Joint Commission Alert: Violence Rising at Health Care Facilities

Controlling access, greater staff vigilance urged.

Oakbrook Terrace, Illinois, June 3, 2010 — A new Joint Commission Sentinel Event Alert warns that health care facilities today are being confronted with steadily increasing rates of crime, including assault, rape, and murder.

The Sentinel Event Alert urges greater attention to the issue of violence and to controlling access to facilities to protect patients, staff and visitors, noting that assault, rape and homicide are consistently in the top 10 types of serious events reported to The Joint Commission.

The Alert cautions that the actual number of violent incidents is significantly under-reported and advises organizations to mandate the reporting of all real or perceived threats.

To prevent violence in health care facilities, The Joint Commission’s Sentinel Event Alert newsletter suggests that facilities take a series of 13 specific steps, including the following:

• Evaluate the facility’s risk for violence examining the campus, reviewing crime rates and surveying employees about their perceptions of risk.
• Take extra security precautions in the emergency department, especially if the facility is in an area with a high crime rate or gang activity. Precautions might include uniformed security guards, scanning people entering the building for weapons and inspecting bags.
• Conduct thorough background checks of prospective employees and staff.
• Report crime to law enforcement.

“Health care facilities should be places of healing, not harm.  But, unfortunately, health care settings are not immune from the types of violence that are found in the other areas of our lives,” says Mark R. Chassin, M.D., M.P.P., M.P.H., president, The Joint Commission.  “The recommendations in this Alert give health care institutions and caregivers specific strategies to take action that will keep everyone safer.”
In addition to the specific recommendations contained in the Alert, The Joint Commission urges hospitals to comply with the requirements described in its accreditation standards to prevent violence. The standards require accredited health care facilities to have a security plan as well as conduct violence risk assessments, develop strategies to prevent violence and have a response plan when a violent episode occurs. The Joint Commission’s standards also are clear that patients have a right to be free from neglect, exploitation, and verbal, mental, physical and sexual abuse.

The warning about violence in health care facilities is part of a series of Alerts issued by The Joint Commission. Much of the information and guidance provided in these Alerts is drawn from The Joint Commission’s Sentinel Event Database, one of the nation’s most comprehensive voluntary reporting systems for serious adverse events in health care. The database includes detailed information about both adverse events and their underlying causes. Previous Alerts have addressed maternal deaths, health care technology, anticoagulants, wrong-site surgery, medication mix-ups, health care-associated infections, and patient suicides, among others. The complete list and text of past issues of Sentinel Event Alert can be found on The Joint Commission Web site.