Chief Nurses Leading the Charge: Addressing Workplace Safety in Healthcare

Healthcare’s maze of point solutions, technology, and administration is an unsustainable path. Figures from a recent Medscape survey of over 9,000 physicians across 29 specialties found:

• 54% report feeling symptoms of strong to severe burnout
• 61% cite bureaucratic tasks as the number one cause of burnout
• 5.9 hours reported spent on average each day on charting and documentation (73% of an 8-hour day)

Becker’s Hospital Review recently sat down with an expert panel to discuss the “death of point solutions,” and the solutions that are paving the way to a better healthcare experience for clinicians and patients:

• Tanay Tandon, CEO at Commure
• Vikesh Tahiliani, MD, VP of Care Transformation and Innovation at HCA Healthcare
• Joseph Byham, VP of Public Safety at Jefferson Health
• Steve Klasko, Board Chair at DocGo, former President and CEO at Jefferson Health

Panelists discussed best practices for implementing cutting-edge technology like artificial intelligence and real-time location systems across real-world use cases. Speakers also discussed Commure’s unique co-development model, including why HCA selected Commure as its exclusive ambient AI partner, and how Jefferson Health worked closely with Commure to develop the RTLS-powered Strongline platform for duress alerting.

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How AI Can Reverse the Technology Fatigue

Tanay Tandon describes a “work tax” phenomenon in healthcare saying, "There's this proliferation of point solutions or individual apps and pieces of software that each solve a small piece of the problem. It's logging into forty different apps in a given day, remembering passwords, dealing with single sign-on and multi-factor authentication. The overhead from that is insane. If you're an administrator, you feel it. If you're a physician, you definitely feel it."

AI can reverse this trend by simplifying workflows and removing repetitive tasks that make healthcare more focused on tech than people. The impact on the healthcare workforce will be profound: AI doesn’t just save time—it can help clinicians reconnect with why they chose to pursue medicine in the first place.

Steve Klasko emphasizes this, saying, "I talk to thousands of doctors a year, and they say 'AI is going to take my job', and I always say, 'AI is not going to take your job. Someone who knows how to work with AI might take your job.'"

To fully harness the power of transformational solutions without adding additional strain, organizations must prioritize a platform-powered approach over point solutions. The most impactful AI technologies will be platform-powered and bidirectionally communicate with EHRs and other critical health IT systems. 

Co-Developing Platform-Grade Solutions‍

The panelists discussed Commure’s platform approach, co-development approach, and forward deployment model, including Commure's ambient AI solution, developed alongside HCA Healthcare, and Commure Strongline, first developed at Jefferson Health.

Commure’s ambient AI solution listens to patient interactions and automatically produces AI-drafted notes, suggests ICD-10 codes, and incorporates custom templates to automate workflows. This has a dramatic effect on efficiency, averaging an 81% reduction in total documentation time and a 32% increase in same-day note closures.

When asked why HCA chose Commure as its exclusive ambient AI partner, Vikesh Tahiliani responded, “We were seeking the latest and greatest most sophisticated engine we could find, and through our vetting process, we landed on Commure.” Vikesh also spoke to the co-development that took place with Commure for the Ambient AI solution, “Their engineers were on site with our physicians and the providers would see a patient, come back, sit with the engineers, and say, ‘My note looks really good, but I would love these two tweaks to be made’, by the time they got back from their next patient, those tweaks were already made.”

Commure Strongline’s RTLS platform enables real-time duress alerting and response via a discreet badge worn by all healthcare staff. Strongline also extends outside of hospital environments, providing protection in garages, outdoor common areas, and even when offsite at patient homes. This gives staff peace of mind knowing that help is just a button press away, leading to higher workplace satisfaction, lower turnover, and a safer overall environment. 

When discussing how Commure Strongline was developed in conjunction with Jefferson Health, Joe Byham shared, “It truly is a partnership with the frontline staff, it can’t be people sitting in offices states away, then nothing gets done. Having this partnership [with Commure] is really important to make these systems evolve.”

Unified, Human-Centered Healthcare

Healthcare faces a profound challenge: half of the physician workforce reports feeling burned out, primarily due to the overwhelming complexity of modern systems. Fragmented point solutions have contributed to this problem, creating inefficiencies and technological fatigue. To address these issues, the industry must shift toward platform-based solutions that integrate cutting-edge technologies like AI and RTLS.

By simplifying workflows and enhancing safety, these innovations can significantly reduce clinician burnout and allow healthcare professionals to focus more on their core mission—delivering quality care. Achieving this transformation requires close collaboration between healthcare providers and technology innovators to ensure solutions address real frontline needs.

HCA Healthcare and Jefferson Health exemplify this approach by partnering with Commure to tackle critical challenges. Through hands-on, iterative development with clinicians, Commure engineers have fine-tuned technologies that drive meaningful impact. This level of radical collaboration is key to solving healthcare’s toughest challenges and paving the way for a more efficient, human-centered future.

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Healthcare providers today face unprecedented demands on their time, with documentation burdens ranking as the top contributor to burnout. Physicians spend nearly 50% of their day in the EHR, an NIH statistic underscoring the critical need for innovative solutions to simplify workflows and enable clinicians to focus on delivering high-quality care.

Enter Commure Ambient: a powerful solution for reducing the documentation burden on clinicians. Following our successful acquisition of Augmedix in October, Commure Ambient re-platforms and enhances Augmedix’s core capabilities and services onto the Commure platform. This game-changing advancement not only harnesses the untapped potential of EHR data, but also redefines how care teams document, access, and utilize critical patient information—all while reducing friction in existing workflows.

We’re excited to share that Augmedix, part of Commure Ambient, achieved Oracle Validated Integration, and is part of the Oracle PartnerNetwork. This validation opens the door to scaling across over 2,700 hospitals, 4,000 physician practices, and over 45,000 providers who rely on Cerner every day.

Enhanced Capabilities Powered by Deep EHR Integrations

At the heart of Commure’s innovation is a commitment to deep EHR integration. This allows Commure Ambient to seamlessly orchestrate patient data from various sources—including historical records, labs, imaging, and more—into a single, context-driven view for providers. By embedding intelligent AI capabilities across the entire provider workflow, the platform enables clinicians to:

Before the Visit: Automatically surface the most relevant data from the EHR, eliminating pre-charting burdens.

‍During the Visit: Leverage ambient AI to transform patient encounters into structured clinical notes in real time, while surfacing decision-support care cues when needed.

‍After the Visit: Deliver pre-drafted documentation for physician review and attestation, ensuring accuracy, compliance, and efficient billing processes.

This seamless integration of Commure Ambient within the EHR allows providers to spend more time with patients and less time navigating screens—restoring the provider-patient relationship while enhancing operational efficiency.

Transforming Documentation into a Strategic Asset

With Commure Ambient, healthcare organizations gain:‍

Improved Outcomes: Streamlined workflows reduce documentation time, freeing providers to focus on care delivery.

‍Operational Excellence: AI-driven accuracy minimizes claim denials and supports compliance with evolving coding standards. The ability to generate error-free documentation enhances operational efficiency, while optimizing revenue cycle.

‍Enhanced Quality: Deep EHR integrations surface critical data and ‘care nudges’ during patient encounters, driving better patient insights and outcomes.

Ultimately, patients reap the rewards of clinicians who are freed to focus on meaningful interactions and informed, data-driven decision-making. In a time of rising costs, mounting burnout, and heightened scrutiny over care quality, this platform redefines documentation as a strategic asset—empowering all stakeholders and enhancing outcomes at every turn.

Building a Healthier, Connected Future

This milestone with Oracle is just the beginning for Commure. It represents not just a technical achievement but a reaffirmation of our mission to simplify healthcare with AI and create a better, more cost-effective healthcare experience, at scale.

By turning documentation into a strategic asset, Commure Ambient is redefining healthcare efficiency and creating a path toward a more connected, patient-focused future.

Welcome to Commure Up Close! In this employee spotlight series, we sit down with team members from across Commure to learn about their backgrounds, their perspectives on our company culture, and their lives beyond work. Through these stories, we aim to provide a deeper look into why talented individuals choose Commure and how we work together to transform and simplify healthcare with cutting-edge technologies.

In this issue, we are excited to highlight Allison Park, who works as a Chief of Staff to the Chief Technology Officer and has been with Commure since January of 2024.

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Tell us about your background and how you landed at Commure?
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I'm originally from Irvine, California, but I spent much of my academic and early professional life on the East Coast. After studying civil engineering and economics at MIT, I moved to New York to work as an engineer for ExxonMobil in their Brooklyn office. While working at Exxon was an incredible experience getting structured training right out of college, I was always interested in what living the startup life could be like. During my four years at Exxon, I discovered my passion for entrepreneurship and how rewarding working in a startup environment can be via a wine startup I helped grow.

To further pursue this passion, I attended Harvard Business School, focusing on scaling and launching tech ventures. Before joining Commure, I was at a tech-enabled Medicare brokerage where I led operations and served as Chief of Staff to the co-founders. Now at Commure as the Chief of Staff to the CTO, I'm excited to dive back into engineering and tech while collaborating with an exceptional team at a growing company.

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What does a day in the life look like for you?
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In short, I'm here to help our CTO oversee the engineering, product, and design teams. Some days, I'm syncing with recruiting on key engineering hires, including tracking the pipeline and figuring out where we need to focus, other times, I'm catching up with PMs and engineers on specific projects. 

Right now, I'm focusing a lot on driving adoption of our ambient AI scribe product, Augmedix, with HCA who is one of the nation’s largest healthcare providers. I join daily standups with our Augmedix engineers and PMs, check progress, review specs, and work with HCA on key initiatives. I also occasionally go on-site to gather feedback on what we shipped and improve our products in real time.

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How would you describe the company culture at Commure?
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Our company culture is pretty unique. It's incredibly fast-paced, and everyone has a high sense of urgency, we all want to ship quickly, and our velocity is unmatched. There's a strong sense of ownership here, which goes hand in hand with one of our company values of “Extreme Ownership”. Everyone feels like they own the product and genuinely want to make it better. We also have a culture of accountability, which leads to high-quality outcomes. Plus, there's this "yes before no" mentality. We believe anything is possible and tackle challenges with that mindset.

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What advice would you give somebody on their first day at Commure?
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Be ready to hit the ground running! This place moves fast, but there's nowhere else with such a steep growth curve. You'll grow a ton very quickly. If you want ownership, it's yours, the sky's the limit. Absorb as much as you can, lean on your peers, ask for help, and don't fail silently. The team here is amazing, and you'll learn so much from them.

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What made you decide to join Commure?
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I was looking for a change from my last company and wanted to lean more into tech. Dhruv, our CTO, is an incredible leader, he’s structured, sharp, technical, and empathetic. A lot of people on the team are drawn to that, and I knew I wanted to work with someone like him.

The team also stood out to me. I wanted to be around motivated, hardworking people who are committed to building high-quality products. I've never been at a company where everyone is this passionate and driven.

Another reason I joined Commure is the impact the company has on healthcare. We're making tangible, positive changes in providers' daily lives, and the work we do directly affects them in a positive way. That was really appealing to me.

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What has been your biggest accomplishment so far at Commure?
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I joined Commure in January 2024, and my first big project was tackling issues concerning eligibility with our Revenue Cycle Management (RCM) product. We launched key rules engines, revamped eligibility handling, and integrated a third-party API. The customer feedback was fantastic—it was a big win for Q1.

Another big accomplishment was integrating with the company we recently acquired, Augmedix. I was very involved in making sure we combined the teams well, aligned them with our culture, and kept everything on track. We are also continuing to expand our partnership with HCA. They're one of our major customers, and we're focused on improving and scaling with them.

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As a kid, what did you want to be when you grew up?
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My dad's a veterinarian, so for a long time, I wanted to be a vet. I love animals, we always had cats and dogs around growing up. But then I saw a surgery, and I quickly realized that wasn't for me. I've always loved building things, and that's what led me to engineering in college. It's also why I love my role at Commure. I love being on the tech side, building things and making an impact.

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What do you like to do outside of work?
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I love staying active and try to spend as much time outdoors as possible. I grew up playing soccer and continued throughout college. These days I have enjoyed playing golf as well. Family is really important to me; they all live in the Bay Area now which I love. I've got an older sister, a younger brother, a new niece named Nora, and of course my cat, Wally, she's the love of my life!

Interested in a career building the next generation of healthcare technology powered by AI? We are always looking for talented people across our departments.

Explore Career Opportunities

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Healthcare now routinely reaches beyond hospitals into patient homes, creating a vital need to keep these caregivers safe. Over 200,000 U.S. nurses—including RNs, LPNs, and APRNs—provide home health care today and that number is expected to grow significantly in coming years. Strongline, our wearable safety duress solution, already protects over 250,000+ nurses in and around the hospital and ambulatory, and is designed to ensure safety for those in home health settings as well.

Strongline Companion

Co-developed with nursing and security leaders from the country's most renowned healthcare organizations, the Strongline Companion App empowers healthcare workers to signal duress and call for immediate assistance by discreetly pressing the Strongline Pro badge.

Key Features

1. Wearable Badge with Mobile App Integration:
   Our badge connects instantly with the app, working seamlessly across hospitals, outdoor campuses, and patient homes.
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2. Walk-With-Me Mode:
   ‍Activates real-time tracking and alerts security if assistance is needed or there’s a route deviation.
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3. Check-In Mode:
   ‍Automatically schedules check-ins and alerts security if one is missed, and also enables
geo-fencing based alerts.
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4. Direct-to-911 Mode:
   ‍Discreetly contacts 911 for immediate help in emergencies without the need to be on the phone. Seamless integrations with county directories ensure the right emergency responders are sent
to the right location, minimizing response time.
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5. Ambient Safety Listening:
   ‍Using Commure AI Scribe, the app can record safety events for improved documentation and trigger alerts based on safe words.
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6. All-in-One Dashboard:
   ‍Centralizes real-time safety monitoring across hospital and home settings.
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7. Customizable Settings:
   ‍Set up workflows in the way that works best for your organization. Tailor alerts and custom instructions for each location, employee type, or staff member, ensuring that security teams can adapt their response to specific needs and environments.

‍Providing Safety, Wherever Work Takes Place

If you are an existing Strongline customer, or you are looking for a proven solution to bolster the safety of your staff, the Strongline Companion App extends Strongline’s powerful duress alerting capabilities to wherever work takes you.

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About Strongline

Strongline safeguards hundreds of thousands of clinical workers across 50+ major U.S. healthcare systems. Powered by Commure, Strongline leverages proprietary hardware and AI-driven software to deliver reliable, scalable solutions for modern healthcare environments.

Commure Team

Health equity is a primary focus across the U.S. healthcare system today, with frameworks established by CMS and HHS to help clinicians improve the health of underserved communities while reducing the cost of care. Federally Qualified Health Centers (FQHCs) and Rural Health Centers (RHCs) are vital providers of care to those communities who need it most, regardless of their ability to pay. According to HRSA:

• Over 1,400 FQHCs and 4,400 RHCs served over 30 millions Americans in 2022. 
• FQHCs and RHCs provide essential access to high-quality primary healthcare services in medically underserved areas, low-income communities, and rural areas. 
• Cost of care is determined by a sliding scale. Among people who received care at FQHCs in 2021, 20% were uninsured and 48% were covered by Medicaid. 

Technology can help FQHCs and RHCs unlock clinical, financial, and operational efficiencies to advance key community health goals and maximize the efficiency utilization of public grants and other funding mechanisms. Here are three ways that clinical care coordination technology can help meet the needs FQHCs and the patients they serve:

1- Improving Clinical and Business Outcomes with Evidence-Based Patient Engagement

Digital patient education and appointment reminders can help improve clinical outcomes by guiding patients on evidence-based clinical journeys to achieve outstanding clinical outcomes, boosting preventative care goals, and patient care adherence to prescribed therapies. Failure to complete preventative health screenings that are essential for early detection of cancers and other diseases that can disproportionately impact communities that FQHCs serve. 

For example, studies have shown that women with public or no insurance are more likely to be diagnosed with breast cancer at a later stage and have more aggressive pathology than those with private insurance. Medicaid-insured patients also have lower breast cancer screening rates and larger time gaps between mammograms. To help fill preventative care gaps, FQHCs can leverage personalized evidence-based patient communications which have been shown to increase patient adherence with critical screenings that can help save lives, such as mammograms. 

Commure Engage is working with Cornell Scott-Hill Health Center (CSHHC) on a multilingual, breast cancer screening program and enterprise-wide appointment reminders. A similar program has been proven to have success reducing the no-show and same-day cancellation rates for breast cancer screenings by 54% at Yale New Haven Health System (where CSHHC is affiliated). 

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Beyond improving outcomes through preventative care, clinical care coordination technology plays a critical role in the long term management of chronic diseases by providing ongoing education, remote patient monitoring, and AI-supported timely intervention. By reducing no-shows and improving patient care plan adherence, FQHCs can optimize the efficiency of their resources and precious provider time. This is essential for nonprofit organizations dependent on public funding and grants. 

Additionally, technology such as AI-powered revenue cycle management solutions can also help automate the processes of getting reimbursed properly for the cost of delivering care –– an especially complex process for FQHCs who provide care on a sliding pay scale for Medicare and Medicaid populations. 

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Learn More About Commure RCM

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2- Scaling Population Health Initiatives to Address Public Health Concerns

The behavioral health crisis, including the opioid epidemic, and persisting health disparities related to social determinants of health, including the digital divide, are costly challenges facing FQHCs, RHCs, and the U.S. at large today. In terms of cost of care, a McKinsey analysis revealed that 60% of overall national medical expenditures are driven by the 23% of members who have mental or substance use disorders. This makes sense because symptoms of mental health and substance use disorders can hinder how patients approach and experience the medical care they need. Additionally, nearly 70% of patients with mental health or substance use issues also have a medical comorbidity. 

FQHCs and RHCs can leverage automated patient engagement and clinical coordination technology to better integrate behavioral health factors into overall patient care. Patient engagement technology can be used to scale behavioral health risk assessments such as the PHQ-9, ASAM, SRA, and others to patient populations at large, and specific tools like The Edinburgh Postnatal Depression Scale (EPDS) in maternal-fetal health. FQHCs and RHCs can then prioritize targeted follow up and digital navigation pathways for individuals who are most at-risk, and facilitate coordination between primary and behavioral/mental health care. 

Research suggests that up to 80% of all health outcomes – good or bad – are due to Social Determinants of Health, factors that deeply interconnect  public health with individual health and wellbeing. For example, socioeconomic status is a known determinant. 6 in 10 adults with Opioid Use Disordered are considered low-income, and nearly 1 in 5 are uninsured, underscoring how the population FQHCs serve are impacted by the opioid epidemic. Life expectancy can vary dramatically based on zip code; in one example in Washington, D.C., a difference of 10 miles translated to a gap in life expectancy by 33.5 years. 

Community resource centers can help fill critical gaps related to social determinants of health. FQHCs can leverage technology to help streamline the process of connecting patients with community resources to meet their individual needs. For patients with Opioid Use Disorder (OUD), this could entail connecting the individual with stable housing, settings that provide Medications for Opioid Use Disorder (MOUD), or other treatment programs like Digital Therapeutics for behavioral and mental health like ADHD or Depression.

3- Increasing Access and Closing Care Gaps with Digital Health Tools

The pandemic dramatically accelerated the adoption of telehealth. Patients have spoken loud and clear that they are going to consume healthcare when they want it and where they want it, and that is largely in the home. Their expectations around digital engagement are here to stay. FQHCs and RHCs should be embracing these technologies to expand access to the communities they serve. With CMS loosening reimbursements on Medicare and Medicaid coverage for telehealth appointments that is more feasible. In communities and geographic areas with limited provider coverage, such as rural communities, digital health tools like virtual health appointments, remote therapeutic monitoring, and hospital at home can fill critical gaps to educate and engage patients along their health care journeys. 

While digital tools hold great potential, digital access is now recognized as a Super Determinant of Health. Multiple Federal and State initiatives exist today to bridge the digital divide. Among low-income adults (households below $30K/year), 4 in 10 don’t have access to broadband services or a desktop/laptop computer, and 1 in 4 do not own a smartphone. RHCs and FQHCs require creative partnerships with payers, payvidors, digital health companies and telecom providers to ensure that their communities have access to the essential resources like mobile phones and basic broadband internet access to be able to engage with state of the art clinical medicine using evidence-based digital health tools. 

Creating Affordable, Equitable, and Enjoyable Care For All 

Now more than ever, the entire healthcare industry must think in terms of creative technology uses and innovative partnerships in order to make real strides on our shared goal of health equity. FQHCs and RHCs serve critical missions to improve the health of communities who need it most. Commure is proud to be one such solution provider to deliver automated clinical care coordination and revenue cycle management technologies that can power the clinical, financial, and operational efficiencies to advance key community health goals.

Jeanne Venella, DNP, MS, CEN, CPEN
Chief Nursing Executive / Strategic Advisor - Commure Strongline

Those that know me know that as a nurse leader with over three decades of experience in Adult and Children’s Emergency Departments, I am passionate about three things:

1. Shaping the future healthcare workforce by educating the next generation of leaders and medical staff.
2. Combating workplace violence (WPV) in healthcare settings, a growing and unsustainable epidemic. 
3. Baseball and the Philadelphia Phillies.

‍Having experienced violence myself as a nurse at work, I do not list baseball and WPV together to be trite. Rather, I believe sports are more than just entertainment. They offer a framework to help us to understand leadership, teamwork, and the world around us.

Thus, in the spirit of combining my three passions, I believe we can leverage key principles from the teachings of Jeff Angus in “Management by Baseball,” to create a winning game plan to address WPV in healthcare. As leaders, we have the unique responsibility and opportunity to foster a positive, collaborative, and safer work environment for teams everywhere. 

First Base: Understanding the Current State

Angus explains how managing the mechanics of baseball is similar to other complex problem-solving. It starts with having a clear picture of the business, management, and the team. Baseball organizations rely heavily on data and analytics to make data-driven business decisions, set objectives, and communicate transparently across the organization.

The picture is clear in healthcare: WPV is permeating the playing field for healthcare staff everywhere.

• 82% of nurses have experienced at least one type of WPV within the past year.
• 5% YoY increase in incidents of WPV in healthcare from 2022 to 2023, reaching an all-time high. 
• 21% of WPV victims require more than 31 days away from work, another 20% require 3 to 5 days away from work.
• WPV incidents occurred most often on psychiatric units, the ED, adult units, pediatrics, and perioperative units, respectively.

Exposure to WPV has a significant impact on staff, impairing effective patient care and leading to psychological distress, job dissatisfaction, absenteeism, high turnover, and higher costs. 

Second Base: Creating a Team-Based Approach to Address Workplace Violence

A foundational component of any baseball organization’s success is encouraging a multi-disciplinary, team-oriented culture where every member understands their role and works toward common goals. 

Leaders of healthcare today must take the same approach to achieve our common objective of combating workplace violence head-on. To do so, health systems must bring together diverse work groups with representatives across various parts of the system. Responsibilities of the interdisciplinary workplace violence committee include:

• Establish a baseline across each facility, department, unit to assess incidents of WPV, even analyzing by patient cohort or time of day or night.  
• Identify and develop targets for reducing the incidence rate of WPV.
• Review the current reporting process and identify what measures to improve or implement.
• Evaluate appropriate interventions and tools, and develop standards, processes, and strategies to prevent and reduce WPV.
• Implement an agreed upon approach to introduce new processes to the organization, using a staged or phased approach.

Third Base: Leading With Authenticity 

Authentic leadership, or as Angus describes, a leader who is acutely aware of him or herself and leads with empathy, plays a crucial role in bringing the best out of team members and creating a positive team culture.

Similarly, authentic leadership from healthcare’s frontline and senior leaders  is essential to reducing workplace violence by fostering a culture of trust, open communication, conflict resolution, and support. Team members should trust that they can report their experience and won’t be blamed for what happened or shamed into thinking it’s “just part of the job”.

Reducing and preventing WPV is just half of the problem, WPV management requires having the proper plan in place to respond appropriately when staff are impacted. This means knowing when, where, and to whom an event has occurred. Highly effective workplace violence prevention programs empower staff to report their experiences. Best practices to operationalize and enable include:

• Establishing a process to report incidents in order to analyze incidents and trends
• Promoting empathetic leaders who are trained on how to respond when a staff member comes to them 
• Supporting victims and witnesses affected by workplace violence, including trauma and psychological counseling, if necessary 
• Reporting workplace violence incidents to the governing body

WPV management is a classic example of interdisciplinary leadership, involving clinical, HR, security, legal, and other departments. The scope of this work goes beyond merely responding to incidents  to laying the foundation for continuous improvement, leveraging hard data to make decisions for staff  safety and response processes.

Home Plate: Adopting New Strategies and Tools to Address Workplace Violence

As a response to declining viewership, baseball has adapted its strategies in recent years and to improve the game, changing its rule to include a pitcher’s time clock and lowering the pitcher’s mound. The result has been an increase in fan engagement, reviving ticket generation and bringing in new audiences.

Healthcare’s governing bodies are also adapting to the epidemic of workplace violence. In 2022, The Joint Commission (TJC) mandated new and revised workplace violence prevention standards that will apply to all Joint Commission-accredited hospitals and critical access hospitals to assure organization’s take a systematic approach to reducing WPV.  

There are three new elements of performance (EPs) and two revised EPs to its requirements. These EPs, which fall within the “Environment of Care” (EC), “Human Resources” (HR), and “Leadership” (LD) chapters, directly address workplace violence.

New tools for healthcare organizations such as Commure Strongline wearable staff duress badges put the power in their employees’ hands. They feature discreet panic buttons that empower your staff to call for help at the first signs of distress: immediately providing security and nearby staff your name and precise location to enable early intervention and de-escalation.

Make it a Grand Slam: Don’t Wait to Address Workplace Violence 

Bringing together these lessons from baseball, we understand that success in healthcare requires acting today to address workplace violence. 

As leaders, we have the unique responsibility and leadership position to foster a positive, collaborative, and safer work environment for healthcare teams everywhere. This is the same objective that every baseball management team aspires to as well. And it’s not just good for the team, it’s good for fans, which is good for business.

Keeping your staff safe is not just a moral imperative, it’s a business imperative, and foundational to healthcare itself. When staff feel secure, they can flourish in their roles, leading to enhanced patient satisfaction and delivery of high-quality care.

Ronald A. Paulus, MD
Strategic Advisor - Commure Strongline

After retiring as the CEO of a nationally recognized health system in 2019, I’ve dedicated considerable time and energy to keeping our team members safe for one primary reason: healthcare is one of the least safe places to work, both in the US and globally. In fact, US healthcare workers are four times more likely to be exposed to workplace violence than police officers or prison guards.

As leaders responsible for so many different things, I understand it is natural that we might feel overwhelmed at times by problems as complex and widespread as healthcare workplace violence. Yet no matter the scope of that challenge, we each bear the paramount responsibility of keeping our patients and team members safe.                

The Hidden Costs of Workplace Violence in Healthcare

Workplace violence not only extracts a heartbreaking human toll, but is also unsustainably costly for healthcare organizations (exceeding $800 million annually in 2017), especially given our unprecedented staffing crisis. Workplace violence associated costs include:

• Harm to Staff Emotional Wellbeing: Those exposed to workplace violence are 2-4x more likely to report high levels of PTSD, anxiety, depression, and burnout.
• Staff Time Away from Work: Violence-related injuries are four times more likely to result in time lost from work compared to other workplace injuries.
• Elevated Staff Turnover: Nurses’ perceived safety of their work environment is the top factor influencing whether or not they will stay in their current patient care role.
• Costly Fines and Fees: Workplace violence events frequently lead to regulatory scrutiny, fines, litigation expenses and settlements.

How Patient Safety Applies to Workplace Violence in Healthcare     

Fortunately for all of us, lessons learned from the patient safety movement provide a clear approach to tackling the complex and systemic problem of workplace violence. 

Recall that we faced an equally alarming and seemingly insurmountable challenge in patient safety when To Err is Human was published in 1999 creating a firestorm by calling out that potentially avoidable medical errors killed up to 98,000 Americans annually.  Even after this watershed report, many hospital and health leaders failed to take action to transform patient safety. To many, the problem seemed too daunting and amorphous and it took nearly a decade after that seminal moment before the industry initiated powerful collective action.

In 2012, the Patient Safety Movement Foundation was established to develop an action-oriented approach to eliminating preventable patient deaths. And by 2020, it had reached nearly 4,800 hospitals collectively saving more than 350,000 lives.  The movement’s powerful recipe for change is directly applicable to our fight against workplace violence.  Using their model, we can tweak it to guide our response to workplace violence as follows: 

• Broadly raise awareness about the frequency, severity, and preventability of WPV.
• Call for national leadership and coordinated efforts to set goals, influence policy, develop safety standards, and support training and research on safety best practices.
• Establish a shared commitment from health system leaders to markedly reduce WPV. 
• Emphasize that WPV stems primarily from faulty systems, processes, conditions and technology (or lack thereof) rather than individual behavior.      
• Promote a cultural shift to openness and transparency about WPV events (or precursors) rather than blame and punishment. 
• Advocate for better incident reporting systems, both mandatory and voluntary, to get data-driven insight into where and why violence occurs and inform strategies for improvement. 
• Perform root cause analyses for each significant violent event to identify opportunities for prevention. 
• Implement best practices and technologies that have been shown to improve worker safety and outcomes.

When healthcare leaders came together enabling collective action on patient safety, we saw tangible change –– hundreds of thousands of lives saved that would otherwise be lost to medical errors.  It’s now our collective obligation to replicate that same approach today to form a movement to eliminate workplace violence.

Preventing Workplace Violence in Healthcare with a Tech-Enabled Approach

One key reason the Patient Safety Movement saved lives was by spurring the adoption of new technology. Tools like medication barcoding, clinical-decision support, and clinical alerts flagging deteriorating patient condition or potential sepsis (with associated clinical protocols) all played key roles in keeping patients safe. 

But the most common tools deployed in the fight against workplace violence today, such as fixed panic buttons and enhanced security cameras, routinely fail to make an impact and do not proactively de-escalate violence. Other partially effective tools, such as those leveraging nurse call systems or hard-wired RTLS systems, typically cover only a fraction of staff and exclusively interior space. To complement a multi-pronged workplace violence prevention program, an optimal staff-safety technology solution must have five core characteristics:

1. Prevention & De-escalation: The system must enable a team member to signal the need easily and discreetly for help early in an escalating situation.  Because de-escalation is so critical, this capability and associated staff training to “press early and often” are essential.‍
2. Real-Time Location Services: When a duress alarm is activated, the system must trigger an alert that identifies the specific team member under duress by name and location, and also provide continuous location updates to all alerted team members until the event is resolved.‍
3. Customizability: The system must notify security, nearby colleagues (who are best positioned to assist with early de-escalation), and subscribed team members via a variety of alerting mechanisms that fit the organization’s existing workflows (e.g.,  hand-held devices, hands-free communication badges, etc.).‍
4. Universal Coverage and Ease of Use: Protection must be provided to all staff in all locations (both indoors and outside in garages and walkways, etc.) without the need for any action or configuration on the user’s part when moving between sites (for instance, from a hospital to an ambulatory clinic, or from one hospital to another).  ‍
5. End-to-End System Monitoring: The system must be affordable, easily installed, and produce minimal disruption to clinical, operational, and information technology resources, while being monitored around the clock to ensure continuous availability.

Designed from the ground up by health care team members to protect health care team members, the Commure Strongline staff safety system meets all of these tests and more. 

Inspiring Hope: Patient Safety’s Roadmap for Workplace Violence in Healthcare

The systematic approach that ultimately mitigated the patient-safety crisis provides important lessons and a roadmap for addressing today’s healthcare workplace violence crisis. It also provides an important reminder of the power of collective action and why we can't afford to wait to take action. Beyond its tragic human toll, workplace violence is also incredibly costly due to staff turnover, time lost from work, workers compensation claims, jury awards, fines, regulatory friction, and even impaired patient satisfaction and clinical outcomes. It is far more effective to use our resources to fund evidence-based strategies to mitigate and ultimately eliminate workplace violence.

By following the lessons learned from the patient-safety movement, we as healthcare leaders can help tame the scourge of workplace violence permanently. That opportunity and our collective responsibility provides a poignant call to action to join the movement to eliminate workplace violence in healthcare.

Please visit Commure Strongline to learn more about their innovative system and schedule a demo to see how these solutions can benefit your organization.