Porto points out that the numbers of criminal, violent and aggressive incidents are based on reported crimes, adding that the US Department of Justice estimates that at least half of all crimes go unreported. “If that’s the case, these statistics are truly huge” she says of the 2012 Crime Survey.
While the need for accurate crime statistics is obvious, Porto claims that collection is hampered because of litigation concerns faced by HCFs over potential liabilities. She urges legislation to hold harmless such institutions for the purpose of encouraging comprehensive reporting of incidents, and the standardization of crime definitions to further enhance accuracy.
Although crime, especially violent crime, has been on a downward trend in the US since 1993, the same cannot be said of HCFs. However, with the latest report from the Department of Justice finding the crime rate for 2011 grew by 18%, Porto speculates that “now maybe what’s going on in society at large is reflecting what’s been happening for some time in healthcare facilities.”
The impact of the increased criminal activity is reflected in results throughout the Survey. There were more HCF requests for outside police assistance than in 2010; more security guards with sworn police powers; and an uptick in the number of security and safety professionals hired by HCFs. “It is of special concern that the greatest rise in calls for outside law enforcement assistance was in the category of ‘more than 75 times’ in the past year,” Porto points out.
So what can HCFs do about this trend? Porto highlights a few of the risk factors that she sees trending higher: greater availability of guns, more gang violence being carried over into the hospital itself, and increased numbers of forensic patients being treated by regular hospitals because prisons have closed down or reduced their own healthcare facilities. “It boils down to the same issues as gun violence in general: if we want safer facilities, what do we need to do to make them safer?” Porto asks, adding “just arming more people is not necessarily the right answer.”
When asked what policies can help reduce HCF crime and violence, Porto lists more vigilant surveillance of people entering hospitals, use of restraints on patients most at risk of being violent, metal detectors to reduce presence of weapons, and training in violence de-escalation for personnel in high risk areas, to name a few.
The public has a role to play as well: “What is the public’s choice about improving safety? Metal detectors and purse searches, or an attractive inviting lobby where it’s not quite so safe?” she asks. Cost is also clearly a factor in implementing such initiatives, particularly the more advanced surveillance and alarm technologies that are becoming available.