Despite widespread coverage of violent incidents in hospitals, shootings inside hospitals are still relatively rare, a new study by the Johns Hopkins Office of Critical Event Preparedness and Response finds.

Researchers searched newspaper and Internet archives for acute care hospital shooting incidents between 2000 and 2011, finding 154 incidents over that time period, with 235 injured or dead victims. Roughly 59 percent of shooting events occurred outside the hospital.

The emergency department environs, which included the ambulance ramp, ED parking and outside walkways, were the most common site of shootings, with 29 percent of all incidents, followed by parking lots at 23 percent and patient rooms at 19 percent. However, incidents in the ED had much lower fatality rates, at 19 percent, than those in other areas of the hospital grounds, were the fatality rate was 73 percent.

Overall, health care workers are more likely to be victims of workplace violence of any sort than other workers; the rate of assaults of any kind on health care workers is 8 incidents per 10,000, compared with 2 per 10,000 in other industries.

Among the other findings:

  • In 23 percent of ED shootings, the weapon used was a security officer's gun taken by the perpetrator.
  • The researchers found most events were typified by a "determined shooter with a strong motive," broken down into "grudge" (27 percent of incidents), suicide (21 percent), "euthanizing" an ill relative (14 percent) and prisoner escape (14 percent).
  • Meanwhile, more random incidents, characterized by the researchers as involving "ambient society violence" (9 percent) and mentally unstable patients (4 percent) were more infrequent.
  • Hospitals with more than 400 beds, which compose 9 percent of all hospitals, had the highest incidence rates of shootings, while small hospitals posted the lowest rates.

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