Building a Systemwide Response to Workplace Violence in Healthcare

As part of our Workplace Violence Prevention Month series, we are exploring how healthcare systems can move beyond policy and into actionable protection. For too long, violence in healthcare was dismissed as "just part of the job.” However, with 75% of all workplace violence incidents occurring in healthcare and social services, the human cost is too high to ignore.

While most leadership teams recognize the need for change, the challenge lies in execution. How do you move from a high-level safety mandate to a functional, systemwide solution that protects every employee without a massive, unmanageable infrastructure overhaul?

A “Wraparound” Approach to Safety

A recent HealthLeaders analysis highlights how one organization has made workplace violence prevention a C-suite priority. Patsy McNeil, MD, MBA, and CMO at Adventist HealthCare, advocates for a "wraparound" approach to safety that ensures every team member is supported, regardless of their shift or role.

McNeil tells HealthLeaders that "a systemic approach to workplace violence includes having a wraparound ability to impact the problem in a positive way and drive down the number of incidents." She offers a unique perspective on consistency that every leader should consider:

"Senior leadership cannot address workplace violence on the day shift differently than they address workplace violence on the night shift."

This need for consistency extends beyond the clock; it encompasses the diverse roles within the facility. A systemwide response cannot protect caregivers in the ICU while leaving receptionists, patient advocates, or social workers vulnerable. True safety is not a "clinical-only" initiative. When any role is left unprotected, it creates an "island of safety" that fails to address the realities of workplace violence in healthcare.

The Leadership Dilemma

For many hospital executives, hearing that they must provide "total, 24/7 protection" for every employee can feel overwhelming, especially when balancing the ask with a limited budget or multiple floors, units, or facilities.

The pressure to "do everything at once" often leads to a standstill. How do you protect a night-shift nurse, a weekend receptionist, and a home health aid simultaneously without a massive infrastructure overhaul? The answer lies in moving away from an "all-or-nothing" mentality and toward a scalable approach that allows for phased rollouts and grows with the organization.

Scaling Safety: From Pilot to Systemwide Rollout

How does a health system move from identifying a problem to achieving systemwide protection? Following the model used by leaders like Adventist HealthCare, we can break deployment down into a clear order of operations:

1. Identify the "Why" Through Data

   Success begins with visibility. Identify exactly where the most frequent escalations occur. Tracking security dispatches (like "Code Greens") provides the data needed to justify the initial investment as well as measure the success of implementations.

2. Select a Scalable Partner

   Before launching a pilot, you must find a vendor that can meet both your immediate needs and your long-term goals. The goal is to find a partner whose platform is flexible enough to handle the initial high-risk unit pilot but robust enough to support a full, multi-facility rollout without switching technologies halfway through.

3. The Single-Unit Pilot

   Rather than a "big bang" rollout, start with a pilot at a single high-risk facility or department (such as the ED or Behavioral Health). This phase allows you to test response protocols and ensure the technology integrates seamlessly with clinical workflows.

4. Governance & Review

   Once a pilot proves effective, the initiative moves to a system-level governance group. Leadership reviews the pilot’s data to ensure the system is driving down incident numbers and that the ROI is clear.

5. Strategic System Rollout

   After clearing governance, the organization can decide on the rollout strategy that fits their budget and culture—whether that means an immediate systemwide implementation for all employees or continuing with a facility-by-facility expansion to prioritize the most vulnerable units first.

One Size Doesn't Fit All: What to Look For in a System

As you look at vendors that meet your needs for everything from a single unit pilot to a systemwide rollout, it becomes clear that a single device or configuration cannot meet the needs of every role. A modern healthcare safety suite must be adaptable to the unique environment of each unit. When evaluating a partner, ensure they can check these six boxes:

1. Multiple Form Factors for Diverse Roles

   You shouldn't be forced to buy a $300 wearable for a receptionist at a locked desk. Look for a system that offers wearables (high-durability hardware) for high-risk mobile staff and software-based triggers (desktop and mobile apps) for desk-bound roles. This ensures every role is protected at a price point that makes sense.

2. Infrastructure Synergy

   A safety system shouldn't just be an "extra" network. It should leverage your existing infrastructure. Beyond network capabilities, your system should improve situational awareness by pulling in other tools—like access controls, cameras, and PA systems—to create a unified response.

3. Unified Device Management

   To manage a phased rollout successfully, you need one platform to manage all devices and alerts. This "single pane of glass" makes it easier to maintain the system as you expand from 50 devices to 5,000.

4. Role-Based Access Control

   Security is only effective if it's controlled. Your platform should allow you to manage system access based on user roles, ensuring that only authorized personnel can configure alerts or view sensitive incident data.

5. Automated, Intelligence-Driven Responses

   The system should do the heavy lifting for you. Look for the ability to trigger automated responses based on the location of the alert, the incident type (medical vs. security), and the role of the person asking for help.

6. Addressing the ROI of "Dual-Use"

   Cost is often the biggest hurdle to systemwide safety. The most cost-effective systems are those that handle everyday needs—like calling for a lift assist or a minor de-escalation—but are built on a backbone that is always ready for major critical incidents. When a system is used daily, its value is proven long before a crisis occurs.

A Unified Front

At its heart, a systemwide response is about putting people first. It’s about recognizing that the clinicians who spend their days healing others deserve to feel protected while they do it.

Leadership can set the tone, and policies can set the rules, but a comprehensive, flexible staff duress system is what actually allows staff to get help fast and improves incident outcomes. It provides the clarity and confidence staff need to do their jobs, knowing that no matter where they are or what shift they're working, help is never out of reach.