Prevention: environmental design, work practices and training

Once the risks are understood, the next step is to control them. The hierarchy of controls applies to violence and harassment as it does to any hazard: eliminate the hazard where possible, substitute safer ways of working, use engineering and environmental controls to separate people from harm, use administrative controls to change how work is organized, and use personal protective equipment and personal alarms as a last layer. In practice, effective programs combine several layers, because no single control stops every incident. This lesson explains the main types of control and how to choose among them.

Elimination and substitution

The most effective controls remove the source of risk. A retail chain that moves to cashless payment at night removes the main motive for robbery. A government office that lets people renew documents online reduces the number of tense face-to-face interactions. A transit agency that stops requiring drivers to enforce fares, and instead uses fare inspectors in pairs, removes a common trigger for assaults on drivers. A hospital that redesigns its admission process to reduce waiting times reduces the frustration that fuels aggression. These changes are not always possible, but they should always be considered first, because they protect everyone without relying on anyone remembering to do the right thing.

Environmental design

Crime prevention through environmental design, often shortened to CPTED, is an approach that uses the design and management of physical space to reduce opportunities for crime and violence. It rests on four main principles:

• Natural surveillance: arrange spaces so that people can see and be seen. Use good lighting, clear sight lines, windows into interview rooms, convex mirrors and open counters, and avoid hidden corners.
• Access control: guide and limit who can enter which areas, with reception points, locked doors, card access, visitor sign-in and clear separation between public and staff areas.
• Territorial reinforcement: make it clear which spaces are private and who is responsible for them, using signs, landscaping and design features.
• Maintenance: keep spaces clean, repaired and well lit, because neglected spaces signal that no one is watching.

Specific engineering and environmental controls for violence include:

• Barriers and counters: deep or raised counters, partial or full barriers, and pass-through trays at cash and service points, chosen so that they protect without making communication impossible.
• Room layout: interview and treatment rooms with two exits where possible, staff seated nearest the exit, furniture that cannot easily be thrown, and no objects that could be used as weapons.
• Alarms and communication: fixed duress buttons, personal alarms, radios or mobile safety devices linked to a monitored response, with regular testing.
• Surveillance: video cameras, visible monitors and signs, used in line with privacy law and with clear rules about who can view recordings.
• Access: locked doors, keypads, controlled entry to wards and staff areas, safe rooms where staff can retreat, and secure staff parking with good lighting.
• Comfort: waiting areas with comfortable seating, natural light, low noise, information about waiting times, water and toilets, which reduce frustration and agitation.
• Cash and valuables: drop safes, time-delay safes, low cash limits and signs stating that staff cannot open the safe.

Administrative controls

Administrative controls change how work is organized. They depend on people following procedures, so they need supervision and review, but they are essential because most workplaces cannot design out every risk.

• Staffing: enough staff, with the right skills, at the right times. Avoid having one worker alone at high-risk times, and plan for breaks, peak periods and sick leave. Short staffing increases waiting times, reduces supervision and leaves workers isolated.
• Procedures: clear procedures for opening and closing, handling cash, admitting visitors, home visits, transporting clients, responding to alarms, and refusing service to abusive customers.
• Information sharing: systems to tell staff about clients or situations with a known risk of violence, consistent with privacy law, including flags, care plans and handover reports.
• Work scheduling: avoiding late-night solo shifts, rotating high-stress assignments and scheduling visits to high-risk clients in pairs or at safer times.
• Codes of conduct: posted expectations for customers and visitors, such as a statement that abuse of staff will not be tolerated, with the authority for staff to end interactions that become abusive.
• Policies on alcohol at work events, relationships between supervisors and subordinates, and use of social media and messaging tools, which help prevent harassment.
• Emergency response: trained response teams, such as hospital codes for violent situations, clear roles and regular drills.

Personal protection

Personal alarms, mobile duress devices, two-way radios, protective sleeves against bites and scratches, and stab-resistant vests for some security and corrections roles are the last layer of protection. They do not prevent incidents, but they can summon help faster and reduce injury. Their value depends on the response behind them: a personal alarm is useless if nobody hears it or nobody knows what to do. Test devices regularly, make sure workers wear them, and track response times.

Training

Training is an administrative control, but it is so central that it deserves its own section. Effective training is matched to the risk: everyone needs basic awareness, while workers in high-risk roles need more in-depth, practical training with refreshers. A typical training program includes:

Training works best when it is interactive and realistic, uses scenarios from the actual workplace, is delivered by credible trainers, and is backed up by management behavior and working systems. A training session that tells workers to report incidents, followed by a manager who ignores reports, teaches the opposite lesson. Training alone cannot make up for unsafe staffing levels or a poor layout, but without training, workers may not recognize risks or know how to use the controls available.

Preventing harassment

Many of the controls above also help prevent harassment, but harassment prevention has some distinctive features. It depends heavily on leadership and culture: what leaders say, what they tolerate and what they do when a complaint is made. Effective measures include a clear, plain-language policy endorsed by senior leaders; consistent consequences regardless of a person's seniority or value to the business; several reporting channels, including one outside the direct chain of command; training that includes bystander intervention; attention to work events and social activities; and regular climate surveys with visible action on the results. Reducing power imbalances, for example by making scheduling transparent or ensuring more than one person evaluates performance, can also reduce the opportunity for harassment.

Choosing and checking controls

When choosing controls, ask several questions. Does the control address the specific risk identified in the assessment? Is it as high in the hierarchy as reasonably practicable? Does it create new risks, such as a locked door that blocks an escape route? Will workers accept and use it? Who is responsible for maintaining it? How will you know if it works? Involve workers in choosing and testing controls, and check them after implementation by observing practice, testing alarms, reviewing incident data and asking workers whether they feel safer.

Involving workers and evaluating cost

Workers who do the job are the best source of ideas for practical controls, and they are more likely to use controls they helped design. A front-line team asked how to reduce aggression at a service counter may suggest changes that managers had not considered: moving the queue so that people can see staff are busy, adding a sign that explains common delays, giving staff authority to offer small goodwill gestures, or changing the time when appointment reminders are sent so fewer people arrive at once. Pilot new controls in one area, ask workers whether they help, and adjust before rolling them out widely.

Cost is often raised as a barrier, but many effective controls are inexpensive, such as better lighting, rearranging furniture, changing procedures or adjusting schedules. When larger investments are needed, such as additional staff, security systems or redesigned reception areas, compare their cost with the cost of incidents, absences and turnover estimated in Lesson 2. In many workplaces, especially health care, the business case for prevention is strong, and the legal duty to take every reasonable precaution means that cost alone is rarely a valid reason for doing nothing.

Finally, document the controls chosen, the reasons for choosing them, who is responsible and when they will be reviewed. This record shows regulators and workers that the employer has taken every reasonable precaution, and it makes the next review of the risk assessment much easier.