R03 – Shielding the Frontline: 9 Health Systems, 5 Principles, and the Future of Staff Safety

Healthcare workplace violence has evolved from a safety concern into a national crisis and a fundamental design imperative. High-profile incidents, such as the lethal shooting at NewYork-Presbyterian Brooklyn Methodist Hospital and the staggering 30,000 weapons confiscated annually at Cleveland Clinic, underscore the severity of the threat. With 33% of nurses contemplating leaving the profession due to victimization, addressing workplace safety is essential for both workforce retention and the delivery of patient care.

This roundtable introduces a multidisciplinary framework for violence mitigation rooted in the Crime Prevention Through Environmental Design (CPTED). Our research draws from C-suite interviews conducted across nine health systems to determine how physical space influences behavioral outcomes. We analyzed how the five core tenets of CPTED: access control, natural surveillance, territorial reinforcement, social management, and maintenance, can be strategically deployed at four scales (campus, building, unit and room level) to shield caregivers in high-stakes environments.

This session invites attendees to participate in a collaborative design ideation. Utilizing a safety checklist derived from our multi-system study, participants will audit floor plans, propose environmental modifications to enhance safety, and engage in a cross-pollination of ideas between clinicians, architects, and administrators to bridge the gap between safety policy and spatial reality.