A Strategy for Violence Reduction

As a society we must move away from focusing on ‘problem individuals’ to organisational approaches in violence risk management, consistent with the World Health Organisation Public Health Model:

  • Primary Controls: Which focus on proactive approaches to reducing conflict and risk
  • Secondary Controls: Equipping staff with the knowledge and skills to defuse and resolve conflict before it escalates further
  • Tertiary Controls: Emergency responses and procedures to prevent harm and which may in some settings include use of physical interventions 

Much is common sense, first we need to understand where the problems lie and their causes, and then focus our efforts on how understanding these can be prevented. This can involve reducing conflict flashpoints by delivering a positive and professional service and reducing exposure to risk through safer working practices and procedures. A violent incident can generate much emotion and pressure for reactive measures such as PPE before we have really understood the problem and first addressed primary and secondary controls.

We may still have to deal with people in difficult circumstances that are not of our making and need therefore to develop staff knowledge and skills to assess risk and defuse and resolve conflicts that arise. Training plays a key role here but is just one strategy within a multi element model. Maybo has developed the ‘8 Element Model’ violence reduction model to illustrate this (pictured).

This multi element model operates at different levels and across various functions in an organisation and part of the challenge is how to co-ordinate this. In our experience, this is easier where there is a single owner of the ‘project’ with sufficient authority and who works with accountable functional representatives. Although HR, Training and Security functions have key roles to play the natural home for this area of risk reduction in most organisations is Health & Safety.

Leadership

Leadership must demonstrate a clear commitment to any violence risk reduction strategy, with close monitoring of progress against desired goals and outcomes. Inputs such as training are important but leaders need to focus on tangible outcomes and best value, especially in the current economic climate.

Reliable information is the key to understanding the nature and extent of the problem and to measuring progress. This can include data and risk analysis along with qualitative surveys of staff confidence and perceived capability and challenges to positive interactions with service users and key stakeholders.

Staffing and Supervision

Staffing and supervision is critical at a local level to ensure policy and training are put into practice and staff behaviours are monitored. This can include ensuring lone working procedures are followed and that staff are using the available resources effectively to improve the safety and well-being of everyone they interact with.

In settings where staff need to be trained in restraint (a ‘tertiary’ control) it is important that we also target a reduction in or, where practicable, an elimination of, restraints. i.e. We need to do more than just teach safer methods. Such activity carries risk for all involved and raises significant safeguarding issues where restraint is used excessively or inappropriately. Recruiting the right staff and effective supervision is critical as training will not fix counter-productive attitudes or culture.

Environment

Some work environments can be controlled easier than others, for example, we can have a reasonable level of control on a building or fixed site, but little control over the environment our remote lone workers operate in. Fortunately, improving technology brings a greater range of safety and communication devices to support those working alone and remotely, but whilst these are an important part of the 'cure', more is needed to 'prevent'.

Layout, design, access control and security measures can all influence levels of conflict and risk and as an example, when the much abused ticket checkers at London Waterloo railway station were replaced by an automated barrier system, levels of conflict and abuse significantly reduced. It is not however always possible or appropriate to simply reduce the frequency of staff interaction with service users and this can occasionally have the opposite effect.

Perhaps counter-intuitively, many organisations we support have achieved positive results by increasing the frequency and proximity of staff interactions with service users, in some cases literally by removing physical barriers such as protective screens and in many cases, simply by creating more welcoming, people-orientated environments.

Working Practices

Some health and safety practitioners often struggle with violence risk assessment. Violence is a complex risk to manage with many obvious and less-obvious contributing factors. It often helps to think in terms of risk behaviours presented by staff and service users and working practices, such as the tasks and activities they perform that increase exposure to risk.

Through this approach and by actively consulting with staff we are more likely to identify safer practices, relevant scenarios to cover in staff training and a broad collection of inter-dependent initiatives that will combine to help us achieve a real, lasting change.

Training

Training has advanced considerably as developments in learning technologies provide greater flexibility to deliver, support and refresh learning in the workplace. A blended learning approach can work well with awareness/induction level training and underpinning knowledge being delivered through self-study such as eLearning, with the addition of practically based courses for key risk groups needing to develop further skills and confidence.

A blended approach allows organisations to get more from their budgets and to focus resources where they are most needed. The ‘sheep dip’ approach that gives everyone the same one-day of training can be over generic and wasteful; some roles need additional and/or more focused training and others need only basic awareness input that can be achieved through good eLearning.

The organisations we support that have achieved the greatest value from eLearning are those that have not treated it as a substitute for face-to-face training, but instead as a means to develop basic understanding and awareness in lower-risk roles who previously didn't receive any training in this area, as a means of delivering regular refresher training in the workplace between formal training courses and as a complimentary learning method for in-person training.

Learning Culture

Training efficacy is directly dependent on a positive learning culture in an organization. We have seen time and time again how the attitudes of staff, their line managers and senior management to 'training' makes such a difference to the value the organisation subsequently draws from any training investment.

A positive, progressive learning culture is about more than training; for example, in an organization with a positive learning culture, staff are more likely to report incidents of workplace violence or any concerns or ideas I they may have. Confidence the organization will 'listen' and 'act' on the insight from their experiences rather than ignore, or in some cases, punish them for sharing is an essential condition for achieving lasting workplace change. 

Service and Engagement

Service and engagement standards impact both the frequency and severity (aka 'Risk') of conflict and challenging behaviours. How well we keep our service users informed through people-orientated systems and processes is a simple example. At a local level, staff attitudes and positive communication skills will be a big factor in both reducing the occurrence of conflict in the first place and in resolving it professionally and effectively when it does occur.

Data Analysis

And finally, data analysis. By properly collecting, recording and analysing incident data it is possible to identify trends and focus resources, training and other interventions where they are most needed and will be most effective, as well as to identify common flash-points and risk behaviours that may be preventable through changes to policies, processes or practice. Monitoring this data over time also providers a valuable indicator of the success of our efforts to reduce workplace violence risks. 

 

In summary, we will be more effective in reducing the risk of workplace violence if we take the time to truly understand their nature, extent and causes, and focus on desired ‘outcomes’ rather than seductive inputs and simple, isolated ‘solutions’. Better still, the organisation-wide multi-element approach brings wider benefits in terms of service delivery and in promoting positive, collaborative relationships and interactions between staff and service users.

 


Posted by Maybo on January 5, 2018

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