Electronic Health Reporter

By Rhonda Collins, chief nursing officer, Vocera Communications.

Hospitals should be places of healing and safety for providers, patients and guests. Yet hospital employees are four times more likely to experience a violent encounter in a hospital than in any other location.¹ According to studies cited in a 2016 review paper in the New England Journal of Medicine, 80 percent of emergency medical workers experience violence during their careers. Seventy-eight percent of ED physicians in the U.S. reported having been the target of workplace violence in the previous year, and 40 percent of psychiatrists reported they had been physically assaulted.²

To mitigate violence and protect staff, experts advise hospitals to form an addiction conflict and substance use disorder team, initiate healthcare-specific training on the management of aggressive behavior, and establish a strategic management assessment response team. In many hospitals, security personnel lead these initiatives and team up with local police, as well as department leaders throughout the hospital.

All of these programs are good recommendations, but in the moment when an armed individual invades the hospital or someone already in the hospital threatens care team members, how can hospital staff respond to minimize violence, protect themselves and others and get help fast from security personnel or police? The answer lies in the right communication system.

In some institutions, the use of mobile communications technology has helped reduce the amount of time required for security to respond to violence or aggression. For example, staffers in some hospitals wear hands-free communication badges to connect quickly and directly to internal security officers when an incident of violence begins or appears likely.

At the emergency department of Upstate Medical Center in Syracuse, N.Y., any ED staff member can use such a badge to summon university police and public safety officers in the event of a violent encounter or other emergency. In many cases, this can be faster than making a phone call. A peer-reviewed study found that this approach reduced average security response times from 3.2 minutes in the six months before the badges were adopted to 1.02 minutes in the six months after use began.³ 

Michael Garron Hospital in the Toronto East Health Network used a similar system to reduce the time it takes security officers to get to the scene of an incident from an average of 2 ½ minutes to 59 seconds. Besides enabling a badge user to contact security personnel quickly, the device can also alert people outside the hospital and act as a real-time locator if a staff member can’t say where he or she is located.⁴ 

A “panic button” system can also be harnessed to help police pinpoint the exact location in a hospital where a violent incident is occurring. For example, in 2014, an armed intruder threatened nurses in Halifax Health Medical Center, a large hospital in Daytona Beach, Florida. They were able to use their clinical communication system, which has a panic feature, to broadcast a special beep that alerted other clinicians and hospital security about the rapidly evolving incident and where in the facility it was taking place. As a result, an ED security officer was able to guide arriving police directly to the site on the hospital’s second floor where the man with the gun was located.⁵ 

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