Workplace violence at hospitals continues to surge

• "The problem of physical security in a hospital is incredibly complex, because you have to have access to the general public. You have to allow people in and out," said Scott Gee, AHA's deputy national adviser for cybersecurity and risk. "It's difficult to determine who's a threat and who's not."

The big picture: Verbal threats or physical assault against doctors, nurses and other health workers typically come from patients' family or friends, or from patients themselves.

• Even as violent crime ticks down in large U.S. cities, violence in health care settings continues due to long wait times, unmet patient needs and resource shortages in the sector, according to a recent review in the journal eClinicalMedicine.

By the numbers: Health care and social services account for 73% of the 57,610 nonfatal workplace violence incidents requiring employees to miss work in 2021 and 2022, per the most recent data from the Bureau of Labor Statistics.

• Federal data shows 14.2 cases of workplace violence in the health care sector in each year per 10,000 full-time workers. Private industry overall had 2.9 cases per 10,000 workers.

COVID-19 worsened the issue. The pandemic and the fierce debate over the response helped sow distrust in the health system, with workers' reports of harassment on the job more than doubling in 2022 compared with before the pandemic, Centers for Disease Control and Prevention data shows.

• But the problem hasn't abated since, and workplace violence in health care settings had been increasing steadily before then, too, rising 62% from 2011 to 2018.
• About 20 U.S. health care workers were killed on the job each year during that span.
• One survey of an urban emergency department last year found that every nurse or provider had been verbally abused, and that nurses and technicians reported experiencing a greater prevalence of physical violence than other providers.
• The actual rate of violence is likely much higher than statistics indicate, because federal data primarily captures incidents that lead to time away from work or job transfers. And not every facility has agreed-on standards for reporting incidents, either.

Health systems have ramped up investments in physical security infrastructure in recent years.

• Jefferson Health spends millions of dollars annually on security tools including metal detectors and an armed security workforce, said health system president Baligh Yehia.
• The academic system, headquartered in Philadelphia, also trains staff on de-escalation techniques, partners with local police forces and has a process to help staff safely get to their cars or public transportation from the hospital at night.

Between the lines: The uptick in physical violence coincides with a major increase in cybersecurity breaches in the health care sector, placing extra stress on health system security.

What we're watching: Federal regulators are slated to propose new standards to prevent workplace violence in health care settings in December, following a review that began in 2016.

• Congress is considering a bill that would give health providers federal protections against attacks and would make it a crime to attack a health worker.
• States also are enacting their own laws. The majority already have some kind of legal penalties for assaults on nurses, according to the American Nurses Association.
• Most recently, as of Oct. 1, North Carolina emergency departments must have law enforcement officers on site at all times.