Developing a customized set of evidence-based quality indicators for measuring workplace violence towards healthcare workers: A Delphi method

Abstract:



Background:

Workplace Violence (WPV) is a significant and growing challenge in healthcare worldwide. It contributes to the well-being and burnout of healthcare providers and can negatively affect vulnerable populations, such as patients experiencing delirium. To address the problem, healthcare organizations need effective means of managing WPV through quality improvement (QI) methodology. However, successful QI requires WPV-specific quality indicators that can demonstrate whether interventions have created change.

Methods:

This study aimed to develop a set of WPV quality indicators specific to healthcare settings, using expert opinion. The study used the Delphi process method to reach a consensus on relevant WPV quality indicators among 30 stakeholders from the University Health Network (UHN) and its affiliates in Toronto, Canada. The experts were presented with literature-based quality indicators that were categorized according to the Donabedian model. They were then asked to participate in two consecutive Delphi rounds.

Results:

The surveys received an average response rate of 81.2% in the first round and 96.7% in the second round. From the initial set of 87 quality indicators from a rapid review process, the expert panel reached a consensus on 17 indicators. These included seven structures, six processes, and four outcome indicators.

Discussion:

The Delphi methodology successfully identified expert opinion-based quality indicators to measure workplace violence specific to the healthcare setting at UHN. The indicators identified in this study were operationalizable at UHN and will provide longitudinal quality monitoring. They will also inform data visualization and dissemination tools that impact real-time organizational decision-making for clinical interventions. Conclusion/Implications:

By having these quality indicators in place, healthcare organizations can better manage and prevent workplace violence, improving healthcare providers' well-being and better patient outcomes for vulnerable populations.



References:

1. Lyver, B., Gorla, J., Schulz-Quach, C., Anderson, M., Singh, B., Hanagan, T., Haines, J., & Sethi, R. (2024). Identifying quality indicators to measure workplace violence in healthcare settings: a rapid review. BMC emergency medicine, 24(1), 1-11.





2. Schang L, Blotenberg I, Boywitt D. What makes a good quality indicator set? A systematic review of Criteria. International Journal for Quality in Health Care. 2021;33(3). doi:10.1093/intqhc/mzab107



Presentation Eligibility: Not previously published or presented

Diversity, Equity, and Inclusion: Addressing WPV through a systemic-focused lens to understand factors through minority stress theory, intersectionality theory, and a trauma-informed approach. This method reduces the negative stigma and reframes a systemic understanding of WPV challenges and opportunities for individualistic interventions. By developing WPV-specific quality indicators through expert consensus, this study seeks to promote equity and inclusion by providing tools to mitigate the impact of WPV on vulnerable populations such as unwell psychiatric patients. Furthermore, through systematic quality improvement methodologies, healthcare organizations can better support their diverse workforce and ensure equitable access to safe work environments, ultimately fostering a more inclusive healthcare system.