Nurse in a hospital setting putting on her face mask in preparation for surgery.
February 13, 2024

Canopy Data Report: Shedding light on violence against hospital staff in 2023

Canopy published 2023 findings detailing the safety crisis that healthcare facilities are facing. Shan Sinha shares his perspective on the data.

The next time you talk to a doctor, nurse, or medical technician, ask them if they've ever experienced anything strange in the hospital during a full moon. You're likely to hear one or two stories, and a personal theory on what the lunar cycle had to do with it.

Despite years of academic research refuting the “lunar effect” – the superstition that full moons bring about strange and chaotic happenings in hospitals – many healthcare workers believe it to be true. In a 2016 Wall Street Journal article exploring this phenomenon, a doctor who spent 40 years of his life working in an emergency department said any research contradicting the lunar effect is “flat-out wrong.”  

Aggregate Canopy data from 2023 suggests there may be some merit to the superstition. Over 200,000 healthcare workers in 40 health systems across the country wear a duress button created by Canopy – which they can press when they are in distress and require assistance from a colleague or intervention from their security team. In what was a surprise to us, we found an actual 9% increase in alerts during full moons.

Is it a kitschy fact? It may be, but data speaks for itself – and sometimes the outcomes are unusual. It’s also one of the more granular data points on hospital security I’ve seen in recent years.

Over the past decade or more, it’s become abundantly clear that there is a growing crisis of safety in American hospitals. According to OSHA, nearly 75% of workplace violence claims of assaults occur in healthcare or social services settings. Violent crime on hospital properties increased 47% from 2020 to 2021 to 2.5 incidents per 100 beds, according to the International Association for Healthcare Security & Safety.

This past October, the CDC published a survey in which healthcare workers reported a sharp increase in hostile incidents between 2018 and 2022. While you’re asking a healthcare worker about the lunar effect, ask for their thoughts on this as well. If they haven’t experienced an incident themselves, they most likely know someone who has.

Hospitals and health systems don’t need to be told about the crisis of safety on their campuses. They’re well aware. And yet, despite all of the reports that have been published and the nightmarish firsthand accounts that have been publicized, it has been difficult for health systems to get a clearer, deeper understanding of this crisis: Where on their sprawling campuses are hostile incidents most likely to occur, and when?

In 2023, Canopy data showed that 22,000 alerts were triggered by healthcare workers, indicating more than 10% were in need of immediate help with an emerging threat or active violence. Let’s take a look at where and when those alerts were triggered.

A deeper dive into the data

Hospitals are pillars in their communities; they’re centers of healing and often a place of solace and restoration for all members of our society and their families. But healthcare is also difficult, demanding, and confusing. Hospitals are hotbeds of raw, sometimes aggressive, emotion – and healthcare workers endure the brunt of it.

Where? Though you may not expect it, Canopy data found duress buttons were activated in every single part of the hospital – not just the emergency department. Breaking it down further:

  • 40.5% of alerts occurred in emergency departments
  • 59.5% of alerts occurred elsewhere on campus (this includes in-patient floors, surgery-related areas, ICUs, critical care units, behavioral health units, and even non-patient care areas)

While the greatest number of incidents by unit type occur in emergency departments, the rest of the campus cannot be ignored. Garages and parking lots, in particular, are a common source of fear and anxiety among healthcare workers, and for good reason – these are sprawling cellular dead zones, often removed from security staff. Hospitals need to ensure their healthcare workers have peace of mind, wherever they are on campus.

When? Weekends and holidays are the busiest – and most understaffed – times for emergency departments. And yet, according to Canopy data, alerts were less frequent during these times:

  • 20% more incidents occurred on weekdays over weekend days
  • There were 12% fewer incidents during holidays than non-holidays
  • COVID surges were associated with an 8% increase in incidents

It’s worth mentioning again that this is aggregate data, representing incidents occurring in 40 different systems, a variety of different environments, urban, rural and everything in between. All of these details – exactly where on campus incidents occur, when they happen, and who is in need of assistance – will obviously vary from hospital to hospital. Every hospital has a distinct campus, a unique patient population and staff makeup, and specialized security needs. Blanket measures will fall short in making those campuses safer.

With the deeper insight Canopy provides, hospitals can better determine whether the procedures and processes they have in place are supporting their staff in the way that they need. They’re optimizing their ability to respond to incidents based on location, time, and frequency. They’re helping staff feel safer. They’re taking a fundamental step forward in prioritizing the security of their staff and safeguarding their peace of mind at work.

Healthcare’s workforce is already in crisis. Health systems everywhere are struggling against historically high rates of burnout and turnover. Labor shortages are putting clinicians under extreme pressures. On their own, these forces are actively interfering with the ability of our clinical workforce to do the jobs they are there to do. Eliminating the lingering fear over safety in the workplace provides hospital staff with the basic comfort they deserve when they show up to work – even if it’s during a full moon.