ACEM statement on emergency department violence

Attributable to Australasian College for Emergency Medicine (ACEM) President Dr Simon Judkins

Any workplace, including hospitals, should be safe, and free from the threat of violence. Staff within emergency departments, like all other employees, have a right to feel safe at work. The safety of staff, patients and visitors at Emergency Departments and the wider hospital must be a top priority.

Following the incident at Sydney’s Royal Prince Alfred Hospital where a patient allegedly stabbed another patient, ACEM encourages the NSW Government to do all it can to minimise the risk to patients and staff.

We know that many people present to emergency departments in a time of deep health crisis and urgent need, and that many of these health crises are extremely complex. Emergency departments need to be resourced and supported so that they can respond properly to complex community health needs in an appropriate way. ACEM believes that a lack of appropriate resourcing is putting frontline emergency department staff, and other patients, at risk of violence.

ACEM would like the following measures to be considered:

  • Under reporting of violence should be addressed. Staff should be encouraged to report all instances of violence in the emergency department and this data should be collected and analysed. (We know that currently staff under-report incidences of violence or abuse).
  • All staff and patients who have experienced violence within an emergency department should be entitled to compensation for any medical or mental health support that may be required and should be entitled to special leave or time off work that may be required for recovery.
  • All parts of the hospital, especially emergency departments, should be weapon free zones, with security and clinical staff able to request weapon searches to be conducted by appropriately qualified security staff.
  • All hospitals should have sufficient numbers of suitably trained security staff; these may need to increase based on where and when the risk of violent incidences is higher.
  • We need to better understand the causes of violence in emergency departments and in particular its relationship to alcohol, drug use and mental health. Governments need to collect and share much more detailed data about violence in our emergency departments including the characteristics and design of emergency departments where patients and staff are less likely to get assaulted.
  • Adequate staffing should be in place at those times where violence is more likely (after hours and weekends). It is vital to have sufficient staff, particularly experienced and senior staff rostered on at times when the risk of violence is known to be greatest.

Emergency departments provide an essential health service to the community at a time of health crisis; ACEM’s view is we shouldn’t have to turn them into fortresses to keep staff and patients safe. However, much more needs to be done to understand the causes of violence in emergency departments and to resource emergency departments to prevent violence and minimise its impact.

They also need to be a safe and stress free place for the staff who work in them and the patients who need help.

Download ACEM’s policy on Violence in emergency departments


ACEM is the peak body for emergency medicine in Australia and New Zealand, responsible for training emergency physicians and advancement of professional standards.

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