Reducing risk
To mitigate the threat of violence, a multifaceted approach is necessary. At a governmental level, we need continuing state and federal legislative efforts to penalize violence against healthcare workers, and ensure that hospital employees’ safety isn’t taken for granted.

At the level of individual hospitals, meanwhile, we need clear processes to manage vulnerable and high-risk populations effectively. For homeless patients, for instance, this might include private rooms where appropriate, access to basic necessities such as food, water, and hygiene facilities, and partnerships with community organizations to provide support services such as job training, affordable housing, and mental health counseling.

The goal should be to treat all patients with compassion, training staff members to create safe and supportive environments and to de-escalate conflict before it happens. Achieving this might also require hospitals to give workers the tools to flag potentially violent patients in hospital records, ensuring that proper care is taken when dealing with people who have a record of violence — and thereby giving hospital workers the ability to engage more confidently with all their patients.

In response to the uptick in assaults, some hospitals have gone a step further than re-training, setting up specialist units dedicated to the de-escalation of violence. In 2022, UC Davis Medical Center in Sacramento launched The Behavioral Escalation Support Team (BEST) — a group of psychiatric nurse practitioners, mental health workers, and lift team members who provide 24/7 support in the event of disturbances. A year on from the program’s initiation, BEST has responded to more than 1,500 calls, successfully preventing 100% of patient, staff, and bystander injuries.

Toward a technological solution
Unfortunately, with American hospitals in the grip of a staff shortage crisis, not all healthcare providers have the resources to implement the necessary changes. For this reason, wider reform must go hand-in-hand with a strengthening of physical security arrangements. Additional guards, security cameras, and panic alarms are a good starting point, but the sad reality is that if hospitals are truly committed to keeping their patients and employees safe, they also need a means to screen for hidden weapons.

Regrettably, healthcare workers from Halifax to Honolulu report seeing more and more concealed weapons being brought into their hospitals. While not every weapon is carried illegally or used in an act of violence, the only way to prevent serious violence in hospital settings is to control the flow of hidden weapons into the medical workplace setting.

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