OR Manager - May 2019 - 31
AMBULATORY
SURGERY CENTERS
Education is everything
Venturella conducts his active shooter
mass casualty incident training in three
parts. His team does an initial evaluation
at the facility to determine any vulnerabilities
and assess where the most
common threats may arise in order to
recommend a plan.
The next step is education. Most facilities
have some kind of plan, but education
is critical and must be followed
by training that covers everything from
prevention to response.
If people aren't properly trained, the
response plan is not going to have an
impact on their ability to survive an attack,
Venturella says. " Even in some of
the bigger hospitals, not everyone quite
understands their role in the event of an
emergency. "
There are many inconsistencies.
Some staff members are unsure of
what actions should be taken, whereas
others have a basic understanding
but fill in the holes with whatever plan
they've created in their minds.
The last piece is to carry out the
training, where people gain an understanding
of what this looks like in their
environment and what they need to do.
Prevention-identifying behavior
before it happens-is what Venturella
strives for in his training of facility staff.
This involves educating people to be
aware of their surroundings and to look
for suspicious people, vehicles, and
items. " If someone is approaching the
facility with a gun, sounding an alarm
can save lives. "
Surgical facilities that want to ramp
up on security and violence prevention
should be proactive about it, says Venturella.
" Any ASC worker who thinks
there's value in having this type of
training should express that to facility
managers and/or leadership to get the
proper security they need. "
Retraining through redirection
At UPMC, hospital and system leadership
have been very responsive to North
Surgery Center's concerns about acwww.ormanager.com
tive
shooters and what they see on the
news. All of its departments have been
asked to do crisis management training,
which teaches de-escalation and interaction
techniques. Training has been
open to leadership as well as primary
care practitioners and nursing.
The ASC has also gained some
knowledge through its hospital emergency
preparedness group. It's not
always apparent where to look for resources
on workplace violence prevention,
says Dickman. Sometimes people
don't know where to start. " We recently
had two staff members at the surgery
center join that group to give us better
ties to resources [in the community] " ,
she says.
Very often, staff feel out of their
depth with assessing these types of
situations, Dickman says. " Nurses are
good at physical assessments and talking
with patients, but they're not always
sure if they should escalate something
they hear on a phone call. " They don't
want to be alarmists, but they also
don't want to miss something.
One strategy is to redirect the conversation
and remind a parent that his
or her child is having surgery. It's important
to ask: Is there anything that will interfere
with our ability to provide a safe
outcome and experience for your child
the day of surgery? With children, the
stakes and emotions are high, and the
stress response takes over sometimes,
Dickman notes.
The power in a cup of coffee
There's a delicacy in handling a patient
who is growing agitated because of a
long wait time to see a physician. In
these scenarios, it's important to exercise
common sense and remain calm-
no matter what the person is saying,
Donlon advises.
" You tell them, 'I'm terribly sorry, I
can find out how much longer you have
to wait. Can I get you a cup of coffee
or water?' A cup of coffee goes a long
way, especially if you ask them what
they want in their coffee. You offer that
hand of assistance, " Donlon says.
Employees at the Center for Advanced
Medicine are trained to inform
a supervisor if a situation appears to be
escalating. Donlon says there are times
when he steps in. " I tell the staff, 'let
me give it a try.' When I show up, things
always seem to calm down, " he says.
Leadership should also remain cognizant
of the emotional pulse within their
facilities. It's not enough to check a
box and say " we did workplace violence
training, " Myburgh says. If an incident
occurred, everyone should get together,
talk about it, and discuss ways to prevent
such incidents in the future.
Staff may be facing their own potential
domestic violence situations
at home. " People don't want to bring
that shame to the workplace. But
they need to overcome that. Leadership
needs to establish venues where
people feel comfortable talking about
these situations, " Myburgh says. Staff
in need of help should receive counseling
about safe spaces and a possible
exit plan.
" Look out for each other, " she advises.
No one should have to sort this
out for themselves. ✥
Jennifer Lubell is a healthcare writer
based in Rockville, Maryland.
References
DeJohn P. Fatal attacks at ASCs
spur stronger safety measures.
OR Manager. 2016;32(8):28-31.
https://www.ormanager.com/fatalattacks-ascs-spur-stronger-safetymeasures/.
https://www.bls.gov/iif/oshwc/cfoi/
cftb0314.htm.
https://www.bls.gov/iif/oshwc/osh/
case/cd_r4_2017.htm.
Joint
Commission. Sentinel Event
Alert. April 17, 2018. https://
www.jointcommission.org/assets/1/18/SEA_59_Workplace_violence_4_13_18_FINAL.pdf.
https://www.stealthsecurityconsulting.com.
OR
Manager | May 2019
31
https://www.ormanager.com/fatal
https://www.bls.gov/iif/oshwc/cfoi/
https://www.bls.gov/iif/oshwc/osh/
http://https://
http://www.jointcommission.org/as
https://www.stealthsecurityconsulting.com
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