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 colleagues 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 (including Security/Police) 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©


  • Short survey completed by colleagues.
  • Provides valuable information from colleagues about how safe they feel, what they believe is working and not working and what violence they have experienced over a specified period of time.

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
  • HARP™ Authorized Trainer Program
  • Workplace violence metrics are monitored to quantify training effectiveness and identify changes necessary
  • Reduces risk and controls liability for your colleagues and hospital/health system
  • Utilizes known neurological processes in moving training material/skills from short-term to long-term memory
    • Reduces need for future classroom training time
    • Improves response time in reasonably managing all levels of aggressive cues and behavior within the critical seconds of an incident
    • Strengthens colleague competency and feeling of safety
    • Improves colleague morale and loyalty


The culture of a hospital (including ambulatory services) is unique.  We already know that achieving and sustaining improvements in workplace violence require that you do some things differently than you’ve ever done before. It is one of the main reasons we built our hospital workplace violence team with FORMER HOSPITAL COLLEAGUES.  This uniquely positions us to provide workplace violence program consulting and evidence-based training (research and metrics) at the level required to truly achieve and sustain improvements in the aggression and violence landscape you and your colleagues face today.

OUR HOSPITAL WORKPLACE VIOLENCE TEAM IS HERE FOR YOU.  The expertise of our executive team includes (years as former hospital colleague):

  • President/CEO – former Pharmacy Tech (6 years)
  • Vice President of Operations – former Human Resources executive (34 years)
  • Vice President of Hospital Workplace Violence – Psychologist (PsyD); former Materials Management and Accounts Payable colleague (8 years)
  • Hospital Security Director – former Hospital Network Director, Safety and Police (4 years)
  • Behavioral Health Director – former Psych RN, ED and other areas (40 years); creator of Behavioral Emergency Response Team (BERT); research – 9
  • Hospital Specialist – Registered Nurse (MSN) (43 years), former Director of ED, ICU and Informatics; research – 2


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

Trauma changes the structure of the brain.  Changes in the structure cause changes in the brain’s function, leading many to experience PTSD symptoms.  According to research, 12% to 20% of all nurses who have been assaulted have at least one symptom of PTSD up to full PTSD, reducing the safety of colleagues and patients. This means that in an emergency department of 100 nurses, up to 20 of your nurses have some level of PTSD.

The incidence of workplace violence most hospitals are experiencing does not have to continue. Together, we can achieve, and sustain, the necessary improvement needed to increase the safety of your colleagues.  As we know, colleague safety equals patient safety!

    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. Colleagues do not feel safe.
  2. Staff members feel current training no longer prepares them to successfully manage the workplace violence they experience today.
  3. Afraid colleagues will be severely injured by a patient or visitor aggressive incident.
  4. Unaware of the gaps within their workplace violence program that are responsible for continued assaults and injuries.
  5. Security and clinical response to aggressive incident is not integrated. 
  6. Unsure of how to educate colleagues on how their behavior triggers and/or escalates aggression in patients and others.
  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 15-minute conversation.  After asking and answering each other’s questions, you’ll know if it makes sense to talk further.  It may not.  At least you’ll know.  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