Violence in healthcare facilities: lessons from the Veterans Health Administration.

Goals: The authors examined assault frequency and risk factors in health care.

Methods: The authors conducted a cross-sectional questionnaire survey in 142 hospitals. Analyses are presented at the level of the individual and aggregated by facility.

Results: Thirteen percent of employees described at least 1 assault in the last year; the proportion assaulted per facility ranged from 1% to 26%. Patients were the most common assaulters. Working in geriatrics, mental health, and rehabilitation or in nursing represented a high risk for assault. Hours of work and work patterns represented major risk factors for assault, as were higher measures of organizational stress. The penetration of training in alternate dispute resolution strategies was associated with lower rates of assaults.

Conclusions: Although work in health care is associated with high rates of assaults, closer scrutiny suggests specific possible intervention strategies.