP2242)

Non-violence crisis intervention including: general and personal safety measures, aggression and violence predicting factors, the assault cycle, characteristics of aggressive and violence patients and victims, verbal intervention and de-escalation.

Course length: Two Hours

Special note: This course is an online e-learning course. Course is restricted to the specified audience.

De-escalating Workplace Aggression, Part 2
(COMP2376)

Physical maneuvers to defuse and prevent violent behavior, strategies to prevent physical harm, appropriate use and risks of physical restraints. 

The class provides an opportunity to practices physical safety intervention skills. 

Course length: Two Hours

Pre-requisite: Flex Part 1 (COMP2242)

Behavioral Medical Center

 

BMC: Prevention and Management of Assaultive Behavior (PMAB) Initial: CE1244

This course includes non-violence crisis intervention including: general and personal safety measures, aggression and violence predicting factors, the assault cycle, characteristics of aggressive and violence patients and victims, verbal intervention and de-escalation.

Physical maneuvers to defuse and prevent violent behavior, strategies to prevent physical harm, appropriate use and risks of physical restraints. 

The class provides an opportunity to practices physical safety intervention skills. 

New Employees to BMC will be required to take the Prevention and Management of Assaultive Behavior (PMAB) Initial: CE1244

Course length: Six Hours

Special Note: Employees who have a CPI Blue Card from another psychiatric facility will be managed on a case by case basis whether they will take the initial or recertification course.

BMC: Prevention and Management of Assaultive Behavior (PMAB) Recertification: CE44

This course serves as a refresher and is required every year after the initial BMC: Prevention and Management of Assaultive Behavior (PMAB) Initial: CE 1244 course.

Course length: Four Hours

Special Note: Employees who are returning to the BMC within 1 year of leaving will have their due date default to the month that PMAB was taken last. Employees who are returning to the BMC after more than 1 year will be required to take PMAB as soon as scheduling allows. Whether the employee will need to take the Initial or Recertification course will be handled on a case by case basis.

 

 

Risk Assessments and Workplace Violence In-Services

To request an environmental risk assessment, departmental in-service on workplace violence, or to find out more about the Workplace Violence Prevention Program. Please contact Brietta Looney, Workplace Violence Specialist at: 

Various Workplace Violence In-services are available:

Course Name and Audience
Course Description

General Workplace Violence In-service

Groups that would like an introduction to workplace violence concepts.

What is covered:

  • What is workplace violence
  • How to respond to workplace violence
  • Importance of reporting, how to report
  • Recovery from workplace violence and available resources

Code Gray and De-escalation In-service

All departments that need an introduction to the Code Gray protocol.

What is covered:

  • How to recognize and address the early signs of escalation
  • Learn and utilize the Code Gray S.A.N.D. Protocol
  • When to call a Code Gray
  • Employee roles and responsibilities during a Code Gray

Code Gray – Combative Person

Code Gray is Loma Linda University Health’s official response to a person exhibiting combative or assaultive behavior. The Code Gray response is based on the S.A.N.D. acronym – Safety First, Assemble Team, Notify, and De-escalate.

Learn more about LLUH’s Code Gray response:

Code Gray Drills

Drilling on the Code Gray response at the unit/department level can prepare staff to rapidly respond to persons exhibiting combative or assaultive behavior. We encourage units and departments to conduct a self-directed Code Gray drill annually, or more often as needed 

Code Silver – Hostage/Weapon/Active Shooter

Code Silver is Loma Linda University Health’s official response in an event involving a hostage/ armed assailant/ active shooter situation that occurs at LLUH.

Learn more about LLUH’s Code Silver response:

Code Gray vs. Code Silver

Both Code Gray and Code Silver fall under the definition of workplace violence. However, our response to a Code Gray and Code Silver is uniquely different:

  • Code Gray – Response to a person exhibiting combative or assaultive behavior
    • S - Safety First
    • A - Assemble a team
    • N - Notify
    • D - De-escalate
       
  • Code Silver – Response to a Hostage/Armed Assailant/Active Shooter
    • Immediate lock-down in response to a Code Silver notification
    • If confronted with an armed assailant or active shooter:
      • Run
      • Hide
      • Fight

WPV Resources

Environmental Health & Safety Office

The Office of Environmental Health and Safety oversees the Workplace Violence Prevention initiatives at Loma Linda University Health and is responsible for leading education and training initiatives, investigation of events, monitoring, and reporting events to Cal/OSHA.  

Contact Brietta Looney, LLUH’s Workplace Violence Specialist:

Policy and Regulation

Loma Linda University Health maintains a zero-tolerance policy on Workplace Violence. Additional legislative and Health and Safety Code references are available as a resource: 

Security

Loma Linda University Health Security is here to assist with prevention and response to Workplace Violence events.

Security may be contacted at:

Security also provides upon request:

  • Escorts upon request
  • Panic alarm assessments

Chaplain Services

LLUMC and LLUMC-M Chaplain Services are available at all times to provide spiritual/emotional support to patients, patient-family members, and staff.

  • LLUMC Chaplain Services may be reached at: x44367 or 909-558-4367
  • LLUMC-Murrieta Chaplain Services may be reached at: x64718 or 951-704-1386
    Office Hours: Monday - Thursday, 8 a.m. - 5 p.m. and Friday, 8 a.m. - 12 p.m.

Employee & Student Counseling Services

Loma Linda University Health’s Employee & Student Counseling Services (ESCS), formerly known as the Employee & Student Counseling Services (ESCS), provides employees, students, and their families with the highest quality of caring assessments and psychotherapy for a wide variety of issues including personal, work, and academic concerns. All care is provided free of charge!

  • The Employee & Student Counseling Services may be reached at: 909-558-6050 and more information about the program here.

Employee Spiritual Care

Employee Spiritual Care and Wholeness promotes a Christ-centered environment by nurturing spirituality and encouraging wholeness in Loma Linda University Medical Center employees and supports them as they care for others.

Employee Spiritual Care may be reached at: 909-558-7261

Code Lavender

A Code Lavender activates peer support after an adverse or traumatic event occurs. Support is provided by a trained Peer Support team member. Additional Care for the Caregiver resources/referrals are provided when needed. A Code Lavender can be requested here: http://one.lluh.org/C4C

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