Major gaps in hospital security

November 2, 2009

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THE TRAGIC attack of a Massachusetts General Hospital physician, Dr. Astrid Desrosiers, by a disturbed patient, and the brave, decisive action of an off-duty security guard in coming to her aid underscore the need to improve safety for health care workers. The health care sector employs more than 10 million workers, more than 75 percent of whom are women. They endure a range of job hazards, such as orthopedic injuries and needle sticks. While it is possible to reduce exposures to some of these hazards, more is needed to address workplace violence.

Had an armed private citizen not been present to defend Dr. Desrosiers, the outcome undoubtedly would have been even more tragic. Without any reasonable means for doctors and nurses to defend themselves against violent attacks at work, hospitals must implement better training programs and a uniform method for reporting incidents. A recent report of the National Institute for Occupational Safety shows major gaps in hospital security, though in states with regulations designed to prevent violence against health care workers, hospitals reportedly have safer working conditions.

Health care organizations need to carefully track incidents of violence, and should provide periodic employee safety training. As most assaults recorded in hospitals are committed by patients, consistent reporting and monitoring procedures are needed to ensure that all staff members know which code words or office warning systems signify that patients may represent a violence risk. Workplace education and training for all medical and administrative staff are urgently needed to identify violent patients before incidents occur and to instruct on how to react to threats or assaults.

Dr. Frederick R. Bieber
The writer is a medical geneticist and forensics expert at Brigham and Women’s Hospital and an associate professor of pathology at Harvard Medical School.

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