At Riverside Regional Medical Center in Newport News, Virginia, metal detectors, aggression risk assessments, and better communication are all important factors in preventing workplace violence.
After an ED employee was stabbed multiple times in the fall of 2021, several measures were taken to ensure team members’ safety.
“Having somebody injured that severely really made us take a pause and a deep dive into what we could do to prevent that from happening in the future,” said Mary Haigh, MSN, RN, senior director of emergency services.
Installing metal detectors at the ED entrances was the first step, followed by overhauling unit locking arrangements that require badge use to enter and exit, and increasing support from both security and local police.
“I think we were doing a lot of good work, but it was a lot of good reactive work. So, it was almost that we were waiting for the event to happen,” Haigh said.
In October 2024, the EDs in the system began using the Broset Violence Checklist to identify patients who pose a potential risk of aggression.
“I think this is when the mindset in the ED really shifted to be more proactive,” Haigh said.
Patients with a history of violence are flagged in the electronic health records and a red light above the entry to those patients’ rooms alerts people who can’t access medical records.
Because data is needed to identify challenges and make changes, updating the incident reporting processes came next.
“We knew there was underreporting. It’s not necessarily that they don’t want to share the information,” Haigh said, “but you don’t necessarily have the time to stop and enter a report that’s outside of your standard workflow.”
The responsibility of reporting was shifted to the security team instead of clinical staff. Between 2024 and 2025, the number of reports jumped by 245 percent.
The clinical team reviews all incidents and shares reports with hospital leadership.
In February 2026, the team developed a behavioral response team, informed by the trends and clinical opportunities identified through case review. The BRT is available to respond anywhere within the facility to provide immediate support and assist with early intervention prior to situations escalating. A secure chat group launched for questions and support that don’t require a full team response.
Reporting assaults to law enforcement also improved. Riverside Medical Center set up an office outfitted with AV equipment from the magistrate’s office for staff to file complaints remotely rather than having to go to the courthouse.
While incident reporting – both internally and to law enforcement – increased, one key measurable decreased. The number of times a patient escalated to the point of needing a locked restraint at Riverside Medical dropped by 62 percent.
“We’re also capturing events that we call ‘near misses’,” Haigh said. “It doesn’t necessarily meet the definition of true workplace violence, but it’s something that … could escalate to a workplace violence event if we weren’t doing all the right things.”
No Silence on ED Violence 