Creating a safe practice environment and team

How can we create a safe practice environment and team?

A robust practice policy and training are key to a well-managed, consistent response when preventing and managing patient aggression and violence. Some strategies to create a safe practice may include:

• having a zero-tolerance policy towards violence and abusive or threatening behaviour
• displaying signs in the practice that inform everyone of your zero-tolerance policy
• building a safety culture within the practice team
• consulting with the team on safety concerns and initiatives
• assessing, and regularly reassessing, your practice’s risks, considering your patient cohort and the physical environment
• clearly defining what acts and behaviours require a response, particularly in relation to a zero-tolerance policy
• setting out clear steps for your team to take when dealing with aggressive or violent patients
• appropriately managing access to, and requests for, drugs of dependence (refer to the RACGP guide to Drugs of dependence: Responding to requests)
• considering the design and layout of your practice and consulting rooms
  • ideally there should be two exit points from each room (this may not be practical in many consulting rooms)
  • ideally the GP or team member should be positioned closest to an exit, avoiding having patients positioned between them and the exit (this may not be practical in many situations)
• installing a duress alarm or phone alert system that the practice team can use if a patient is threatening or violent, and establishing a response plan for when the alarm is triggered
• considering the appropriateness of closed-circuit television (CCTV) – patient privacy and workplace surveillance laws must be considered if CCTV is used, and you should display a notice in the waiting room and on the front door informing people that CCTV monitoring is in progress
• ensuring no team member is alone on the premise at any time
• ensuring (as far as possible) that outside areas such as walkways to car parks are well lit
• conducting thorough team member induction and regular training on the practice’s incident response procedures.

All strategies should be documented in your practice’s policies and procedures manual.