Addressing workplace violence in healthcare settings is a key priority for Colorado health facilities as they aim to retain workers.
Experts discussed healthcare workforce challenges and retention efforts at the 2023 Colorado State of Reform Health Policy Conference. Colorado Health Institute Director Nina Bianchi referenced a 2021 Mercer report that shows the state will have a shortage of 54,000 lower-wage healthcare workers, 10,000 registered nurses, and 4,417 mental health workers by 2026.
“These stats are from 2021, so those numbers have probably significantly increased at this point,” Bianchi said. “Colorado has the third-largest projected nurse staff [gap] in the entire nation. And over one in 10 public health employees plan to leave their position in the next six months.”
Panelists said workplace violence is a primary barrier in retaining workers. Denver Health Chief Nursing Officer Kathy Boyle said the organization has been working to address that for over a decade.
“We have done so many different interventions to try and make a difference,” Boyle said. “This year we have a goal to reduce assaults at Denver Health across the enterprise by 15 percent. This is a tricky goal because we all know that violence is under-reported across the nation. We’re five times more likely to be assaulted in healthcare than any other profession.”
Richard Bottner, vice president of clinical excellence at the Colorado Hospital Association, noted that about 75 percent of the nearly 25,000 workplace assaults reported annually occur in healthcare and social service settings.
“A nurse is assaulted every 30 minutes, and 90 percent of all healthcare workers have reported experiencing violence themselves or witnessing violence against one of their co-workers,” Bottner said. “Patients deserve safe places to receive care, (and) staff deserve safe places to deliver that care. We’re really in a place where we need to find a much better balance.”
— Bottner
Bottner said the solution needs to be tailored to the problem.
“We need to think about the situations that may lead to violence in our hospitals,” Bottner said. “There are patients who, due to their medical condition, may not be aware of the actions they’re committing. And that response needs to be different than the patient who does have intentional control of their actions.”
Boyle said Denver Health has taken several steps to address workplace violence.
“We have more metal detectors coming into the organization than we had before,” Boyle said. “We have an electronic health record to tell us if somebody has a history of violence. We have supports for our staff. We’ve had a peer assault care team for probably eight years.”
Denver Health designed a peer responder system in 2020, Boyle said. The phone system is operated by 35 peer responders.
“We quickly expanded from one service line to seven. We created a drop-in (center). People get a coffee, grab a snack, (and) talk to a peer responder. Over three years, we’ve had over 310,000 touches from this program. And over 12,000 have been actual psychological first aid. So that speaks to prevention from harm.”
— Boyle
Bottner said healthcare facilities need more metal detectors, ergonomic staff positioning, and support groups.
“A lot of what Denver Health is currently doing is best practice,” Bottner said. “We need to figure out how to expand that practice across the state. This is a very important issue.”
Frank Cornelia, deputy executive director at the Colorado Behavioral Healthcare Council, said the council continually focuses on workforce initiatives in its policy work, predominantly raising wages.
“Behavioral health workers and frontline workers have been undervalued and underpaid for years,” Cornelia said. “So we work consistently to try to bring those wages up. Many of our members have implemented salaries for full-time employees. WellPower, serving the Denver area, implemented a $50,000 minimum salary for all full-time employees.”