Bill summary: SHB 1931 - Workplace Violence in Health Care

In 2019, Washington State Nurses Associ­a­tion collab­o­rated with health care stake­holders on a bill to address violence in the workplace. The bill passed both houses of the state legis­la­ture unani­mously and was signed into law. It updates our state’s workplace violence in health care statute to provide more speci­ficity about what hospi­tals must include in their required workplace violence preven­tion plans, requires those plans to be updated every three years, with an annual review of any violent incidents informing that plan. This bill also updates training require­ments to ensure all hospi­tals provide quality, hands-on training.

Substi­tute House Bill 1931 passed the legis­la­ture on April 15, 2019 and went effect January 1, 2020.

The bill updates provi­sions related to workplace violence preven­tion planning and training in Washington’s workplace violence in health care law. Details related to each section are below.

(Read the full text of the bill passed by the Legis­la­ture.)

Definition

1. The previous defin­i­tion of workplace violence in RCW 49.19 is ​“any physical assault or verbal threat of physical assault against an employee of a health care setting.”
2. That defin­i­tion is now expanded to include involve­ment of a weapon, including a firearm or a common object used as a weapon, regard­less whether the use of a weapon results in an injury.

Workplace violence prevention plans

1. Prior to this bill, hospi­tals were required to conduct a security and safety assess­ment and to develop and imple­ment a workplace violence preven­tion plan, but the law did not specify how frequently this plan must be updated nor did it specify how incidents of violence might inform the plan – so having a workplace violence preven­tion plan that was drafted five, ten, or even 20 years ago would have met the letter of the law.
2. Previous law also did not specify who in the hospital was respon­sible for devel­oping and imple­menting the workplace violence preven­tion plan.
3. The new law adds the following:
   1. A health care facility must update its workplace violence preven­tion plan every three years and must conduct an annual review of incidents and make any neces­sary adjust­ments to the plan based on that review.
   2. Either the Safety Committee or Workplace Violence Preven­tion Committee will be respon­sible for devel­oping, imple­menting, and monitoring progress on the plan, and that these commit­tees must be made up of 50% employer-selected and 50% employee-selected representatives.
   3. The workplace violence preven­tion plan may include but is not limited to: physical attrib­utes of the setting (including security, alarms, etc.), staffing patterns, job design and facil­i­ties, first aid and emergency proce­dures, employee educa­tion and training require­ments, processes and expected inter­ven­tions to provide assis­tance to an affected employee when a violent incident occurs, and the reporting of violent acts.
   4. In devel­op­ment of the plan, the health care setting shall consider workplace violence guide­lines from appro­priate state and federal agencies (listed in bill).

Workplace violence prevention training

1. Under previous law, workplace violence training lacked unifor­mity in Washington state – varying greatly from facility to facility. Some facil­i­ties required hands-on training that includes self-defense, while others used an online training system that allows an employee to ​“pre-test” out of the training.
2. Previous law required health care facil­i­ties to provide workplace violence training within 90 days of initial hire but carried no require­ment for ongoing training.
3. The new law adds the following:
   1. Training must be provided to applic­able employees, contracted security personnel and volun­teers as deter­mined by the workplace violence preven­tion plan.
   2. The method and frequency of train­ings shall be deter­mined by the workplace violence preven­tion plan.
   3. Topics that must be addressed in the training are listed in the bill and includes de-escala­tion strate­gies, strate­gies to preven­tion physical harm with hands-on practice or role play, violence predicting behav­iors and factors, proper appli­ca­tion of restraints, documen­ta­tion and reporting of incidents, the debrief process for affected employees following an incident, and resources avail­able to employees for coping with the effects of violence.

Record keeping

1. No substan­tive changes were made to this section.
2. Requires health care facil­i­ties to keep a record of each violent event on file for at least five years and outlines what elements must be included in that report.

Effective date

The bill took effect January 1, 2020.