1. Procedure description
The Royal Children's Hospital (RCH) is committed to the provision of a safe and healthy work environment for all employees, contractors and visitors and the continuous development and improvement of its safety management system in order to:
- Achieve best practice Workplace Health and Safety (WHS) performance for the health sector.
- Identify, assess and control risks.
- Incorporate WHS considerations into all work processes.
- Consult with staff on WHS issues.
- Provide WHS training and instruction.
- Set WHS performance targets for the organization and management.
RCH actively supports zero tolerance towards aggression and violence in the workplace. RCH will achieve this by establishing an environment that promotes identification of hazards, assessment and control of risks, preventative training and education, reporting and effective management of all incidents and incorporating safety into facility design. These harm minimising practices, and the active reduction in the
use of restrictive interventions will assist RCH in achieving a safe and
effective work environment.
This Procedure applies to all RCH employees, students and
Employee to employee violence, bullying or harassment is not
included in the scope of this Procedure. These behaviours
are covered by the RCH
Safe and Positive Workplace Behaviours Procedure.
2. Definition of Terms
An incident in which an employee, student or contractor is abused, threatened or assaulted. This includes incidents of clinical aggression and family/visitor aggression and violence. It may include:
- Verbal, physical or psychological abuse.
- Intimidating or threatening behaviours.
- Aggravated assault.
- Threats with a weapon or object.
- Sexual harassment and/or sexual assault.
Assault as defined below
The direct or indirect application of force by a person to the body, clothing or equipment worn by another where the application of force is without lawful excuse and with the intent to inflict or being reckless as to the infliction of bodily injury, pain, discomfort, damage, insult or the deprivation of liberty and results in infliction of any such consequence. It is also an act that causes reasonable fear in another person of injury or intimidation.
Code of Conduct
The agreed set of minimal standards of behaviour that all staff, patients, families and visitors are expected to comply with to ensure the RCH is a safe, professional and friendly environment. See RCH Code of Conduct
A patient, family member or visitor who has been identified by RCH as posing an ongoing risk of aggression and/or violence to staff.
Aggression & Violence Prevention Committee
provide organisational leadership in the prevention, intervention and management
of aggression & violence at RCH.
Chief Executive Officer
- Ensure that the RCH program to manage occupational violence complies with all statutory and common law requirements.
- Provide leadership and support for zero tolerance of occupational violence.
Aggression & Violence Prevention Committee
- Provides leadership in the prevention,
intervention and management of aggression and violence at RCH.
- Develops and review policies, procedures
relating to occupations violence and aggression.
- Review incidents of aggression and violence
within organisation, and make recommendations following critical incidents.
- Ensure compliance with governing policies and procedures of occupational violence.
- Ensure that appropriate risk management actions are taken where risk of occupational violence is identified.
- Ensure that all front line staff receive appropriate training and instruction.
Department Heads /Unit Managers / Supervisors
- Identify violence and aggression risks in your work area.
- Ensure compliance with occupational violence policies and procedures.
- Encourage staff to report all incidents of occupational violence and aggression through VHIMS.
- Investigate all incidents of occupational violence and aggression including risk controls.
- Promote a culture that does not accept violence and aggression.
Emergency Management and Planning Manager
and maintain Code Grey/Code Black response capability at RCH in collaboration
with the Clinical Nurse Consultant – Aggression Management/Code Grey
Aggression Management/ Code Grey Coordinator
- Coordinate and manage response to occupational violence during business hours (After hours response managed by After Hours Hospital Manager).
- Oversight of all incidents of occupational
violence and initiates appropriate follow-up and investigation (as per critical incident review procedure).
The RCH’s management of clinical aggression training.
incident review following code black incidents.
- Coordinate a multi-disciplinary
team debrief post OVA incidents to improve the measures taken to reduce the
likelihood of aggression
- To ensure systems and procedures are established and implemented to effectively provide a proactive means of preventing and reducing incidents of workplace aggression and violence.
- To provide guidance on hospital wide risks and means for control.
- To ensure that systems of harm reduction post event (EAP and trauma counselling) are made available to all staff exposed to occupational violence.
- To support staff suffering injury/illness post event.
Comply with this procedure and RCH Emergency procedures.
- Participate in training in the management of violence and aggression in the workplace.
- Report all incidents and potential incidents of violence and aggression via VHIMS .
4. Procedure details
Risk Identification and Assessment
of occupational violence will be reported in accord with the Incident, Injury and Hazard Reporting procedure procedure
of occupational violence will be managed in accordance with the Emergency
Grey and Code Black
incidents of aggression and violence with patients or families, a
security alert on the Electronic Medical Record (EMR) should be considered.
- The establishment of an ongoing management plan for all patients/families exhibiting aggressive/violent behaviour.
- This plan will be reviewed and modified regularly in order to implement appropriate risk control measures.
- This plan should be developed by the lead clinician/ treating team for the patient, in collaboration with the Clinical Nurse Consultant - Aggression Management (Code Grey Co-ordinator) as required.
system to reduce harm resulting from exposure to occupational violence
will be available to all staff. This may include EAP
and other internal or external services i.e. Critical Incident Debrief, Restorative Review
police are involved, appropriate RCH hospital management will be notified
Reporting an assault or threat
to the police
In circumstances where an
employee has been assaulted or threatened, employees are entitled to make a
formal report of the incident to Victoria Police.
RCH takes a zero tolerance
approach to Occupation Violence and does not believe that being assaulted or
threatened is part of the job. There is specific legislation that relates to
protecting hospital staff from assaults. The legislation treats threats to kill
or inflict serious injury seriously which carries the risk of imprisonment for
between 5 – 10 years. A mental illness does not exclude a person from being
interviewed and/or being charged by the police with a criminal offence.
To make a report to the
police, employees are not expected to request permission from the hospital
prior to making a report. RCH does however recommend that employees discuss
their intentions with their managers prior to making a report so that all
relevant information is presented and the employee is given the support they
require. To make a report to the police, employees may report an assault by
attending North Melbourne Police Station. The police will need the following
sort of information:
- Your name
- Contact details
- The parties involved in an incident
- Details of the nature of the incident
The level of injury
5. Related Policies and Procedures
Incident Review Process
of Reference - Aggression and Violence Prevention Committee
Safe and Positive Workplace Behaviours
Incident, Injury and Hazard Reporting
Behavioural Assessment Room EBAR
Restorative Review Toolkit
behavioural disturbance: Acute management Acute
behavioural disturbance: code grey
Victorian Government Department of Human Services (Final
Report): Victorian taskforce on violence in nursing 2005
WorkSafe Guidebook: Prevention
and management violence and aggression in health services
DHHS Organisational framework: Framework
for preventing and managing occupational violence and aggression
ANMF New guide for health services to create safe
workplaces: 10-Point Plan to End Violence and Aggression: A Guide for Health