18 June 2014

We explore some simple ways to help make a medical practice a safer and less stressful place to work.

According to recent research, close to three in every five general practitioners (GPs) have experienced aggression in their surgeries. Yet only a few have clear strategies for creating a safer, less stressful workplace.

This insight comes from the report “Workplace aggression prevention and minimisation in Australian clinical medical practice settings – a national study”. And the findings suggest that key approaches recommended by leading international organisations and other researchers to tackle aggressive behaviour aren’t widely implemented in clinical medical workplaces in Australia.

“Aggression can be physical, verbal or written and perpetrated by anyone from patients and their relatives to co-workers,” says Dr Danny Hills, Assistant Professor in Nursing at the University of Canberra and one of the authors of the report. “Serious incidents can have a devastating impact though, fortunately, they are rare. But aggression at any level can wear people down, affecting their level of job satisfaction and possibly influencing their career options. It can also affect their health and wellbeing.”

The patterns of exposure to aggression are complex, but the report found that the strongest predictor is a doctor’s age.

“We saw that the younger the doctor, the more likely he or she is to have experienced aggression in the previous year,” says Dr Hills. “This might be because communication skills and the ability to manage difficult situations tend to develop with experience.”

In terms of preventing, minimising or escaping aggressive behaviour, Dr Hills found that his research is consistent with other work in this area. “There are some quite simple strategies that seem to work well, and which I’d recommend for anyone working in a medical practice.” he says.

Six ways to improve safety in your practice

  1. If a patient shows any sign of aggression, note this on their record and tell them that you aren’t prepared to accept that kind of behaviour. Make it clear that they may no longer be welcome if it happens again.
  2. Arrange your consulting room so you’re sitting closer to the door than your patient. If someone becomes aggressive, simply leave the room.
  3. Be mindful of what’s on your desk and lying around the office. Avoid having any objects that a patient could use to hurt you or damage property.
  4. A personal duress alarm may be a smart investment for your safety.
  5. For all new patients, ask reception staff to collect relevant background information where appropriate then read their notes before your patient’s first appointment. It’s always good to know who you’re sharing a room with.
  6. How your front-line staff greet your patients and handle issues – such as an unexpectedly long waiting time – can establish a patient’s mood for the whole visit, yet few receptionists receive any instruction in this area. Consider providing communication training courses.

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