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By Diane Doherty, MS, CPHRM
Senior Vice President, Healthcare Risk Management

The Hippocratic Oath states that a physician’s primary function is to help and heal the wounded or sick. While traditionally taken by rising physicians, nurses and other medical staff abide by the same principle.

That’s why it is so shocking when hospitals are rocked by violence, be it between patients, providers, or patients and providers. Yet, despite tragic events unfolding in Houston and New York as recently as this summer, too many hospitals fail to take the appropriate risk mitigation steps to safeguard their property, staff and patients.

It Can Happen to You

According to the Occupational Safety and Health Administration (OSHA), violence is four times more common in a healthcare setting than across all private industry. Unfortunately, many providers still see violent incidents as remote threats that will never happen at their organization.

The key to understanding how vulnerable all hospitals are to violence is understanding the myriad of red flags that could trigger an incident. While most hospitals recognize how long wait times for services and rude staff could escalate tensions, there are several less common, but equally important, triggers to consider:

  • Language and cultural barriers that result in the delayed delivery of care or misdiagnoses
  • Stressful working conditions, including long periods of isolation or overburdening of staff
  • Complexities of navigating through a healthcare system
  • Prevalence of weapons among patients and staff 

There’s Much at Stake

Ensuring the physical safety of staff and patients is paramount in the event of a violent incident. Yet, more providers might be spurred to take preventative action if they understood the full extent of their related exposure, beyond those involving physical safety.

Consider, for example, the extensive technology systems that are utilized in a hospital setting, including everything from electronic medical records to surgical robots. If those machines are unable to operate or a hospital can’t treat a patient as a result of a violent incident, hospitals could face significant revenue loss. Additionally, if it can be proven that a hospital knowingly failed to take appropriate risk mitigation measures or willingly ignored red flags, the organization, as well as its directors and officers, might be held liable for damages.

These exposures, on top of related medical professional liability and workers compensation claims, can cost a hospital millions of dollars. In addition, the reputational damage associated with a violent incident can linger for years, an impact that is often impossible to quantify.

Take Action Today

Ideally, hospitals will recognize the need to take action when they understand how quickly a violent incident can unfold and the full scope of what they could lose.

When they do, there are several risk reduction best practices to employ: 

  • Ensure a zero tolerance policy for violence
  • Appoint a multidisciplinary committee from all departments to ensure no vulnerability is overlooked. Doing so will also help ensure an enterprise-wide commitment
  • Conduct a facility-wide assessment, surveying all shifts and reviewing safeguards in high-risk areas 
  • Train staff on how to deliver bad news, observe warning signs and report red flags 
  • Provide guidance on when staff should intervene to diffuse or deescalate a situation, and when to retreat to safety 
  • Conduct unannounced drills

For more information about how to safeguard your hospital, visit

The material presented in this article is not intended to provide legal or other expert advice as to any of the subjects mentioned, but rather is presented for general information only. You should consult knowledgeable legal counsel or other knowledgeable experts as to any legal or technical questions you may have.