The rates of violent crime are rising in hospitals and care settings across the United States, fueled by a myriad of issues, including mental health, emergency room wait times, domestic disputes, and our ongoing struggle with an opioid epidemic that’s bringing patients to hospitals for drugs or addiction treatment. For hospitals leaders understanding what type of crime is occurring and how that compares to the national landscape can be a valuable input into developing a security program that is adapting to this rising issue.

First, and foremost, it is important to understand the type of crime that is occurring within the facility and how that compares to national rates of crime. Categorizing incident reports and tracking crime to nationally recognized standards is important. The 2019 Healthcare Crime Survey conducted by IAHSS Foundation identifies crime rate per 100 beds to provide healthcare leaders with an effect methodology to compare crime rates. The chart below compares crime rates per 100 beds for each crime category.

2018 Crime Rates per 100 beds


The primary risk and most resource intensive risk to a healthcare organization are assaults and aggravated assaults (violent crime). When evaluating assaults and aggravated assaults sub-categorizing these incidents into the FBI’s workplace violence typology is helpful:

  • Workplace Violence Type 1: Violent acts by criminals, who have no other connection with the workplace, but enter to commit robbery or another crime.
  • Workplace Violence Type 2: Violence directed at employees by customers, clients, patients, students, inmates, or any others for whom an organization provides services.
  • Workplace Violence Type 3: Violence against coworkers, supervisors, or managers by a present or former employee.
  • Workplace Violence Type 4: Violence committed in the workplace by someone who doesn’t work there, but has a personal relationship with an employee—an abusive spouse or domestic partner.

The greatest incidents of assault or aggravated assault in a healthcare setting is Type 2. From the 2019 Healthcare Crime Survey conducted by IAHSS Foundation, the chart below breaks out the assaults and aggravated assaults into the FBI categories.

Workplace Violence by Type

Healthcare security programs must address this risk from the outside to create a safe workplace for healthcare team members. Effective programs are multi-faceted and address threats and vulnerabilities in:

  • Security staff management and development
  • Access control
  • Visitor management
  • De-escalation
  • Monitoring
  • Response methodology
  • Appropriate use of armed versus unarmed officers
  • Behavioral health unit management
  • Code management and training
  • Alarms, alarm response, and alarm training
  • Use of specialty services and technologies (magnetometer, K9 teams, etc.)

An effective security program enhances employee and visitor safety, reduces costs associated with litigation and workers comp, improves hiring and retention of all employees, and improves overall general labor-management relations.