The U.S. Occupational Safety and Health Administration has updated its workplace violence prevention guide for the health care and social services industry — but a comprehensive workplace violence prevention plan is a best practice for all employers, experts say.

The federal agency's recently updated guidance targets health care and social services workers, because they were nearly four times as likely to be injured as a result of violence on the job than other private-industry workers in 2013, the Bureau of Labor Statistics said of the latest data available.

In addition, more than one-quarter of the 341 private-industry workplace homicides in 2013 were in the retail trade sector, which includes grocery, clothing and accessories stores, and gas stations, said Washington-based BLS economist Stephen Pegula.

But while workers who deal directly with the public have a higher exposure to violence, no workplace is immune, sources say.

“Workplace violence is recognized as an occupational hazard in a variety of industries,” an OSHA spokeswoman said in an email. “In addition to the health care and social services industry, OSHA has guidance or has investigated workplace violence in other industries such as late-night retail, security/correctional settings and in transportation sectors.”

“(Employers) have a duty to be both responsible and accountable for the safety and the protection of their workforce,” said Kevin Wilkes, Pittsburgh-based security practice leader at Willis North America Inc. Yet, he said, the vast majority of employers do not have a comprehensive workplace violence prevention plan.

A written program should include management commitment and employee participation; a worksite analysis; hazard prevention and control; safety and health training; and recordkeeping and program evaluation, according to OSHA.

“Probably 95% of the workplace violence plans I see are inadequate and missing key components like mitigation,” said Dick Sem, president of security and workplace violence consultant Sem Security Management in Lake Geneva, Wisconsin. Some employers may have only an active shooter plan, but “we want to keep it from rising to that level in the first place,” he said.

Roanoke County, Virginia, Police Sgt. Chris Kuyper said the police department routinely works with schools on violence prevention, but most businesses have no plan.

Sources said workplace violence, which includes stalking, harassment and physical assault, often involves customers, clients or patients; employees or supervisors; and domestic partners or relatives of employees.

As an employer, West Bend Mutual Insurance Co. continually updates its 5-year-old workplace violence prevention policy so employees, especially those working with claimants, know how to address potential threats, said Mark Riesinger, corporate security manager for the West Bend, Wisconsin, insurer.

Since employees work in an office building with a receptionist, usually “we have time to react and ... look at all of the circumstantial evidence (such as any emails exchanged) to determine if there's a true risk for a threat or if a simple phone conversation can de-escalate the situation,” he said.

Employers have to take all threats against workers or the organization seriously, Mr. Wilkes said. “That means getting local law enforcement involved immediately so they can take the proper steps to assess the threat and bring it to some type of resolution.”

While Mr. Riesinger said West End takes a proactive approach to workplace violence prevention, Messrs. Wilkes and Sem said at least half of employers that contact them for guidance do so only following an incident.

Mr. Sem recommends putting together a “threat management team,” including representatives from human resources, security, safety, legal and risk management. The team can help mitigate or prevent such events, he said.

“Oftentimes, there's a moment,” such as a termination of employment or a refusal of service, “that can set a person off,” Mr. Sem said. “You need to consider how you're going to present that safely. Most organizations do that ... without any formalized mitigation process.”

Another best practice for employers is communication, sources said.

“If you look at these active shooter events in schools or in businesses, a lot of times other people know about them before they even occurred,” Sgt. Kuyper said. “We talk to business managers and owners about having an open communication plan with their employees” and suggest they ask if there's “something they need to know that puts their employee, or other employees, at risk of an event.”

For West End employees, communication and “good listening skills are mandatory ... because if you don't hear exactly what's being said, simply answering that question incorrectly could escalate” an incident, Mr. Riesinger said.

Every workplace violence situation is different, Mr. Sem said, so whatever the best response is, employers need to communicate it to their workers in real time and tell them how to stay safe.