Addressing Workplace Violence in Outpatient Settings

By The Institute at MagMutual®

Workplace violence is a growing threat in healthcare — and outpatient settings are especially vulnerable. Physicians, nurses and staff increasingly face verbal abuse, threats, and even physical attacks, often from patients or their families. The consequences go beyond individual harm, affecting patient care, staff morale and the overall functioning of healthcare organizations.

A Growing Problem
Healthcare workers experience violence at disproportionately high rates. Studies estimate that between 8% and 38% of professionals encounter physical violence during their careers, and reports of harassment have more than doubled since 2018. Despite these alarming trends, many incidents go unreported, as providers may perceive aggression as part of the job. Factors like longer wait times, patient frustration and administrative burdens only heighten the risk of conflict.

Why Outpatient Settings Are at Greater Risk
While hospital-based violence has received significant attention, outpatient facilities remain underexamined – and often underprotected. These locations typically operate without on-site security, making staff more exposed. Patients and families dealing with insurance issues, delays or lack of information may become agitated, leading to confrontations in waiting areas or exam rooms.

The Toll on Individuals and Organizations
Violence takes a measurable toll on healthcare workers, contributing to burnout, anxiety and depression. For organizations, it leads to increased staff turnover, potential legal liability, reputational harm and disruptions to patient care. Failing to address safety in outpatient settings can compromise both employee wellbeing and clinical outcomes.

Proactive Strategies to Improve Safety
Creating a safer work environment requires clear policies, proper training and environmental safeguards. The following strategies can help reduce the risk of violence in outpatient practices:

1. Anticipate and Communicate: Train staff to recognize warning signs and use clear, empathetic communication to prevent escalation. Simple apologies and updates during wait times can diffuse frustration.
2. Establish a Zero-Tolerance Policy: Implement and consistently enforce policies prohibiting violence, harassment and threats. Make it clear that abusive behavior will not be tolerated.
3. Train in De-Escalation Techniques: Provide training in both verbal and non-verbal de-escalation skills. Encourage staff to practice active listening, maintain calm body language and access patient liaisons when needed.
4. Improve Environmental Security: Design facility layouts with safety in mind:
   • Restricting access to clinical areas
   • Using electronic locks
   • Separating staff-only zones from patient areas
5. Install Video Surveillance: Place cameras in key locations such as reception areas, hallways and entrances. Footage can deter aggression and provide documentation after incidents.
6. Implement Emergency Alert Systems: Equip staff with panic buttons or alarms. Establish code words or hand signals to discreetly signal distress.
7. Enforce Weapon-Free Policies: Post clear signage and establish strict no-weapon rules in accordance with state law to reduce the risk of violent escalation.
8. Conduct Regular Safety Drills: Run simulated drills, including active shooter scenarios, to prepare staff for emergencies. Partner with professional security consultants for best practices.
9. Foster a Culture of Reporting and Support: Encourage staff to report all incidents without fear of retaliation. Build a workplace culture that prioritizes safety and supports open communication.

Violence in outpatient healthcare settings is a serious but preventable issue. By implementing proactive strategies, healthcare organizations can create safer environments for staff and patients. A strong commitment to security, training and clear policies will not only protect healthcare workers but also improve patient care and organizational stability.

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Disclaimer

The information provided in this resource does not constitute legal, medical or any other professional advice, nor does it establish a standard of care. This resource has been created as an aid to you in your practice. The ultimate decision on how to use the information provided rests solely with you.

You have an opportunity to join the Columbus physician who created the successful Walk with a Doc program for conversation and discussion. We shared in April that the Walk with a Doc program, started by Columbus physician Dr. David Sabgir, was launching a new reading program at local libraries in collaboration with the Columbus Medical Association and Affiliates and the AMA Alliance.

Dr. Sabgir will host the first Read with a Doc on June 29, 2025, at the Westerville Public Library uptown and focus on Tools for Living Longer and Better. The sessions are intended for adults and physicians are very welcome to join in the conversation. Dr. Sabgir will return to the same location for the next session on July 27, 2025, with a focus on The Power of Social Connection.

Find out more information about the sessions and register here.

The Walk with a Doc program continues nationwide with more than 500 chapters across 48 states and 40 countries. Find out more information and get involved here.