Hospital violence isn't confined to EDs, often rising during COVID-19 surges, full moons, data show

Most alarms triggered by hospital staff’s wearable safety alert systems occurred outside of the emergency department and more often during weekdays, non-holidays, surges of COVID-19 and even during full moons, according to new data.

Canopy, which makes the Canopy Protect system worn by about 200,000 healthcare workers across 800 U.S. facilities, said hospital staff used its devices to log 22,000 alerts in 2023 requesting immediate help due to an emerging threat or active violence.

The logged duress incidents occurred “throughout every part of the hospital” and affected over 10% of staff in every role “from nurses to physicians, to cafeteria and gift shop workers,” the company said Tuesday. The findings echo recent warnings from the Centers for Disease Control and Prevention (CDC), provider groups and others that violence against healthcare workers is on the rise.

"Frontline healthcare workers want to save lives and care for patients—workplace aggression isn't part of the job they sign up for,” Shan Sinha, co-founder and CEO of Canopy, said in a release. “This data reflects the fact that health systems are taking action to protect their staff by deploying technology to get ahead of workplace aggression and de-escalate threats as they emerge."

Emergency departments, often a focal area for reports of healthcare workplace violence, were home to 40.5% of the duress alerts logged by Canopy last year. However, an equal amount originated within inpatient and surgery-related areas of the hospital, whereas the remaining 19% were triggered everywhere else within the hospital including ICUs, critical care units and non-patient areas, the company found.

As for when the alerts occurred, Canopy saw 20% more incidents occurring during weekdays and 12% fewer during holidays. Both of these are noteworthy considering that weekends and holidays are “some of the busiest, and often understaffed, times for hospital emergency departments,” the company said.

Logged incidents rose by 9% during full moons, adding fuel to the long-standing superstition that Canopy noted has previously led some hospitals to increase staffing during the full moon. A 2011 study published in the World Journal of Surgery found that more than 40% of medical staff believe that lunar phases can affect human behavior, or what's referred to as "full moon madness." Most studies find no direct correlation between the full moon and hospital admission rates.

Duress alerts were also 8% more frequent during periods in which COVID hospital admissions rose by 50%.

Sinha said Canopy’s aggregate data from more than 40 hospital and health system customers “underscores the need to be proactive and give every staff member the tools to ensure their safety and be confident we have their back."

Recent months have seen health systems like Cleveland Clinic and Scripps Health explicitly point to upticks in workplace violence when sharing word of new patient safety investments, though nurses broadly say that healthcare employers could still be doing more to address workplace violence. Survey data released last fall by the CDC suggested that feelings of burnout, stress, anxiety and depression have all increased in the last couple of years, a trend tied to an uptick in harassment.

Last month, provider groups like the American Hospital Association and the American College of Emergency Physicians convened lawmakers and aides on Capitol Hill to drive support for the Safety from Violence for Healthcare Employees Act.