By Jim Burke

Stephanie Ross, a 25-year-old mental health coordinator in Florida, was murdered by a client in 2013 when visiting him in his home. The tragedy is still raised today when violence in the healthcare industry, particularly against home health workers, is discussed.

Ross’ case notes outlined her discomfort with the patient. She was unaccompanied on her last visit, despite her request that she not go alone. Her employer was cited for two “serious” safety violations by the U.S. Department of Labor’s Occupational Safety and Health Administration. The patient was institutionalized, deemed unfit to stand trial. And Stephanie lost her life.

Workplace violence is a big issue in home healthcare, one of the fastest growing healthcare sectors, whose employment expanded by 55 percent between 2006 and 2016. Studies show that as many as 61 percent of home health nurses have experienced some form of workplace violence, with 59 percent reporting pervasive verbal aggression and 30 percent, sexual harassment. And, of course, it’s not just nurses who may be subjected to it. Home health aides, occupational therapists and social workers are also at risk.

Sometimes the threat is from the clients themselves. Patients with psychiatric issues are an obvious potential danger, and those suffering from Alzheimer’s or other forms of dementia also can inflict physical harm. Other members of the household who live with the patient may also pose a risk as they themselves may suffer from their own psychiatric issues or abuse drugs. Some homes may have dogs or other pets that may present a danger to the home health worker.

Ensuring three best practices are instituted and followed will put home health workers – and their workers – in a better position to manage the risk of violence:

  1. The employer must thoroughly vet every home health assignment so that workers are not put in situations that will jeopardize their safety.
  2. Written plans are a must, detailing policies and procedures for ensuring home health workers’ safety, including the requirement that every incident of any severity is reported, and police are contacted, when necessary.
  3. Train home health workers on ways to recognize and respond to risks. Employees should go through training during onboarding as well as annually. As part of the program, protocols and precautions should be shared for assignments in high-crime areas, along with strategies to defuse aggressive behaviors. For example, working in pairs may be called for, and home health workers should chart out the safest travel routes. Training in de-escalation strategies and escape planning are also important.

The death of Stephanie Ross at the hands of her client was a tragedy that put greater focus on the risks – and high costs – of violence against those who go into others’ homes to deliver needed care. It’s important that the industry continue to take this lesson to heart.

HUB International brokers have extensive experience working with healthcare organizations of every type, helping to identifying and resolve their risk exposures, as well as claims management, negotiation and advocacy.