What is Workplace Violence in Healthcare?

Workplace violence includes any act or threat that puts healthcare workers at risk, from verbal threats in emergency departments to physical assaults in psychiatric units. The range is broad, and the impact is serious.

Workplace Violence

Ultimate Guide to Workplace Violence Compliance for Hospitals

This Cognosos guide explains how to build a prevention program that protects staff, meets compliance standards, and strengthens your hospital’s safety culture.

Introduction to Workplace Violence

Understanding Workplace Violence in Healthcare Settings

Healthcare workers are nearly five times more likely to experience workplace violence than the average U.S. worker, according to Bureau of Labor Statistics (BLS) data. Yet many hospitals still fall short of building safety programs that work in practice. Protecting staff means moving past checklists and creating systems that genuinely keep people safe.

This guide explains how to build a prevention program that protects staff, meets compliance standards, and strengthens your hospital’s safety culture.

Output and Interface

Healthcare facilities face four main types of workplace violence:

Criminal Intent (Type I): Violence committed by someone with no legitimate connection to the facility, such as robberies or random attacks.
Patient/Visitor Violence (Type II): The most common threat, involving patients in crisis, those under the influence, or distressed family members.
Worker-on-Worker Violence (Type III): Includes bullying and conflicts between colleagues.
Personal Relationship Violence (Type IV): When domestic situations spill into the workplace, putting staff and bystanders at risk.

Each incident spreads across an organization. Beyond injuries, workplace violence drives burnout, turnover, and undermines a hospital’s culture of care.

The Real Cost of Inadequate Safety Programs

BLS data show that healthcare workers account for nearly 75% of all workplace assaults that result in days away from work. The effects go beyond numbers:

Victims may need medical care and time off.
Witnesses carry trauma and anxiety.
Recruitment and retention suffer.
Patient satisfaction declines when staff feel unsafe.

The financial toll is also high. Hospitals face workers’ compensation claims, overtime, legal costs, and turnover expenses. Nationally, hospitals spend billions each year addressing violence. For many facilities, this adds up to millions annually.

Unchecked violence changes workplace culture. Nurses request transfers. New graduates choose safer facilities. Over time, the focus shifts from healing to survival.

Navigating Compliance Requirements

The regulatory environment for workplace violence prevention has tightened. Federal guidelines, accreditation standards, and state laws now require proactive programs.

Federal Guidelines

OSHA has not issued a specific standard for workplace violence in healthcare but uses the General Duty Clause to hold hospitals accountable for failing to protect staff from known risks. OSHA’s guidance highlights five elements:

Management commitment and employee participation
Worksite analysis
Hazard prevention and control
Safety training
Recordkeeping and program evaluation

The Joint Commission

As of January 1, 2022, The Joint Commission requires accredited hospitals to show measurable violence prevention efforts:

EC.02.01.01 (EP 17): Annual worksite analyses with documented risk mitigation.
LD.03.01.01 (EP 9): Leadership must establish and oversee a workplace violence prevention program, with board-level reporting.
HR.01.05.03 (EP 29): Hospitals must provide initial and annual training, role-specific education, and updates based on emerging risks.

State Mandates

Information current as of September 2025

State laws add another layer of requirements:

California (SB 553, 2023): Requires written violence prevention plans with annual review. Earlier Cal/OSHA rules already applied to hospitals.
Illinois (SB 1435, 2025 proposal): Would require hospitals to equip staff with wearable panic buttons. As of Sept. 2025, this bill is not law but under consideration.
Texas (SB 240, 2021): Requires hospitals to form workplace violence committees, create prevention plans, and provide annual training.
Oregon (SB 537, 2023): Expands reporting, annual training, and post-incident support.
New York (A203B/S5294B, 2025): Awaiting the governor’s signature, this bill would require hospitals and nursing homes to implement comprehensive prevention programs.

Hospitals in multiple states must carefully track these varied requirements.

Building Your Compliance Foundation

Successful hospitals focus on six core steps:

Comprehensive Risk Assessment – Map facilities, review incident data, and analyze patient and visitor patterns.
Policies That Drive Action – Prevention, response, reporting, and aftercare protocols written in plain language.
Cross-Functional Team – Executives, frontline staff, security, HR, facilities, and labor representatives collaborate.
Training That Sticks – De-escalation practice, universal safety skills, role-specific scenarios, practice with actual tools, and reporting procedures.
Reporting Culture – Simple mobile reporting, zero retaliation, and feedback on actions taken.

Continuous Improvement – Regular reviews, tracking of patterns, benchmarking, and keeping up with regulations.

Leveraging Technology for Protection

RTLS is transforming industries with its versatile applications. Here’s how different sectors are benefiting:

Panic Buttons

Wearable devices extend protection beyond fixed stations. They enable quick alerts but are not a complete solution.

Real-Time Location Systems (RTLS)

Provide room-level accuracy for emergency response and help identify patterns of risk.

Metal Detectors

Provide an added physical security layer by screening visitors and detecting weapons before they enter sensitive areas.

AI and Analytics

May highlight trends such as incidents linked to long wait times. These tools should support human judgment, not replace it.

Integrated Systems

Linking panic buttons, RTLS, reporting, and training data streamlines compliance and response.

Learning From Healthcare Leaders

Hospitals that commit to prevention achieve meaningful improvements. For example:

Some facilities report faster emergency response after implementing RTLS and panic buttons.
Others use analytics to identify high-risk times or units and adjust staffing accordingly.

From Reactive to Proactive with Cognosos

Workplace violence in healthcare is not inevitable. With committed leadership, staff involvement, and the right technology, hospitals can prevent incidents and build a safer culture.

Cognosos provides campus-wide AI-powered location intelligence, wearable panic buttons, and incident tracking designed for healthcare environments. These tools aim to strengthen compliance and staff safety, but success depends on a comprehensive prevention strategy supported by leadership and culture.

Request a demo

Frequently Asked Questions

Do states require panic buttons?

Currently, no state universally mandates wearable panic buttons for hospitals. Illinois has proposed such a law. California and others require prevention plans but not specific devices.

How much training is needed on panic buttons?

At minimum, annual training is required by The Joint Commission and many state laws. Effective programs include refreshers, role-specific drills, and post-incident debriefs.

What are the consequences of non-compliance?

OSHA can issue fines in the tens of thousands of dollars per citation. The Joint Commission can revoke accreditation. States may impose penalties or corrective actions. Hospitals also face liability risks in civil litigation.