Study: Workplace violence continues to plague hospitals

May 16, 2017
'2017 Healthcare Crime Survey' reveals crime trends at hospitals across the country

Acts of violence against nurses and doctors in recent years have spurred the introduction of new legislation in states across the country designed to stiffen penalties against those who assault healthcare workers. But while lawmakers have begun to take notice of the problem, data from the International Association for Healthcare Security and Safety (IAHSS) Foundation's "2017 Healthcare Crime Survey" shows that incidents of workplace violence continue to plague hospitals at an alarming rate.

The study, which analyzed the responses of security professionals at 222 U.S. hospitals, found that "Workplace Violence Type 2" assaults, which are acts of violence committed against hospital staff by patients and visitors, accounted for 89 percent of all assaults and aggravated assaults at hospitals from 2012 to 2016. Drilling down even further, the study found that hospitals suffered 1.4 Type 2 assaults and 0.7 Type 2 aggravated assaults for every 100 employees on staff last year.

Despite the increased emphasis in many states on cracking down on violence against healthcare workers, there doesn’t appear to be a correlation with a rise in charges for workplace violence incidents. In fact, the survey found that for hospitals that saw at least one person charged under an existing "Assault on Healthcare Worker" law, only 15 percent of Workplace Violence Type 2 incidents resulted in a charge in 2016.

"The workplace violence trend persists each year and clearly shows that patients and visitors assault healthcare employees at a much higher rate than other people assaulting employees," Karim Vellani, CPP, CSC, the study’s lead author and president of Threat Analysis Group, LLC, says.    

The issue has not gone unnoticed by regulators who have either enacted new rules designed to better protect workers in healthcare settings or are in the process of developing such guidelines.

For example, last October, the California Division of Occupational Safety and Health approved a rule that requires hospitals, as well as other healthcare providers, to perform security assessments that also incorporate feedback from workers and subsequently develops a plan to help mitigate the identified risks. In addition, the federal Occupational Safety and Health Administration (OSHA) in December published a request for information in support of a new standard on workplace violence in the healthcare and social assistance settings.

However, Vellani says that the development of a workplace violence prevention standard by OSHA will likely take several years and that healthcare providers need to be more proactive in protecting their workforce.  

“Like the real estate mantra of location, location, location, healthcare security’s mantra should be protect employees, protect employees, protect employees!  The single biggest takeaway from the 2017 report, much like prior healthcare crime surveys, is that Workplace Violence Type 2 needs to be addressed at every hospital,” he adds. “Hospitals should not wait to for states and OSHA to develop laws or standards.  A holistic, multi-disciplinary approach should be developed to protect employees from assaults by patients and visitors.”

Beyond incidents of workplace violence, the study found a slight increase in each of the other crime categories analyzed. To provide greater context to security professionals in the healthcare environment, the survey takes the total number of crimes reported and incorporates the bed count for all of the hospitals included in the study to calculate crime rates on a per-bed basis.

Between 2015 and 2016, the violent crime rate, which includes murder, rape robbery, and aggravated assault, rose from 0.9 to 1 incident per every 100 beds. Assaults increased from 8.1 to 9.3, vandalism rose from 2.1 to 3, burglary ticked up from 0.4 to 0.6, and motor vehicle theft also increased slightly from 0.3 to 0.4. Incidents of theft and disorderly conduct saw the biggest increases, rising from 5.7 to 8 and 21.4 to 34.1 respectively.

While there may be some concerns that these trends will continue, Vellani emphasizes only theft and disorderly conduct increased significantly and that some of the reason for the differences could be attributed to the survey’s sampling methods. “In other words, the hospitals that responded this year may not be the same as those that responded last year,” Vellani explains.

Moving forward, Vellani says the IAHSS Foundation will be delving deeper into other areas of hospital security programs to examine their effectiveness and potential impact on reducing some of the aforementioned crimes.  

“As part of my consulting practice, I speak with employees at all levels of healthcare organizations across the country.  While they generally tell me that workplace violence is the broad area of concern, the more specific concern is events with extreme violence wherein someone enters the hospital with a gun,” Vellani says. “This invariably leads to a discussion of potential solutions such as visitor management and metal detectors.  The IAHSS Foundation is embarking on a research project soon to further study the effectiveness of these and other potential solutions."

Click here for more information about the 2017 Healthcare Crime Survey or to download the full report. 

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