Allan Ridings

Allan Ridings is a senior risk management & patient safety specialist at the Cooperative of American Physicians, Inc. He has more than 25 years of experience in risk management and health care operations. He can be reached at aridings@capphysicians.com.

Risk Insider: Allan Ridings

Protecting Health Care Workers From Violence

By: | February 20, 2015 • 3 min read
Allan Ridings is a senior risk management & patient safety specialist at the Cooperative of American Physicians, Inc. He has more than 25 years of experience in risk management and health care operations. He can be reached at aridings@capphysicians.com.

Most of us have seen it happen to a colleague or been on the receiving end of abuse from an upset patient, family member or some other individual. Inevitably, we ask ourselves the following questions:

  • What happened and how did it escalate to this level?
  • Was it something I did?
  • Was it something another physician or caregiver did or didn’t do?
  • What signs did I miss?
  • How can I be more observant and prepare for this in the future?

I’m talking about workplace violence in health care settings.

Workplace violence is considered any act or threat of physical violence, verbal harassment, intimidation or other disorderly behavior. These actions are often stressful, frustrating and can be physically harmful.

Many state Occupational Safety and Health Administration (OSHA) departments believe that a well-written and implemented workplace violence prevention program, with top-down guidance and staff training can reduce workplace violence.

It is essential that all workers understand the policy and know that all allegations of workplace violence will be investigated and remedied promptly.

Health care workers face an increased risk of work-related assaults stemming from several factors. Some include:

  • Patient frustration over service delays.
  • Burglaries of drugs or money from health care offices.
  • A growing proximity of gang members, addicts, or distraught family members to patients.
  • A growing frequency of weapons possession.
  • Fluctuations in staffing levels. Some attacks happen when staff is on a meal break or attending to other patients.
  • A lack of staff training in recognizing and managing escalating types of violent behavior.

The risk of assault can be minimized or prevented if employers take appropriate precautions. One of the best protections that can be offered to health care workers is for their workplace to establish a zero tolerance policy toward any workplace violence. The policy must cover all workers, patients, clients, visitors and anyone else who may come in contact with personnel of the facility.

Having a zero-tolerance policy can assist staff members with common situations that may arise. Staff should be well-versed in conflict resolution during stressful situations. This will require training. Some of these policies should incorporate:

  • A written program for workplace violence, safety and security that should be incorporated into the office safety and health program.
  • Clear goals and objectives to prevent workplace violence that should be adaptable to specific situations in each department or location.
  • Responsibility for the program with individuals or teams through appropriate training and skills.
  • Adequate resources for this effort and the team.
  • A patient acknowledgment of “rights and responsibilities” including the facility’s zero-tolerance policy as it relates to verbal or physical abuse towards all staff, patients, or visitors.

A well-prepared workplace violence policy is a crucial and essential component of workplace safety. With this in place, educated staff members can evaluate and recognize potentially threatening situations and feel comfortable knowing they have the tools and the administrative support to professionally take control of a situation, if necessary. Some of these methods also provide employees with adaptable strengths to maintain safe working conditions, improve morale, safety and effectiveness.

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Risk Insider: Allan Ridings

Do You Know if Your Electronic Communications are HIPAA Secure?

By: | August 19, 2014 • 2 min read
Allan Ridings is a senior risk management & patient safety specialist at the Cooperative of American Physicians, Inc. He has more than 25 years of experience in risk management and health care operations. He can be reached at aridings@capphysicians.com.

As ubiquitous as text messaging is, many wonder why doctors can’t freely text with their patients. But regulators are clear on this. Text messaging is too vulnerable to information theft to be used unguarded in provider-patient communication.

The responsibility to secure medical information is clearly outlined and enforced by the Health Insurance Portability and Accountability Act or HIPAA.

In order to manage the risk of new forms of electronic communication, there are specific rules for health care professionals to follow when using text messaging and email as provided by the Centers for Medicare and Medicaid Services Office for Civil Rights (ORC).

Below are best practices regarding electronic messaging of patient information.

What’s the importance of security and encryption in relation to text messaging in health care?

The Joint Commission states that in addition to its violations of HIPAA, unencrypted text messaging provides no way to verify the identity of the person sending the message or to retain the information sent and validate it as part of the medical record.

What is unencrypted text messaging?

Traditional Short Messaging Service (SMS) messaging is transmitted over non-secure and noncompliant networks. The majority of traditional SMS messages are delivered as mobile phone to mobile phone messages; however SMS messages are also delivered via other electronic technologies, which also fall under HIPAA governance:

• Email to mobile phone number

• Mobile number to an email address

• Phone number to alphanumeric pager

• Email to alphanumeric pager

So how do medical professionals text or email information to and from colleagues and patients in a secured encrypted network?

HIPAA requires that a covered entity be in accordance with §164.306 and implement a mechanism to encrypt and decrypt electronic protected health information. (45 CFR § 164.312(a) (2) (iv)). It is also required to implement the Advanced Encryption Standard (AES) encryption protocol system with either 128-bit or 256-bit encryption.

Your company or office IT and telecommunications department needs to ensure compliance with the above encryption standards.

What are the benefits of these encrypted / secured services?

Once the physician or medical office has implemented an encrypted mechanism, the sending and receiving of instant information, patient health issues, reports, and referrals as well as communicating with peers, will all be transmitted in secure, protected environments.

Are there any limits when using SMS?

Yes, there is a strict limit of 160 on the number of characters allowed to be sent. Only the first 160 characters will be sent from an email message to a mobile phone and from a mobile phone to an email user. To avoid misunderstandings, it is recommended that caregivers use approved abbreviations when communicating peer-to-peer.

Does your IT department need to make changes to your smart phones or devices?

Yes, your IT team must enable remote access capabilities on your smart phone, so that you can erase (scrub) all the data from it if it is lost or stolen; and you must keep a record of this loss or theft of your smart phone for auditing purposes.

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