How to spot and respond to disruptive, aggressive individuals

Workplace violence seldom “just happens.” The typical review of such incidents show several points during the preceding days and hours when the perpetrator’s behavior caused concern and when intervention would have been appropriate and effective.

Early intervention is the key to preventing workplace violence. Here at the U-M Health System, early intervention can start with a phone call to:

• Hospital Security (911 or 936-7890)
• Health System Risk Management (763-5456)
• Office of Clinical Affairs (936-5814)
• Department directors and administrators
• Health System Human Resources, in the case of employees showing aggression (647-2385)

A team approach is used, with the makeup of the team depending on who is involved (i.e. patient, staff, visitor, etc.) and the severity of the situation. This approach allows for a comprehensive and timely response that works to remove the immediate threat of violence and to reach a permanent resolution.

Getting help

When and how does a staff member ask for help and intervention? There are times when it is clear that an intervention needs to occur, such as when a person becomes angry and their behavior is escalating.

Perhaps they are rapidly pacing while clenching their fists; their face is turning red and their voice keeps getting louder.

If faced with this situation:

• Increase the space between yourself and the escalating person
• Move so that they are not between you and the room’s exit
• Keep your voice low and as calm as possible
• Dial 911 if it is safe to do so
• If you are unable to dial 911, ask a co-worker for a yellow card, which signals them to call 911 and contact Security

Do not:

• Attempt to handle the situation yourself
• Move closer to the individual
• Argue with the individual

Other times are not quite as clear, but early intervention is still critical to prevent violent behavior.

These are times when you or your co-workers:

• Feel uncomfortable by a person’s behavior
• Observe bullying or intimidating behavior
• Feel threatened by someone either explicitly or implicitly

In these situations, staff members should notify their supervisors or Security and explain their concerns so they can be investigated and the appropriate intervention taken.

The UMHHC workplace violence prevention website, www.med.umich.edu/i/security/behavior.htm, provides detailed information for managing aggressive and disruptive behavior, as well as various policies and references.

Trust your gut instinct. If it tells you something is wrong, tell someone. Don’t be the person saying, “I knew I should have called Security.”