When Geisinger Medical Center, a 536-bed Level I trauma center in central Pennsylvania, established its Workplace Violence Prevention Committee in 2018, it was clear education and a cultural change were needed.
“At that time, executive leadership did not yet have full understanding of the level of violence at the bedside or the challenges created by limited violence prevention resources,” said Jami Studebaker, RN, the ED administrative team coordinator and chair of the Violence Prevention Committee. “Once presented with data, executive leadership fully endorsed and empowered the committee’s efforts.”
The original four committee members – representing inpatient operations, safety, nursing education and the ED – faced another early challenge: helping staff understand workplace violence is not part of the job and encouraging them to report incidents.
“Changing this longstanding mindset required persistent education, transparent communication and a collaborative effort across departments,” Studebaker said.
The foundation of Geisinger’s program included training for all new nurses in verbal and physical de-escalation during orientation, a new nurse-security liaison position and the development of a class on managing incarcerated patients.
Enhanced security measures were added, including a security guard in the ED who participates in purposeful rounding with the nursing staff, which Studebaker said has fostered a strong relationship between the two departments. A badge system was implemented that alerts security and nearby employees when activated, as was a magnetometer at the ED entrance to screen patients and visitors. A K9 program was made possible with the help of hospital endowment funds.
To collect data and continually assess what works or what needs attention, the committee initiated a Workplace Violence Dashboard. Over time, efforts have been replicated across the system’s nine campuses, and the committee structure expanded to include more leaders across the hospitals, including the hospital’s chief operating officer, an associate vice president of nursing and members of the risk management and human resources teams, with a quarterly subgroup of representatives from the ED and each inpatient unit.
The data collected demonstrates improvements across the system, thanks to the enhanced security and interdisciplinary collaboration, according to Studebaker. From 2024 to 2025, Code Gray incidents decreased by 37 percent, and the number of times security had to be called for a workplace violence incident decreased by 5.1 percent. Calls for police dropped by 3.6 percent.
Studebaker said getting buy-in from leadership was crucial for the Workplace Violence Prevention Program’s success. For example, when a new associate vice president of security was hired, he valued nurses’ input and recognized their unique insights into safety risks, and he quickly implemented improvements and prioritized staff protection.
“Staff need to feel confident that leadership will back them and take necessary actions,” Studebaker said.
No Silence on ED Violence 