1824 – The first documented assault on a nurse.

Today, achieving – and sustaining – improvements in healthcare workplace violence require that we do some things differently than we have ever done before.

In fact, doing things differently is THE driving force behind improving workplace violence metrics and increasing the safety of our healthcare providers and patients.

To prevent assaults on your hospital staff, you may have:
  • A Workplace Violence Committee/Task Force
  • A Workplace Violence Policy (Zero Tolerance)
  • Security/Police
  • De-escalation Training
  • Panic Buttons
  • Code Response Teams
  • A Process to Flag Aggressive Patients
  • Metal Detectors
  • And, more…

Yet, assaults on your staff continue.  Even more alarming, they are being injured physically, psychologically and physiologically from patient and visitor assaults.

Why is this?

One word – GAPS.  Gaps in your workplace violence program policies, processes, training and culture are responsible for almost all workplace violence incidents and injuries.

Hospital Workplace Violence Program Protocol©

Eight years ago, our initial 10-month investigation into the annual increases in healthcare workplace violence uncovered fundamental gaps in hospital workplace violence programs. This work led us to create the components of our Protocol.  Each component is effective on its own.  Together, they provide you with a comprehensive workplace violence program – a program that becomes integrated into your daily culture of safety.  All components are applicable to acute care and ambulatory services.

Our expertise as risk managers and former hospital employees, along with our continual analysis of current healthcare workplace violence research and hospital client experiences, provide you with the most current evidence-based best practices and guidance.

  • Three Main Components
    1. Comprehensive Workplace Violence Program Gap Analysis
    2. Colleague Assault Survey
    3. HARP™ – Hospital Assault Response and Prevention Training©

Comprehensive Workplace violence program gap analysis

  • An analysis is performed to identify gaps in your workplace violence program. Policies and processes are thoroughly reviewed.
  • Gaps identified, along with recommendations on how to close those gaps, are provided to you.
  • Action plans to close gaps are created from the recommendations.
  • Workplace violence metrics are monitored as gaps are closed.


  • Hospital-specific, including the ambulatory services you provide
  • Combines OSHA, Joint Commission and Cal/OSHA requirements and recommendations for healthcare workplace violence training
  • Authorized HARP™ Trainer Program
  • On-site, virtual and hybrid training
  • Workplace violence metrics are monitored to quantify training effectiveness and identify changes necessary
  • Designed by a psychologist and risk managers with over 50 years of combined hospital experience
  • Controls liability for your staff and hospital/health system
  • Utilizes known neurological processes in moving training material/skills from short-term to long-term memory
    • Reduces future classroom training time
    • Improves response time in reasonably responding to all levels of aggressive cues – critical in the 1-10+ seconds of an incident
    • Improves staff preparedness, competency and feeling of safety
  • Reduces the overall number of assault incidents
  • Recuces your assault injury rate (AIR) and OSHA recordables
  • Minimizes the severity of injuries unable to be prevented


​ED nurses assaulted by patients experience symptoms of PTSD, negative stress and decreased work productivity. When nurses and other staff are fearful of being assaulted, they have difficulty concentrating on their work and patients. This can affect employee safety and compromise patient care (medication errors, patient infection and increased LOS). (Gates, Gillespie and Succop, 2011).

When it comes to PTSD, 12% to 20% of all nurses who have been assaulted have at least one symptom of PTSD up to full PTSD. Further, assaults change the structure and function of the healthcare provider’s brain, affecting the hippocampus, amygdala and medial prefrontal cortex. Assaults are difficult on all involved, even when physical injury is absent. When present, the physical, psychological and physiological injuries can be far-reaching and long-lasting. Additionally, nurses and staff contemplate leaving the hospital or the profession after being assaulted. This can lead to staff shortages along with numerous other direct and indirect costs to the employees, patients and hospital. This trend does not have to continue. Together, our consulting and training can help greatly reduce assaults on staff and minimize the consequences of assaults!

SPECT (Single Photon Emission Computed Tomography) Image Courtesy of Amen Clinics.

What our healthcare providers are saying

  • The years of experience and knowledge of WPV in hospitals is evident. KLA Risk was instrumental in helping us quickly find the gaps in our WPV program. KLA worked with us to set WPV reduction goals. Their training was well-received and absolutely closed the gaps for our staff.

  • This training should be hospital-wide.

    ER Nurse

  • The techniques and information will be a great benefit to me in behavioral health.

    Behavioral health nurse

  • This training helps to prepare you for what to do when de-escalation techniques have failed or you don't even have time to attempt them.

    ER Nurse

  • Was a very interesting training. It kept my attention and I feel like I was able to learn a lot!

    ER Nurse


KLA Risk provides consulting and training nationwide


  1. Afraid a staff member will be severly injured by a patient or visitor assault incident
  2. Staff members feel current training no longer prepares them to succesfully manage the workplace violence they experience today
  3. Workplace violence metrics are still too high
  4. Staff members do not feel safe
  5. Concerned that unidentified gaps within their workplace violence program are responsible for continued assaults
  6. Are not clear about what more is needed to improve workplace violence metrics (reporting, assault injury rates, OSHA recordables, etc.)
  7. Nervous that a staff member will use excessive force in responding to a patient or visitor assault

Take the next step.  Connect with Dr. Kelly Austin for a 10-15 minute conversation.  After you ask and answer each other’s questions, you’ll know if it makes sense to talk further.  Complete the form below, call or send an e-mail.  Dr. Austin will contact you to schedule a time to connect.


Vice President/Senior Risk Manager

Phone: 866.537.7775, ext. 3

Mobile: 949.929.6404