Montage Health

Daniel B. McKernan

Patient Mobility Advisor

Technology Strengthens Staff Safety

There is a tremendous amount of technology available to strengthen workplace violence prevention in healthcare. At Montage Health, we have taken several proactive measures that use technology to help keep our staff safe, including:

Duress alert badges: Staff are provided with small, discreet badges that are worn behind their employee ID. When activated with a double press “double press when in duress” the badge immediately sends an alert to the Security team. Security can see the employee’s name and exact location, down to the room number and can continue to track their location if they are moving. In 2025 alone, Security responded to 317 duress alert activations.

Weapons detection systems: Montage Health has been proactive in implementing weapons detection technology. New legislation will require hospitals to screen visitors for weapons, but Montage Health already has a system in place. We have successfully identified weapons during the screening process and had them removed before a visitor entered the facility, helping prevent potentially dangerous situations before they occur.

Violence Assessment Tools (VAT) within the electronic health record (EHR): Our EHR includes a Violence Assessment Tool that allows staff to see whether a patient has previously exhibited violent behavior while receiving care. This information allows staff to take appropriate precautions and prepare for potential risks. A discreet visual indicator is also placed at the entrance to the patient’s room to alert staff.

Mass communication tools: Several years ago, Community Hospital of the Monterey Peninsula (CHOMP) conducted an active shooter full-scale exercise. During the after-action review, an important question emerged: How do we communicate with all staff during a rapidly developing emergency?  

That question led us to implement a mass notification software program that allows us to send messages directly to staff members’ cell phones within seconds. The system is multimodal, meaning notifications can be sent through multiple channels, including text messages, backup contacts and email. The system can continue sending notifications until staff acknowledge receipt. This technology has become an important tool for communicating quickly during emergencies.

Real Examples Explain the Why

Staff need to understand the “why” behind safety initiatives if we want to change the culture. Simply writing policies and requiring employees to complete e-learning modules is not enough to create a true culture of safety.

For workplace violence prevention, training should incorporate real-life examples that demonstrate what went wrong, why the situation escalated and how the incident might have been prevented. When training is approached this way, employees can recognize how the lessons apply to their own work without feeling blamed or being made to feel that they were at fault.

The same principle applies to regulatory requirements. Regulations and accreditation standards should be viewed as consultative opportunities rather than simply compliance obligations. Organizations should welcome recommendations and suggested changes when they can ultimately create a safer environment for both patients and staff.

Frontline Reporting Turns Data Preventive

Leadership plays a vital role in ensuring workplace violence prevention programs are implemented, adequately funded and sustained and just as importantly, in listening to frontline staff.

Without leadership endorsement, accountability, resources and ongoing support, even the best programs can fail to produce meaningful change. One of the most important tools leadership has is data and that data comes from frontline staff reporting incidents.

Reports can range from verbal harassment and threats to physical assaults. While not every report requires a root cause analysis or a critical incident stress debriefing, many do. More importantly, every report contributes to a larger picture of what is happening within the organization. That information allows leaders to identify trends and make informed decisions about prevention and mitigation strategies.

"Simply writing policies and requiring employees to complete e-learning modules is not enough to create a true culture of safety."

Frontline staff need to understand the importance of reporting as well. Even if an incident seems minor, it is still worth reporting. A seemingly small event may be part of a larger trend and without that information, leadership cannot fully understand the risks staff are facing.

Ultimately, the data drives prevention. Reporting creates visibility, visibility drives action and action leads to a safer workplace.

Distance, Escape and Awareness Matter 

Through our workplace violence prevention training program, staff are taught how to recognize the signs of escalation using what is commonly referred to as the stress and assault cycle. Understanding where an individual is in that cycle allows staff to determine the most appropriate intervention or avoidance strategy and, when possible, prevent further escalation.

When a physical assault does occur, we often find that three critical factors were missed: a staff member did not recognize the warning signs of an attack, appropriate distance from the escalating individual was not maintained, or an unobstructed means of escape was not maintained.

When we drill scenarios based on actual violent incidents that have occurred within our organization, it becomes clear that many of these incidents might have been avoided if these three principles had been maintained.

The goal is not simply to teach staff how to respond after violence occurs. It is to give them the skills and awareness to recognize risk early, intervene appropriately and position themselves to remain safe if a situation continues to escalate.

Loop Closure Builds Staff Trust

Workplace safety must be consistent and become part of the everyday culture, not something that is addressed only after an incident occurs.

At Montage Health, we start each day with a safety huddle and review safety reports on a daily basis. Just as important as reporting, however, is follow-up and loop closure. Staff need to know that when they report a safety concern or violent incident, the organization has heard them and is taking action.

If communication from frontline staff to leadership stops after the initial report and staff never hear what happened as a result, a perception can develop that reports are not being addressed and that leadership does not care about the concerns being raised.

Consistent communication is therefore critical. Staff need to understand what programs are in place to protect them, what happens when they report an incident and what changes are being made as a result.

A culture of safety is built through repetition, communication, accountability and trust. When frontline employees see that their concerns lead to action, safety becomes more than a policy it becomes part of the organization’s culture.