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Health Care High Risk Strategy

The Health Care High Risk Strategy (HRS) focuses WorkSafeBC resources on identified high-risk work activities within health care and community social services worksites. The primary focus is on work areas and occupations where direct patient care or services to individuals are provided and the interactions between the worker and the patient or individual can be observed.

Officers will apply a point-of-care inspectional process to help identify at-risk workers. Six percent of all time-loss claims are from health care assistants, making that occupation the most injured in B.C. Combined, health care assistants, registered nurses, licensed practical nurses, social workers, home support workers, and paramedics represent 75.8 percent of all time-loss claims from 2013 to 2017 in the health care and social services subsector. Point-of-care interactions between workers and patients or individuals pose the greatest risk of injury to workers, including serious injuries due to acts of violence.


The goals of the 2018–2020 HRS are to:

  • Reduce the risk of workplace violence and related injuries to health care and community social services workers
  • Reduce health care and community social services workers’ risk of overexertion or musculoskeletal injuries (MSIs) due to patient/individual lifting and patient/individual mobility limitations


Our approach in 2018–2020 is to:

  • Apply point-of-care inspectional protocols focusing on violence prevention, MSI prevention, and employer internal responsibility systems
  • Implement various initiatives to educate employers, workers, and supervisors; build relationships; and encourage safe work practices focusing on violence prevention and MSI prevention

2019 additional focus

When we developed the 2018–2020 HRS, we recognized that within the three-year timeframe we would need to retain flexibility to add additional focus areas. In 2019, a communication and research initiative to prevent violence in health care is an additional focus. This initiative includes:

  • A review of Violence Risk Assessments (VRAs) in selected organizations for compliance and best practices
  • Consultation with senior leadership, directors, managers, and joint health and safety committee members of selected organizations to gather baseline information on current perspectives of violence prevention programs and the purpose and content of VRAs

The goals of this communication initiative include:

  • Communicate the findings from consultations with senior leadership in selected employer groups to help increase support of their violence prevention programs
  • Increase awareness and ownership of violence prevention and violence risk assessments in health care organizations
  • Facilitate compliant VRAs in accordance with OHS Regulation 4.28
  • Optimize WorkSafeBC’s resources and identify new resources for development

Deliverables and timelines



Inspections — Violence
Q1–Q4 2019

Implement a program of planned inspections at locations (selected by employer and classification units), with a focus on preventing acts of violence in high-risk classification units, employers, and occupations.

Inspections — Overexertion
Q1–Q4 2019

Implement a program of inspections focused on preventing overexertion injuries due to patient handling in long-term care and social services.

Education and outreach

Violence prevention resources
Q1–Q4 2019

Develop and distribute violence prevention resources designed to improve awareness, change behaviour, and assist with OHS Regulation compliance.

Overexertion resources
Q1–Q4 2019

Develop and distribute overexertion prevention resources designed to improve awareness, change behaviour, and assist with OHS Regulation compliance.

Updates and results

As part of our strategic initiative to develop measures to assess the effectiveness of prevention activities, we are providing updates of our High Risk Strategies and Industry Initiatives.

Note: To save space in bulleted lists, our update documents may refer to occupational health and safety as OHS. All references to the Act, refer to Part Three of the Workers Compensation Act. Penalties and warning letters reported in updates may have been initiated by inspections in a previous quarter.

Related resources