Statement on Workplace Violence

The following statement was developed by the ACS Workplace Violence Statement Task Force and approved by the Board of Regents at its October 2024 meeting.

Healthcare workers are increasingly victims of violence. Surgeons are at the forefront of high-stakes medical decisions/interventions and are particularly vulnerable to this behavior.

The American College of Surgeons posits that surgeons and all members of the healthcare team have a right to perform work free from the threat of verbal, physical, or psychological violence. We endorse a culture of safety, respect, dignity, and accountability for everyone to allow for the treatment and care management of our patients. We believe an inclusive and supportive environment free from disruptive behaviors allows for the highest quality of care and optimizes patient outcomes.

Elimination of workplace violence and protection of surgeons and healthcare allies is the responsibility of everyone and must be an institutional priority within individual healthcare systems and the medical community. It is the position of the American College of Surgeons that regulatory bodies, healthcare agencies, and institutions develop formal policies to systematically address and eradicate violence against surgeons and their teams. Protective strategies and enforcement of these policies is a priority of the American College of Surgeons and should be a priority of all healthcare institutions and regulatory agencies.

ACS Workplace Violence Resources

The following resources have been compiled for reference by healthcare facilities working to create a Workplace Violence Policy.

1. Understanding Workplace Violence

1. Definitions
2. Examples
3. Data/Statistics about workplace violence
4. Special and vulnerable populations
5. Recognition of workplace violence
6. Addressing stigma of workplace violence
7. What to do when you encounter workplace violence—interpersonal versus patient/family

2. Hospital Resources

1. Infrastructure and systematic to support safe environments
   
   1. Screening centers at check-in
   2. Police call/assist buttons
   3. Overhead safety paging systems- sentinel event alert system
   4. Emergency protocols and simulations
   5. Patient and family code of conduct document
   6. Disruptive behaviors committee
   7. Data collection and monitoring of violent events
   8. Leadership training in workplace violence identification, reduction, and response
   9. Violence reduction leadership appointments 
   10. Program improvement and sustainability
   11. Identifying barriers to a culture of safety
2. Post-violence support for providers
   1. Medical/Psychologic leave policies
   2. Mental health resources
   3. Debrief/root cause analysis
3. Community resources
   1. Community outreach and violence interrupters programs
   2. Open house days
   3. Family and team member 
   4. Relationship with community police services

3. Advocacy and Legislative Efforts for State and Federal Laws

1. Legislation Currently Being Considered in State Legislatures
2. Current State Laws and Regulations 2024

4. Frontline Provider Resources

1. De-escalation techniques
2. Risk assessment and mitigation protocols
3. Anonymous/No blame reporting system
4. Conflict resolution and interpersonal skills training
5. Criteria for patient dismissal resources 
6. Understanding of criminal behavior

Corresponding Resources