When it comes to occurrences of home health workplace violence, there is a major disconnect between the number of incidents and the number of reported incidents.

That’s one of the key takeaways from a recent study published in Home Healthcare Now. Researchers found that 57% of home health workers have experienced physical violence while working at their current agency – and that a culture shift is needed to increase reporting.

As part of the study, University of Cincinnati researchers utilized a cross-sectional survey. Home health workers employed by seven Ohio and Oregon-based home health agencies completed questionnaires about their knowledge of the organizations’ policies, workplace violence procedures, as well as their experiences involving these incidents.

The participating agencies included two small agencies consisting of 25 to 100 employees, and five mid-size agencies with 100 to 500 employees.

The Occupational Safety and Health Administration (OSHA) describes workplace violence as “any act or threat of physical violence, harassment, intimidation, or other threatening disruptive behavior that occurs at the worksite.” Broadly, this can mean anything from verbal threats and abuse to physical or sexual assault.

The study found that 37% of home health workers experienced either instances of verbal or emotional violence on a daily basis. Plus, 20% of workers experienced monthly occurrences of physical violence.

About 57% of workers reported that they experienced physical violence at least once as an employee at their current agency.

In what the study authors described as one of their most “alarming” findings, every surveyed worker said they’ve experienced exposure to workplace violence. However, these incidents of workplace violence weren’t reported to the agency’s management, according to the study.

Though workplace violence occurs in other health care settings, working in the home presents distinct challenges.

“Home health care is a health care specialty that presents unique occupational hazards, including the potential for [workplace violence] within the home or community of the patient,” the authors wrote in the study. “Individuals who work in home health care often do so independently and may not have the same resources provided to those in the traditional hospital or clinic setting.”

While agencies have workplace violence policies in place, and 100% of surveyed workers said they were knowledgeable of reporting procedures, this has not translated into increased reporting.

In fact, 40% of workers stated that management did not encourage reporting, and 33% don’t feel comfortable going to management with their workplace violence concerns.

“A possible explanation is that management has instituted policies and reporting guidelines to fulfill corporate requirements without [home health care worker] buy-in,” the authors wrote. “There also may be a concern about management retaliation or victim blaming when reporting [workplace violence]. There needs to be a culture change in organizations to encourage [home health care workers] to report [workplace violence].”

Other research has also found workplace violence to be common in the at-home care industry. Last year, a Transcend Strategy Group study found that over 50% of caregivers have experienced or witnessed at least one incident of workplace violence or harassment at some point.

In recent years, OSHA has taken on a more watchful eye regarding the home-based care space.
“For years, home-based care sort of flew under the radar,” private-practice attorney Elizabeth E. Hogue, previously told Home Health Care News. “Nobody paid much attention to providers, but now home-based care is sort of the care du jour. People, at least, pay lip service to the idea that it’s important, and we need more of it, and it needs more funding. Along with all of those things, undoubtedly comes increased scrutiny.”