Washington — Seeking written guidance that will facilitate the posting of signage discouraging violence in ERs, the American College of Emergency Physicians and nine other health care organizations have written to the Centers for Medicare and Medicaid Services.
In a Jan. 20 letter addressed to CMS Administrator Mehmet Oz, the coalition claims that violence in ERs has “escalated significantly in recent years” and many health care workers – including emergency doctors and nurses – are “reaching their breaking point and leaving a health care workforce that is already stretched distressingly thin.”
The group contends that signage is necessary because it “sets expectations for respectful behavior and emphasizes that violence toward staff, patients or visitors is unacceptable and could have consequences.”
It adds that CMS previously stated that hospitals can post signage if they can demonstrate that the signs don’t deter patients from staying for medical screening exams and stabilizing treatment.
However, the coalition says it still hasn’t received clarity on what could or could not be a deterrent – and that CMS has declined to offer further explanation or overarching guidance. In addition, it says, some hospital surveyors are questioning (or citing) “neutral” workplace violence signs as potential violations of the Emergency Medical Treatment and Labor Act of 1986, known as EMTALA.
“This essentially forces hospitals who want to protect vulnerable frontline staff to take a leap of faith in posting signage that is their ‘best guess’ as compliant,” the letter says.
Along with written guidance, the group is asking CMS to communicate any clarifications directly to state survey agencies and accrediting organizations and to incorporate acceptable workplace violence signage into surveyor training materials and FAQs.
Along with ACEP, the letter was signed by the American Hospital Association, American Medical Group Association, American Nurses Association, American Psychiatric Association, American Society for Health-System Pharmacists, America’s Essential Hospitals, Children’s Hospital Association, Emergency Nurses Association and National Rural Health Association.
