QI In Action: Addressing Occupational Violence Towards Remote Healthcare Workers

We spotlight Ms Helen Gill and Mrs Sara Jacob’s impactful project which focuses on addressing occupational violence and improving the safety of healthcare staff at NT Health.

The Quality Improvement Lead (QIL) Program is a 9-month training course run by the ACHS Improvement Academy, supporting participants in implementing quality improvement projects within their own organisations.

Ms Helen Gill – Quality and Safety Manager and Mrs Sara Jacob – CQI Facilitator, worked on a project titled ‘For Your Safety, Tick the Box,’ at the Northern Territory (NT) Health Central Australia Region. The project aimed to enhance staff safety by improving compliance with pre-visit risk assessment procedures for all after-hours callouts and community visits.

Central Australia Health Service is the principal provider of health services in the central Australia region of the NT. The majority of the primary and public health care branch of the Central Australia Health Service is provided in remote and isolated Aboriginal communities.

Project Background

Exposure to violence remains a significant issue for healthcare staff working in remote settings. The tragic murder of nurse Gayle Woodford in Fregon, South Australia, in 2016, brought national attention to the risks faced by healthcare workers in these environments. Gayle’s death highlighted the urgent need for improved safety measures to protect those providing essential care in remote communities.

Following a state-wide review, NT Health introduced the pre-visit risk assessment form to help remote area nurses evaluate risks and establish contingencies before attending potentially unsafe situations.

However, an audit revealed that only 7% of these forms were completed for 318 after-hours callouts over two weeks across 26 communities across the Central Australia Region Health Service. This low compliance rate, combined with rising reported incidents of occupational violence, security breaches, and alcohol-related violence in communities, prompted an urgent review of safety protocols.

Recognising the potential dangers to staff, NT Health set a clear aim to ensure 100% compliance with pre-visit risk-assessment forms by December 2022, improving safety before after-hours callouts or community visits.

Building Compliance Through Engagement and Process Improvement

An initial audit provided baseline data, revealing significant non-compliance with safety guidelines. A staff survey identified barriers, including human factors such as forgetting to complete forms and insufficient administrative support.

The team implemented a multifaceted improvement strategy involving :

Engagement and Education: Face-to-face discussions, staff feedback sessions, and mandatory pre-visit risk-assessment training during orientation.

Process Refinement: Reviewed and updated the staff safety procedure and risk-assessment form.

Awareness Campaigns: Interactive sessions, PowerPoint presentations, and online learning modules.

PDSA Cycles: Conducted iterative Plan-Do-Study-Act cycles to trial and implement effective interventions.

Results and Learnings

The remoteness of communities, transient staffing, and logistical constraints posed significant barriers. However, the team’s commitment to adaptive solutions ensured steady progress despite these challenges.

While official results from a follow-up audit are pending, early indicators show improved awareness and engagement among staff. Initiatives like "starting the chat" about safety have fostered a culture of vigilance and responsibility.

This project represents a vital step forward, empowering clinicians to prioritise their safety while delivering essential care.

Explore projects from QIL Program Graduates

You can read more projects like this in the QIL Projects Summary booklet undertaken by QIL 2021-2023 participants over the course of our 9-month program.

The booklet contains summaries of real work-based improvement projects across various healthcare categories including acute healthcare, community, drug and alcohol services, partnering with consumers and more. The Project Summaries 2021-2023 booklet is available for viewing here.

Keen to hear more about the QIL Training?

Our next QIL Training Program will start in February 2025. Click here to view full details.