Targeted mobile ad drive raises issue of abuse against health care workers

People turning to their phones to kill time in waiting rooms at health care facilities may soon see an unexpected image: a person in blue scrubs, with dark purple bruises on her arm.

It is one of the ads in a targeted mobile campaign launching Wednesday, designed to raise awareness about the pervasive problem of abuse against health care workers. It is using new advertising technology – targeting people with mobile ads based on the GPS location of their phones – to get the message out.

The campaign, launched by Ontario's Public Services Health & Safety Association (PSHSA), will show ads to people in more than 100,000 health care facilities in the province, including hospitals and rehabilitation centres. Ads will appear in mobile apps people use to play games, read the news, or map their routes home, for example, as long as those people have agreed to allow those apps to gather information about their whereabouts.

"The issue of violence against health care workers is growing," said Henrietta Van hulle, executive director of the PSHSA, a non-profit funded by the Ministry of Labour. The association is charged with taking a preventative approach to workplace health and safety (as opposed to enforcement, which is the purview of the Occupational Safety and Health Administration, or OSHA.)

The campaign is the beginning of a multiyear process to push for better tools to protect these workers. That will include more awareness among families of patients, who need to inform doctors and nurses if the patient has certain triggers or warning signs of a violent outburst. It could also involve tools such as personal alarms workers can wear to call for help when a situation arises. More generally, it also means informing workers of their rights, and encouraging workplaces to do better risk assessments and even flag patients who may become violent. For people working in home care, who do not have security nearby, risk assessment is even more important.

Last year, 639 health care workers in Ontario were injured in a violent incident, badly enough that they were unable to work their next shift. That statistic does not account for incidents where workers are pushed, hit, or scratched, for example, and do not report them or take time away from work.

"They're seeing [these incidents] as part of the job," Ms. Van hulle said.

In October, a nurse was stabbed in the head and neck at the Brockville Hospital Mental Health Centre in Ontario.

The issue is not limited to Ontario. In December, a nurse was punched and thrown against a wall at a hospital in Kamloops, B.C., and a doctor was beaten severely at a hospital in Penticton, B.C. Last month, a home care worker was stabbed in Parksville, B.C.

According to a decade-old Statistics Canada study, 33.8 per cent of more than 73,000 nurses surveyed in hospitals and long-term care facilities reported being physically assaulted by a patient in the past 12 months. Nearly half of more than 100,000 surveyed reported emotional abuse on the job. More recent national statistics are hard to come by, but industry associations and unions say the problem is growing.

This is due to a couple of factors. First, there has been a move to de-institutionalize people with mental health issues. While it is seen as positive to put fewer people with mental health issues into institutions, protections for workers dealing with these patients have not kept pace with the changes. Another major issue is Canada's aging population, and rising cases of dementia. Although not everyone with dementia is violent, people who are cognitively impaired can easily become frightened and lash out, Ms. Van hulle explained.

The campaign uses technology from Los Angeles-based company Factual that identifies places by business type or points of interest – in this case, health care facilities in Ontario – and through "geofencing," can serve ads to mobile devices inside those facilities.

"When someone is in a hospital and they see a message targeting people in a hospital, the context makes it relevant," said David Katz, executive vice-president of EQ Works, the digital media buying company for the campaign.

This kind of technology is attractive to advertisers because the more relevant an ad is, the less likely a person is to ignore it – known as "banner blindness" for digital ads.

The trouble is that location-based ads can seem creepy. Because this is dealing with a serious issue – and not selling something – it is less likely to trigger that reaction, said Robert Wise, partner at Scratch Marketing, PSHSA's ad agency. The campaign will not involve storing information about people it targets.

"We're targeting generically, people who are visiting facilities," Mr. Wise said. "It's not invasive ... We're trying to identify that there is an issue out there and everyone should be aware of it."