title: Hospital workers bypass traditional occupational injury reporting systems when reporting patient and visitor perpetrated (type II) violence.
abstract: Under-reporting of type II (patient/visitor-on-worker) violence by workers has been attributed to a lack of essential event details needed to inform prevention strategies.
  
  
  
  Mixed methods including surveys and focus groups were used to examine patterns of reporting type II violent events among ∼11,000 workers at six U.S. hospitals.
  
  
  
  Of the 2,098 workers who experienced a type II violent event, 75% indicated they reported. Reporting patterns were disparate including reports to managers, co-workers, security, and patients' medical records-with only 9% reporting into occupational injury/safety reporting systems. Workers were unclear about when and where to report, and relied on their own "threshold" of when to report based on event circumstances.
  
  
  
  Our findings contradict prior findings that workers significantly under-report violent events. Coordinated surveillance efforts across departments are needed to capture workers' reports, including the use of a designated violence reporting system that is supported by reporting policies. Am. J. Ind. Med. 59:853-865, 2016. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Division of Epidemiology, Human Genetics, Environmental Sciences, School of Public Health, University of Texas Medical Center, Houston, Texas. lisa.pompeii@uth.tmc.edu.
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Pompeii
authors.affiliation: Department of Occupational Medicine, Duke University Medical Center, Durham, North Carolina.
authors.forename: Ashley
authors.initials: A
authors.lastname: Schoenfisch
authors.affiliation: Department of Occupational Medicine, Duke University Medical Center, Durham, North Carolina.
authors.forename: Hester J
authors.initials: HJ
authors.lastname: Lipscomb
authors.affiliation: Department of Occupational Medicine, Duke University Medical Center, Durham, North Carolina.
authors.forename: John M
authors.initials: JM
authors.lastname: Dement
authors.affiliation: St. Luke's Medical Center, Houston, Texas.
authors.forename: Claudia D
authors.initials: CD
authors.lastname: Smith
authors.affiliation: Division of Epidemiology, Human Genetics, Environmental Sciences, School of Public Health, University of Texas Medical Center, Houston, Texas.
authors.forename: Sadie H
authors.initials: SH
authors.lastname: Conway
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D017144:Focus Groups; D006761:Hospitals; D006801:Humans; D008297:Male; D008875:Middle Aged; D009657:North Carolina / Q000453:epidemiology; D060051:Occupational Injuries / Q000453:epidemiology*; D010361:Patients; D010564:Personnel, Hospital / Q000706:statistics & numerical data*; D011159:Population Surveillance / Q000379:methods*; D013781:Texas / Q000453:epidemiology; D014481:United States; D014789:Visitors to Patients; D064450:Workplace Violence / Q000706:statistics & numerical data*
keywords: hospital workers; occupational injury surveillance; reporting violence; type II violence