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Appendix 4: Workplace Violence - Risk Assessment Form and Samples

Example 4: Primary Care East

Section 1: Context Appendix 4: — setting the scene

Location: After Hours Medical Centre	Division: Primary Care East
Area/Activity/Person: Assessment of the risk of violence to those employees currently working in the Community Hospital’s After Hours Medical Centre (AHMC), focusing on the following elements: • Escape routes • Lone working, and • Response and de-escalation of violence

 

Section 2: Identifying Hazards — what can go wrong and who will be affected

Hazard	Something with the potential to cause harm	Persons at risk [√]
A	Vulnerability of receptionist as patients can easily mobilise over the low-level reception counter.	S [√] V [ ] P [ ] O [ ]
B	A single point of access/egress to/from the consulting room. Current room design has resulted in positioning the patient between the consultant and the escape route (records of previous incidents)	S [√] V [ ] P [√] O [ ]
C	Incident records indicate that the last person to close the building at 22:00 hrs has been subject to harassment which could lead to future attacks.	S [√] V [ ] P [√] O [ ]
D	Employees are faced with aggressive situations on a weekly basis and find it difficult to identify early signs of aggression through lack of appropriate training (records of serious harm exist)	S [√] V [ ] P [√] O [√]

S = staff; V = Visitor, P = Patient; O = Other

Section 3: Existing Control Measures —what practical steps are already in place

Hazard	Existing Control Measures
A, B and D	Staff have been issued with personal attack alarms which can readily be heard throughout the centre. This measure may introduce new risks as responding individuals are not equipped with the skills to de-escalate that violence.
B	Cardiac arrest pull cords are available to summon assistance, however the same limitations to those responding apply.

 

Section 4: Evaluating risk — not ‘worse case scenario’; takes into account existing controls

Hazard	Consequence ( 1 – 5 )	X	Likelihood (1 – 5 )	=	Risk Rating (1 – 25 )
A	3	X	2	=	6
B	4	X	3	=	12
C	2	X	4	=	8
D	4	X	2	=	8

 

Section 5: Risk prioritised action plan - applying the hierarchy of controls:

E=eliminate I=isolate M=minimise

Hazard	E /I/ M	Practicable Steps required to further control risk	Responsibility
A	I	Submit Estates ‘New Works’ order to retrofit low-level area of reception with a shatterproof clear Perspex barrier. Ensure persons with disabilities are not disadvantaged by providing a suitable gap under the barrier to exchange paperwork.	AHMC manager to submit ‘new works’ form
B	M	Submit Estates ‘New Works’ form to provide additional outward opening door fitted with a push-bar to the consulting room. Positioning of this second egress route is critical to ensure it easily accessed in an emergency.	AHMC manager to submit ‘new works’ form
C	M	Develop a written ‘lock-up’/opening protocol which ensures there are at least two persons when the centre is being closed or opened to avoid lone working.	AHMC manager in consultation with staff
D	M	Train all After Hours Medical Centre frontline staff in violence identification, de-escalation and non-injurious break-away skills and techniques.	Hospital manager/ AHMC manager
D	M	Ensure the roles and expectations of those employees attending emergency calls for assistance are clearly defined and communicated. This document should include guidance on when to call 111.	AHMC manager in consultation with staff
D	I	Develop a policy complete with screening mechanism to ensure other agencies/third parties do not introduce known violent patients to the After Hours Medical Centre without providing appropriate escorts/support. Example: Police may bring a member of the public in a drunken state into the centre for sutures. The screening of the patient should identify this and medical staff may insist that the patient remains under escort during treatment.	AHMC manager/ ReceptionistConsult with local police station etc.

 

Section 6: Further Information: cross-sector safety responsibilities

Who is responsible for local monitoring?: Hospital manager/After Hours Medical Centre manager

Is further competent (clinical risk, manual handling) advice required? Yes / No Comments: Required for selection of appropriate training programme

Do third parties (agencies) require a copy of this risk assessment for their safety? Yes / No Comments: Other agencies that use the after hours medical centre need a copy of this assessment and policy for the management of hazard D – Employees are faced with aggressive situations on a weekly basis and find it difficult to identify early signs of aggression through lack of appropriate training (records of serious harm exist)

 

Section 7: Assessment Sign-Off – assessment monitoring responsibilities

Assessor’s name: After hours medical centre representative

Date of assessment: 25 November 2005

Assessor’s signature:

Review: (tick one) daily weekly monthly yearly

Reassessment date: 26 February 2006

Manager’s signature:

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