Patients are feeling less safe in hospitals

For the report, Press Ganey analyzed data from 12.5 million patient encounters, 1 million health system employees, and over 550,000 safety events that were reported in 2023. The patient experience data was collected from more than 500 healthcare organizations.

Overall, patients' perception of safety in hospital settings declined while their perception of safety in outpatient settings increased between 2019 and 2023. For outpatient settings, 81.9% of patients gave the top safety rating ("very good") in 2019, compared to 78.1% in 2019.

However, only 68.5% of patients in hospital settings gave the top safety rating in 2023, compared to 73.6% in 2019. 

Patients' feelings of safety can affect their likelihood of recommending a healthcare organization in the future. According to Press Ganey, 84% of patients who give top safety ratings are likely to recommend an organization, compared to only 34% of patients who don't.

Currently, almost half (48.5%) of employees also have a low perception of their organization's safety culture. Safety culture includes organization-wide prevention and reporting, pride and reputation, and resources and teamwork.

However, employees' overall perception of their organization's safety culture is trending upward, suggesting that efforts are being made to identify and address potential challenges. In 2023, employees gave their organizations an overall safety score of 4.01 out of five, slightly up from the score of 3.99 in 2022.

The most significant improvement was in employees' perception of resources and teamwork, which increased from 3.68 to 3.74 between 2022 and 2023. 

Violence against healthcare workers grows

Although 80% of healthcare workers said their organizations value employee safety, violence against healthcare workers has also been on the rise.

Between 2022 and 2023, reported assaults on nursing personnel increased from 2.59 per 100 nurses to 2.71 per 100 nurses. In a sample of 329 hospitals, there were 16,975 assaults, or around 1.89 per hour. The units that saw that most frequent violence were psychiatric units, the ED, adult units, pediatrics, and perioperative units. 

According to the Press Ganey report, 29% of RNs reported occasional or frequent violence from patients or patients' family members. RNs also rated their organizations lower on having security measures in place to prevent violence compared to senior management (3.36 vs. 4.30, respectively).

Al'ai Alvarez, an ED doctor and clinical associate professor in the department of emergency medicine at Stanford University, said violence against healthcare workers can contribute to burnout and push them to quit — or even harm themselves.

"The cost of burnout is more than just loss of productivity," said Alvarez, who has lost colleagues to suicide. "It's loss of human beings that also had the potential to take care of many more people."

To combat the growing levels of violence against healthcare workers, some state and federal lawmakers have introduced legislation to increase the penalties for these attacks.

For example, lawmakers in California have introduced a bill to make the penalty for assaulting an emergency worker consistent whether they're in the field or in the ED. Currently, the maximum penalty for simple assault against an emergency medical worker is a $2,000 fine and a year in jail, but only if they are working in the field, such as responding to a 911 call, instead of in a hospital.

Separately, federal legislation called the Safety From Violence for Healthcare Employees Act was introduced in 2023. The legislation would set sentences of up to 10 years for assault against a healthcare worker, and up to 20 years in situations that involved weapons or bodily harm.

Stephanie Jensen, an ED nurse and head of governmental affairs for the Emergency Nurses Association, California State Council, said that if lawmakers don't act to protect healthcare workers, then there won't be enough workers to care for patients who need them in the future.

"It's hard to keep those human resources accessible when it just seems like you're showing up to get beat up every day," Jensen said. "The emergency department is taking it on the chin, literally and figuratively." (Bean, Becker's Clinical Leadership, 4/2; Press Ganey "Safety in healthcare 2024" report, accessed 4/2; Press Ganey, Business Wire, 4/2; Parekh, KFF Health News, 4/3)

Use these resources to gain a global perspective of how violence is impacting frontline staff, and learn strategies to confront this issue at your own organization.