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Hospital workers in Ontario are no strangers to the threat of violence. Many healthcare workers have been physically assaulted and verbally abused while trying to perform their duties. Hospitals and other healthcare institutions should be safe havens for healthcare workers and patients. However, violence and other security threats are widespread across healthcare institutions resulting in security cost increases of greater than 55% over the last six years.

Some violent events are so severe that they result in many medical and psychological problems including persistent mental stress, depression, anxiety, depression, and post-traumatic stress disorder.

According to the Ontario Workplace Safety and Insurance Board, attacks, violent events, and harassment in healthcare institutions have gradually risen. It is estimated that the occurrence of these acts has doubled from 2012 to 2019.

Furthermore, workplace violence in hospitals accounted for 14% of all lost-time injuries in 2019 higher than the injury claims permitted for exposure to dangerous substances or conditions. These data are only the tip of the iceberg, as problematic as they seem. The actual situation is likely more frightening as violent and aggressive episodes have been significantly underreported.

According to Sharleen Stewart, head of SEIU Healthcare, hospital employees are overwhelmingly female, the violence is preventable, and the rise in assaults is contributing to understaffing.

“Health workers should not have to be apprehensive about being physically mauled by a patient or a patient’s relative as they continue to fight on the front lines of COVID-19, tending to patients and saving lives. But regrettably, this is their reality due to a lack of security and support from healthcare institutions and the Ontario government.”
Sharleen Stewart, Head of SEIU Healthcare

Exclusive BIG Intelligence Data

Security Costs of Rising Hospital Violence in Ontario

BIG Healthcare (a healthcare company that collects and analyzes financial and operational data from hospitals in Ontario, Canada) provides detailed information on the costs of hospital violence in Ontario.

  • Since 2020, hospitals have substantially increased expenditure to provide secure environments for hospital staff, patients, and visitors.
  • Since 2016, Ontario hospitals have raised their security costs by more than 55 percent, with over half of that investment occurring during the pandemic in FY2020/21 and FY2021/22.
  • Small hospitals have had the most significant increase in hospital security expenses with a 174 percent increase since FY2016/17.
  • Large community security expenditure has climbed by 74 percent (since 2016) with a 30 percent increase occurring since the pandemic.
  • Teaching hospital security expenses have grown by 55 percent (since 2017) with the highest increase of 38 percent occurring during the pandemic.

The Response from Unions

According to Michael Hurley, President of the Ontario Canadian Union of Public Employees (CUPE), the high number of violent cases is causing a hostile work environment.

“The violence has taken the shape of racially focused abuse, sexual assault and harassment, verbal abuse, and physical attack… violence is widely acclaimed as a major source of employee dissatisfaction.”

Michael Hurley, CUPE President

Unions of Healthcare workers, including the SEIU Healthcare and Canadian Union of Public Employees (CUPE) unions, have been negotiating with the Ontario Hospital Association for a new contract that will include increased health and safety measures for hospital workers. Also, the unions have demanded that the government of Ontario enhance the safeguards in place to protect front-line employees.

The unabated rise in hospital violence has necessitated increased security investment by healthcare institutions.

The unions of hospital workers have also highlighted some steps that could be taken by health stakeholders and the government to address the precarious state of hospital security.

  • Increasing the number of hospital workers
  • Ensuring that hospital employees working alone are protected. Also, hospitals should implement measures to prevent health workers from being in situations that could put them at risk of violence, such as working alone in isolated or secluded spaces.
  • Hospitals should be required to display signs stating that violence and hostility will not be permitted.
  • Amendments to the Canadian Criminal Code to make aggression against a hospital worker a more serious crime in terms of sentence
  • Early warning systems to flag and alert health workers about potentially aggressive patients

These measures are capital intensive and will require vast and consistent investments in hospital security by healthcare stakeholders and the government.

Reasons why Hospitals are Experiencing Increased Violence

Security services are an essential aspect of any healthcare institution. Hospitals are obligated to ensure the safety and security of patients, employees, and visitors. Yet, many hospitals struggle with increasing levels of violence. Below are some of the possible reasons for surging hospital violence.

Hospitals are open and readily accessible. According to Tony York, a hospital security expert and Executive Vice President at Paladin Security and PalAmerican Security, “hospitals are distinct in that they are open and accepting of everyone.” It means that other patients and staff may be exposed to erratic or volatile people, such as drug addicts, people with mental health problems, or convicts visiting for care.” Furthermore, healthcare security must not be intrusive or get in the way of people accessing critical health services.

Hospital buildings are not optimized for security. Many hospitals do not prioritize security during construction. Also, some hospitals have obsolete infrastructure that does not meet current security needs.

The COVID-19 pandemic has worsened the security crisis in hospitals. It has created an environment highly fraught and conducive to hostility and violence. Additionally, hospital employees are grappling with societal disagreements over implementing public health regulations, new screening protocols, and visitor restrictions. Patients can sometimes act aggressively toward hospital workers out of grief for losing a loved one or worry for their health.

Next Steps and Conclusions

A 2018 survey conducted by the ASHE (American Society for Healthcare Engineering) on Hospital Security confirms that maintaining security has become 82 percent more challenging over the past two years. As a result, 61 percent of hospitals want to increase security spending, while 91 percent intend to introduce aggressive behavior training.

In conclusion, BIG Healthcare’s data suggests that security costs for healthcare institutions in Ontario will continue to increase. The inevitable rise in hospital security expenditure is necessary to provide a secure environment for hospital staff and patients.