Hospital Employee Assault Rates Before and After Enactment of the California Hospital Safety and Security Act

PURPOSE: This study examines changes in violent event rates to hospital employees before and after enactment of the California Hospital Safety and Security Act in 1995. METHODS: We compared pre- and post-initiative employee assault rates in California (n = 116) emergency departments and psychiatric units with those in New Jersey (n = 50), where statewide workplace violence initiatives do not exist. Poisson regression with generalized estimating equations was used to compare assault rates between a 3-year pre-enactment period ( 1993-1995) and a 6-year post-enactment period (1996-2001) using New Jersey hospitals as a temporal control. RESULTS: Assault rates among emergency department employees decreased 48% in California post-enactment, compared with emergency department employee assault rates in New Jersey (rate ratio [RR] = 0.52, 95% confidence interval [CI]: 0.31, 0.90). Emergency department employee assault rates decreased in smaller facilities (RR = 0.46, 95% CI: 0.21, 0.96) and for-profit-controlled hospitals (RR 0.39, 95% CI: 0.19, 0.79) post-enactment. Among psychiatric units, for-profit-control led hospitals (RR 0.41, 95% CI: 0.19, 0.85) and hospitals located in smaller communities (RR = 0.44, 95% CI: 0.21, 0.92) experienced decreased assault rates post-enactment. CONCLUSION: Policy may be an effective method to increase safety to health care workers.