Violence in the health-care sector

Ontario guide aims to help employers, supervisors and workers

Violence in the health-care sector
Stuart Rudner

By Nadia Zaman


Every employer has a vested interest in providing a safe and healthy working environment for employees. Not only is a safe workplace imperative for employee productivity and satisfaction, employers have legal duties and obligations pursuant to provincial health and safety legislation that revolve around providing a safe workplace for employees.


Recently, the Ontario government released a guide to help prevent workplace violence in the health-care sector (meaning hospitals, long-term care homes and private home care facilities). This guide aims to help employers, supervisors and workers understand their obligations under the Occupational Health and Safety Act (OHSA) and the Health Care and Residential Facilities Regulation (O. Reg 67/93).


The overview of the guide states as follows:


“Health-care workers have the right to do their jobs in a safe and healthy workplace, free of violence. According to Ontario's Workplace Safety and Insurance Board, workplace violence accounted for 13 per cent of all lost-time injuries in the health-care sector in 2018. There must be zero tolerance for workplace violence — one incident is one too many. Addressing this issue in Ontario's hospitals, long-term care homes and home care settings will help create safer environments for workers and improve patient care." 

First, the guide sets out the definition of workplace violence and workplace harassment under the OHSA and explains other key terms such as “workplace” and “internal responsibility system.”


Next, the guide discusses the role of the joint health and safety committee or health and safety representative, as well as best practices for committee members who have the power to recommend workplace violence prevention practices beyond the legislative requirements of the OHSA. For example, committee members can recommend enhancing the workplace violence program, based on a review of workplace violence trends, such as incidents, notifications received for critical injuries, fatalities and accidents, violence causing injury and investigation results. The guide also mentions the requirements under O. Reg 67/93.


In addition, the guide lays out how to develop a successful workplace violence policy and program, including:

  • the recommended process for controlling risks of workplace violence and communicating risks to workers
  • reporting obligations under the OHSA and the Workplace Safety and Insurance Act (WSIA)
  • the process for investigating incidents or complaints
  • providing information to workers
  • refusals to work due to workplace violence
  • domestic violence awareness
  • the prohibitions against reprisals.


The guide also discusses reporting under the OHSA, the WSIA and the provincial quality improvement plans. For instance, Health Quality Ontario, an agency of the Minister of Health and the Minister of Long Term Care, included workplace violence prevention as a key component of the Quality Improvement Plan process for hospitals in 2018-2019. Under these plans, hospitals, primary care organizations, long-term care homes and local health integration networks must submit the plans annually to describe how the organization will address its quality improvement goals including on workplace violence prevention.


Providing a safe and healthy workplace is critical to providing quality health care. This guide is quite ambitious and it will be able to fulfill its ambition if employers in the health-care sector take it seriously and properly train supervisors and workers. With time, hopefully this guide will help bring about a cultural shift such that the internal responsibility system becomes the norm and violence in the workplace becomes a rare incident.


Every employer has an obligation to take all reasonable steps to ensure the safety of workers. For many employers, this will mean preparing and implementing written workplace health and safety policies and procedures (including training for employees), which are reviewed and updated based on regular workplace risk assessments, and which are consistently enforced. It will also include appropriate and ongoing training and education for employees.

No employer wants to find itself in the midst of a health and safety incident, but understanding its obligations as an employer and how to respond appropriately can allow it to address and resolve the issue, and prevent future problems from arising.

Nadia Zaman is an associate at Rudner Law in Toronto.

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