Seven months after the Health Ministry set up a committee to minimize violence in the healthcare system and give workers a greater sense of security on the job, its members on Sunday published their comprehensive recommendations, which Deputy Health Minister Ya’acov Litzman said he will implement.
The committee’s formation was triggered by the murder of Tova Carrero, a 56-year-old Clalit Health Services clinic nurse in Holon, who was burnt to death on March 14 by a crazed 78-year-old patient. Her daughter, Nofar, was a public representative named among the two dozen members of the committee. The body was headed by Prof. Shlomo Mor-Yosef, a former director-general of the Hadassah Medical Organization and of the National Insurance Institute who now heads the Interior Ministry’s population registry.
In the past, the ministry had received recommendations from the Israel Medical Association on dealing with violence in the healthcare system, but these were ignored. This time, the ministry said it is serious about implementing the report.
“The phenomenon of violence against doctors and medical teams is serious and unacceptable, and it is a blow that threatens the health system,” said Litzman after receiving the 56-page report in his Jerusalem office. “It cannot be that a doctor, nurse or administrative official will suffer violence of any kind, whether physical or verbal.”
Ministry Director-General Moshe Bar Siman Tov added, “Health system employees are entitled to work in a safe and protected environment without violence. The way to reduce violence and increase the sense of security is long, complex and challenging. It requires the involvement and commitment of patients, policy-makers and medical staffers. Only the unification of forces and cooperation will lead to the desired change and ensure the preservation of our social values within and outside the health system.”
Mor-Yosef noted that violence in the health system is a reflection of widespread violence in Israeli society as a whole. “Violence is violence, whether it occurs at home, in the street, in sports fields, on the road, in schools or in the health system. The health system is a central and vital part of society.”
He added that there are millions of interactions each year among doctors, nurses, patients and family members. “As part of the committee’s work, we have set a goal of formulating a comprehensive and operational recommendations program that will lead to a significant reduction in the number of violent incidents, to create a safe environment for teams and patients,” he said, “working under pressure, with life-and-death matters and under a chronic shortage of manpower, to create a tense atmosphere in hospitals and clinics. We have tried to propose solutions that can be implemented both on the practical side and on the budgetary side over the next two years.”
Among the recommendations are the establishment of motorized national security units; emergency buttons for each employee; placement of cameras in public areas; an ongoing media campaign against violence in health facilities; the creation of a computerized national reporting system for collecting and analyzing data and publishing an annual report summarizing activities in the field of dealing with violence; adding the subject of violence to the patient experience survey; the development of uniform training materials for staff training; publishing a file that includes all the legal tools available to the management of a medical institution to deal with violence; issuing a clear directive regarding sections of the law according to which a complaint can be filed; establishment of a committee to discuss the possibility of recording a violent incident in the patient’s record; setting up physical barriers between administrative workers and patients; setting more severe legal punishments for those who are violent; considering the possibility of referral violent patients to receive treatment in another clinic or hospital; appointing a commissioner for prevention and treatment of violence; establishing a central computerized reporting system connected to the ministry reporting on violence incidents; improvement of conditions in waiting rooms; improving contacts with the police and setting down their responsibilities; expanding the authority of the security guards in the hospitals; and the filing of indictments by the state attorney’s office in a short time in appropriate cases.