Step 3 – Developing the program components

To ensure a comprehensive program, organizations must design a Workplace Violence Prevention Program that consists of a workplace violence prevention policy and a program that includes; reporting, response and investigation procedures; environmental control procedures; work practice and administrative control procedures.²

The Prevention, Protection, and Post-incident Response (the 3 P’s) conceptual model was adapted from risk management practices (Wiskow, 2003) that are widely accepted and used in the occupational health and safety industry.
To adequately address workplace violence aggression, and responsive behaviour, organizations should take a three-pronged, cyclical approach: Prevention, Protection, and Post-incident Response (the 3 P’s). Wherever possible, the emphasis should be on implementing measures to prevent the workplace violent event. Organizational culture may affect the success of each prong.⁴

Prevention involves strategies undertaken prior to an incident to deter the onset of workplace violence. Four important stages include:
1. Recognizing risks;
2. Assess existing precautions and prioritizing risk;
3. Controlling and communicating risk;
4. Evaluating and refining the action plan, i.e., R.A.C.E. information gathered in Step 2 complete the first 2 stages of Recognition and Assess. This information should be used to develop the measures and procedures to Control the hazards identified.⁴

Resources for “preventing” injuries may include:

Procedures to control Administrative and Work Practice hazards such as:

• Client assessment and screening – PSHSA Individual Client Risk Assessment
• PSHSA Communicating the risk of Workplace Violence: A Flagging alert Program handbook

• Triggers and care planning
• Engaging patients and families in workplace violence prevention for leaders

Protection focuses on strategies undertaken during an incident to manage workplace violence and limit the extent of harm.

• Activities may include:
  • Early identification of violent, aggressive, or responsive behaviour;
  • De-escalation and diffusion techniques;
  • Avoiding physical contact where possible;
  • Protocols for managing individual behaviours;
  • Use of coded requests for help;
  • Crisis management training;
  • Prompt and appropriate attention by managers;
  • Mobilization of resources and security measures; and
  • Keeping safety a priority.⁴

Resources for “protecting” workers may include:

• Policy and procedure development for Reporting of incidents:
  • Workplace Violence Reporting Procedures
  • Employee Workplace Violence Event Report Form and Investigation Tool
• PSHSA Security and PSRS toolkits
• Occupational Health and Safety Agency for Healthcare in BC Guidelines: Code White Response
• Ontario Hospital Association Code Silver (Person with a Weapon) Resources
• Procedures to control Administrative and Work Practice hazards such as:
  • Preventing client aggression through a comprehensive training program: Training matrix
• Preparing for a meeting with a potentially violent client
• Work-related travel
• Working alone or in isolated areas – PSHSA Fast fact – Protecting Workers Who Work Alone
• Behavioural contracts between client and facility which outline agreed-upon behaviour, treatment and expectations
• Working in the community – PSHSA Assessing Violence in the Community: A Handbook for the Workplace
• Dealing with visitors and the public

Post-incident Response strategies are undertaken after an incident has occurred to reduce long-term negative effects on the victim(s), other people involved, and the workplace following the incident.

• Suggested post-incident responses cover the following:
  • Assistance and support for victims;
  • Information-sharing and team debriefing;
  • Reporting procedures, and workplace investigations to prevent recurrence.⁴

Resources for “post incident response” may include:

• Systematic Approach to Post Incident Follow Up – RCA, incident Debriefing- including steps taken to prevent a recurrence – PSHSA Fast Fact – How to Investigate an Incident
• Victim assistance and support (Incident and treatment options such as EAP, in house resources, or peer counselling).