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"We'd rather invest the time and find out it was a waste of time rather than say, Oh, the chances are this person was just venting. We have to ask ourselves, Are we gonna be able to sleep if we turn this case away?"


Keeping Threateners at Bay
Team approach. Hopkins Hospital, University and Health System have set up a step-by-step protocol to prevent and deal with violence in the workplace.

With the stress you're already handling at work, the last thing you need is fear of being attacked on the job.

Some employers simply deny that assaults ever occur on their turf. But Hopkins Hospital and University take the issue so seriously that they want you to tell them if an incident happens. Furthermore, they've created specific protocols for dealing with workplace violence, beginning with a far broader definition than a "disgruntled" employee "going postal."

Verbal threats, intimidating gestures, someone getting in your face-all are actions Hopkins considers part of the spectrum of workplace violence. Not only do heated voices or shaking fists unnerve the person on the receiving end, they can escalate. In 1996, after the close-knit friendship of Hopkins University students Rex Chao and Robert Harwood started to unravel, Harwood began pestering Chao with e-mails and up to 20 phone calls per day. Then, the unthinkable happened. Following a meeting where Chao was elected chairman of Hopkins' College Republicans, Harwood shot his former friend, first in the head and then in the chest.

Chao's murder stunned the entire Hopkins community. But even before that tragedy occurred, says Alfreda Hanna, Hopkins Hospital employee relations advisor, hospital administrators had noted national statistics showing a high incidence of violence in the health care workplace and took a close look at the voluntary guidelines the Occupational Safety and Health Administration issued in 1995 to deal with it.

"A lot has changed in the last decade," says Clifton Scott, director of employee and labor relations for Hopkins Hospital. "Everyone's thinking more about what we're hearing and reading in the news. Employees need to feel secure. If someone says, A co-worker threatened me, we investigate that. We've had a process in place for more than five years."

Scott and Hanna are members of Hopkins Hospital's Risk Assessment Team (the University has formed one as well), a group that, besides human resources, includes representatives from security, the legal department and the Faculty and Staff Assistance Program. They examine every situation that's brought to them, then recommend next steps to decision makers in the department involved.

About once a week, an allegation reaches the team, says Scott. Most often, it's a perceived verbal threat between peers. Issues tend to be work-related, and pecking order is a frequent ingredient. "A common theme," says team member Michael Heitt, associate director of FASAP, "is an employee who refuses to carry out a supervisor's order, then knocks something off the desk on the way out, or maybe turns away muttering, 'I could kill you'."

Still, the group members emphasize, statistics don't really tell the story. And as every parent who's disciplined combative siblings knows, the one who lashes out may not be the only one at fault. "There's always a twist," says Margaret Garrett, senior legal counsel for the Health System. "Evaluation on both sides is common. And it happens at every level-from administration on down. We've terminated support staff, supervisors, nurses, physicians."

But before the team members can reach any conclusions, they need information. Besides interviewing witnesses and doing criminal background investigations, the security department steps in to physically separate the individuals, if necessary, and make sure everyone in the area is safe and protected.

"We'll provide a walking escort, set up a different parking arrangement-whatever the concerns are, we try to provide service," says Ruth LaFontaine, Hopkins Hospital security director.

Among the threats of particular concern is domestic violence that spills over into the workplace.

"If an individual has a protective order and gives us a copy of it and a photograph of the person," says LaFontaine, "we can alert all entrances. Our investigators will even accompany staff members to court and walk them through the process to get what they need."

Another key element in evaluating each situation comes from the Faculty and Staff Assistance Program, which does an in-depth psychological evaluation of one or both parties. Drugs or psychiatric impairment can be factors. So can love relationships gone sour, or a personal crisis like a divorce or death in the family.

"We ask about everything-relationships, employment history, physical and emotional health issues," says Michael Heitt. "We try to maintain confidentiality as much as possible, and preserve as many rights as possible, but our primary goal is to assess, minimize and manage risk, to both employees and to the organization. We don't want a hostile work environment. We also don't want someone suing because they feel harassed. That's why legal, security and human resources are part of the team."

During the fact-gathering phase, interim decisions can include suspending one or both of the employees involved, or having them work separate shifts or in different locations. When the Risk Assessment Team meets to examine overall findings, conclusions can run the gamut from a determination that nothing happened to a recommendation that both people be discharged.

"In between," says Clifton Scott, "there is a whole range of disciplines-individual or group counseling, anger management, leave of absence, team building when there are issues in the employees' department."

Some cases turn out to be crystal clear, say team members, while others come down to "she said, she said." Even so, says Heitt, "We'd rather invest the time and find out it was a waste of time rather than say, Oh, chances are this person was just venting. We have to ask ourselves, Are we gonna be able to sleep if we turn this case away? Hopkins is a safer place, partially as a result of this committee. We've prevented things from escalating in many situations. We like to retain employees whenever possible, but there are times when there's no escaping dismissal."

"We do a lot of discussion to determine the best course of action for the individual and the institution," says LaFontaine. "We put a lot of thought into our recommendations, and we're very honest about them with administrators and managers."

Though the recommendations aren't binding-some supervisors choose a different course of action-just having the input of the Risk Assessment Team can be important. "I have felt like an island, trying to make these decisions by myself," says Jim Creech, clinical services administrator in the Department of Pathology. "Putting together a case against an employee is not pleasant. I dread these things with a passion. But I think the committee treats both parties fairly. There is comfort in having that expertise and that overall concern to do the right thing for both the employee and the institution."

-Mary Ann Ayd

Where to Turn for Help

If you see physically violent behavior or feel the threat of violence is imminent
  Call security, 410-955-4444, or 911
To initiate a Risk Assessment
Call the Faculty and Staff Assistance Program, 410-955-1220
Call the Human Resources, Employee/Labor Relations Office, 410-955-6783
Call the Corporate Security Services Office, 410-955-5585
    Call the Legal/Risk Management Office, 410-955-7949
To read Hopkins Hospital's Workplace Anti-Violence Policy
    See the Human Resources Policy and Procedure Manual or the new Employee Handbook.
For the complete Risk Assessment Team protocol
    Go to


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