The Oregon Association of Hospitals and Health Systems has designed a detailed, 172-page toolkit in collaboration with nurses and doctors associations and organized labor.

It shows health care organizations how to assess risks, review best practices, collect baseline incident/injury and cost data related to workplace violence and identify hazards and risks that need to be addressed. The focus is on violence perpetrated by patients against workers.

The Joint Commission, one of the main national accrediting bodies for hospitals, highlighted the toolkit on its website as a recommended resource.

In Oregon between 2013 and 2015, there were 1,646 work-related accepted disabling claims from assault, according to information in the toolkit.

Health care and social assistance in both the private and public sector accounted for nearly half of these claims, more than any other industry. A majority of claims occurred in nursing and residential care facilities, and 84 percent of injuries occurred as a result of health care workers being hit, kicked, bitten or shoved, according to the Toolkit.

Workplace violence may be underreported in health care, however, especially bullying and other forms of verbal abuse, possibly due to a lack of reporting policies or lack of faith in the system.