Violence in emergency departments has risen in the last few years, affecting clinician burnout and harming patient care, according to a survey conducted by the American College of Emergency Physicians (ACEP).
Approximately 85% of emergency physicians surveyed said violence in emergency departments has increased, with 45% stating that violence has "greatly increased," according to a of nearly 3,000 U.S. emergency physicians conducted in August.
Additionally, two-thirds of emergency doctors said they have been assaulted in the past year, with one-third reporting that they were assaulted more than once, the survey found.
Nearly a quarter of physicians said they were assaulted multiple times a week, up from 8% in 2018. Patients were the aggressors in nearly all assaults against emergency providers.
"At this time, given the current measures, given the current support that we have received from various stakeholders, unfortunately we believe this cycle is going to continue to rise," said Chris Kang, MD, president-elect of ACEP, in a press briefing. "That overall not only affects us physically and emotionally and psychologically, but impacts the care that we need to deliver to you individually, as well as your communities."
Around 85% of physicians said emergency department violence has resulted in an increase in wait times, and 60% said attacks often result in patients leaving the emergency room without receiving care. Approximately 87% reported a loss of productivity as a result of violence, and 85% reported trauma or increased anxiety.
Jeremy Faust, MD, MS, emergency doctor at Brigham and Women's Hospital in Boston and editor-in-chief of 鶹ý, said there should be harsher penalties for assaulting a physician on the job.
"Emergency physicians and our colleagues don't choose our clients," Faust said. "We treat everyone, anytime, regardless of anything. I think that warrants added protection."
Physicians expressed experiencing little support from hospitals and law enforcement in response to incidents of violence in the emergency department. Many stated that hospital reactions to violent events are minimal, with some escorting the patient off property or restraining the patient, but in many cases taking no action at all.
The most common hospital response to assault was placing a behavioral red flag on patient charts. Among physicians whose hospital responded to their assault, charges were pressed for only 2%, the poll revealed.
Many respondents also cited COVID-19 as a catalyst of rising violence, with two-thirds of emergency physicians stating there has been increased violence in emergency departments following the pandemic. Additionally, seven in 10 doctors said that COVID-19 has decreased the level of trust between patients and emergency room physicians or staff.
Frustration among patients, lack of access to care, and social isolation are all factors that may be leading to increased violent interactions between patients and hospital staff, whether that be verbal or physical assaults, Kang noted. "That's impacted the level of trust, and somewhere along the way that also erodes that quality of care that can be provided," he said.
Kang noted two pieces of federal legislation introduced in Congress aimed to further protect healthcare workers: the and the . But additional supports from hospitals to quantify incidents in their own facilities and provide more support to staff are necessary, he added.
"Emergency medicine is hemorrhaging," Alex Skog, MD, president-elect of the Oregon chapter of ACEP, said in the briefing. "Now more than ever, I fear that we will lose these frontline medical professionals, unless action to increase the accountability and add protection in emergency departments is addressed with the seriousness and urgency required to stem the tide of violence."