Violence in the consulting room. A multifactorial strategy for prevention and harm minimisation.

BACKGROUND: Workplace violence in the medical setting should be approached in the same manner as any other occupational health and safety issue. The hazards need to be identified, the risk quantified and appropriate steps to minimise the risk taken.
OBJECTIVE: This article discusses a prevention strategy to increase the barrier to patient initiated violence, and suggests steps that can be taken after an assault to assist the clinician or staff member involved. DISCUSSION: The steps involved in an assault are: the assailant makes the decision to attack, overcomes his or her internal barriers, creates the opportunity, and executes the attack. A prevention strategy involves risk assessment and increasing the barriers in each stage leading to an assault.