Injuries and costs associated with patient-to-worker violence in hospitals

Background and Objectives: Approximately 60% of all nonfatal workplace assaults and violent acts in the United States occur in the health care and social assistance industry, with 22% of incidents occurring in hospitals. The majority of these violent acts are perpetrated by patients (Type II workplace violence). However, most hospitals lack reliable methods for measuring the injuries and costs associated with patient-to-worker violence. This study examined the injuries and costs of Type II violence in a metropolitan hospital system over a one-year period. Methods: Data was drawn from the system-wide database of reported incidents of workplace violence within the hospital system (n=15,000 employees). Analyses were conducted on the total sample of 214 Type II incidents reported by employees in 2011. Injury rates were calculated as the number of injuries per 100 full-time equivalents (FTEs). Total direct costs were calculated based on loss time insurance claims in addition to future estimates of cost by a third party insurance administrator. Results: The rate of injury from Type II violence for 2011 was 2.3/100 FTEs. Of the 214 recorded incidents, 72 (34%) had loss time claims. The total amount paid plus future reserves for these 72 events was $249,739, with a rate of $2,969/100 FTEs across the 7 hospitals within the system. Conclusions: One-year injury rates and costs of Type II violence were substantial and reflect the impact of workplace violence on hospital worker health and productivity. Such data may offer indications of the need for specific violence interventions in hospital settings.