AUSTIN, Texas — Risk managers need to work with senior leaders at health care systems to devise prevention strategies that can reduce incidents of violence against medical providers, panelists said at the American Society for Healthcare Risk Management's annual conference in Austin, Texas.

Several dynamics can lead to violence in hospitals and other medical facilities, including substance abuse, stress from dealing with medical bills and problems with navigating a complex health care system, Diane Doherty, New York-based vice president of Ace Medical Risk, a division of Ace USA, said Tuesday.

She said all medical groups need to acknowledge that violence can occur in their organizations, and they should work to craft up-to-date violence prevention programs that take a medical system's unique vulnerabilities into account. This includes encouraging employees to report acts of violence in health care facilities and getting buy-in from senior managers to take a zero-tolerance approach to violent acts in the workplace.

“Preventing workplace violence is everyone's responsibility,” Ms. Doherty said. “It takes a multidisciplinary team approach, and the risk manager plays and an important role in leading and guiding that team.”

Richard D. Sem, president of Lake Geneva, Wis.-based Sem Security Management, also offered advice for health care systems that are looking to prevent violence in their workplaces. Mr. Sem, who provides security consulting for health care organizations, said he has seen an increase in “rude and aggressive” behavior at hospitals.

Risk managers should develop close relationships with internal security managers, as well as police or sheriff's departments in their communities, she said.

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“You need to have that liaison with your local law enforcement agencies,” Mr. Sem said. “They need to know you. They need to know your plans. They need to tour your facility. They need to have layouts. They need to know what you're going to do in case of violence and what their relationship is. They can be a great resource.”

He recommended limiting the number of entry points to hospitals and having people greet visitors as they enter facilities. By establishing contact with people entering the hospital, Mr. Sem said staff can make an early assessment of whether a person might pose a threat of violence.

“I think the most powerful five words in security are 'How can I help you?'” Mr. Sem said. “They're not a threatening question, (and) most … people coming in will appreciate the question. But it's a good way of assessing what people might be up to.”

Mr. Sem also recommended providing security training for all employees in medical facilities.

“Your staff needs to have responsibility,” he said. “Often when I talk to nurses and physicians, they'll say, 'It's not our job, it's security's job.' Well, it is their job really. It's part of their role.”

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