Using the Hazard Risk Matrix to identify hospital workplaces at risk for violence

Background and Objectives: The healthcare industry employs over 5 million workers in U.S. hospitals. Hospital employees are at increased risk for workplace violence and violence-related injury requiring time away from work. A key barrier to violence injury prevention in hospitals is the lack of methodology for prioritizing allocation of limited resources. The hazard risk matrix was used to categorize the probability and severity of violence in hospitals to identify units at greatest need of safety intervention. 

Methods: The study was conducted within a multi-site hospital system with a central, standardized system for recording workplace violence incidents and related injuries. The hazard risk matrix was used to identify hospital units at increased risk for violence based on data collected January 2010 to June 2012. The probability of violence was based on violence incidence rates; severity was based on lost time management claims. Cells of the hazard risk matrix were populated with hospital units categorized as low, medium or high probability and severity. Hospital stakeholders reviewed the matrix after categorization to address the possible confounding of underreporting.

Results: 42 hospital units were categorized as medium or high on both severity and probability and were prioritized for intervention. Probability and severity were highest in psychiatric, security, emergency, and nursing units. Hospital stakeholders representing both management and labor verified results and deemed the matrix useful, informative, and feasible. 

Conclusions: The hazard risk matrix is a useful risk analysis tool for hospital administrators and safety professionals in prioritizing worksites for violence injury prevention efforts.