A patient throws a chair. A visitor shouts threats. A frustrated family member crosses a line.
Unfortunately, these situations are becoming increasingly common across healthcare. Nationally, healthcare workers experience more workplace violence injuries than employees in any other private industry sector, and healthcare settings account for most nonfatal workplace violence injuries requiring time away from work.
The reasons are complex. Hospitals care for people experiencing pain, fear, grief, mental health crises, cognitive impairment, and life-changing diagnoses. Stressful environments, the complex nature of healthcare, and growing societal tensions can further escalate emotions. Healthcare workers are often the people standing closest to that stress.
But if workplace violence is one of healthcare's greatest challenges, it has also become one of Montage Health's greatest areas of focus.
Over the past five years, Montage Health has steadily expanded its approach to workplace violence prevention, investing in technology, training, reporting systems, security measures, organizational policies, and cultural changes designed to protect staff before incidents occur.
Escalation prevention
One tool helping employees safely respond to escalating situations is a wearable duress alert badge. Worn discreetly behind an employee ID badge, the system allows staff to silently summon help with a simple press of a button. Security immediately receives the employee's name and exact location, down to the room number, and can continue tracking the employee's movement if they relocate. In 2025 alone, Montage Health's security team responded to 317 duress badge activations.
Montage Health also moved proactively to implement weapons detection technology before new state requirements mandated visitor weapon screening. Today, individuals entering certain facilities can be screened through advanced weapons detection systems capable of identifying potential threats before they reach patient care areas.
Another major advancement is the violence assessment tool integrated into patients’ electronic health records. The tool helps staff identify patients who have previously exhibited violent behavior while receiving care, allowing teams to take precautions, adjust care plans, and prepare for potential risks before entering a situation.
The violence assessment tool also helps inform the use of care consideration magnets placed outside the rooms of patients with a higher violence risk. The magnets give care teams added awareness before entering so they can take appropriate precautions and be better prepared for potential safety concerns.
Setting expectations
Preventing violence also means establishing clear expectations from the outset. In recent years, Montage Health strengthened its patient and visitor code of conduct, making it clear that threats, harassment, discrimination, physical violence, abusive language, inappropriate touching, and other disruptive behaviors are not tolerated. The policy is reinforced through signage, online resources, educational materials, videos, and formal enforcement communications when necessary.
The goal is to create a welcoming environment while making clear that every employee, volunteer, patient, and visitor deserves to be treated with dignity and respect.
"Many people who come to us are experiencing some of the most difficult moments of their lives,” says Greg Smorzewski, chief people officer of Montage Health. “They may be scared, overwhelmed, or facing circumstances they never imagined. Our responsibility is to care for those patients and families with compassion while also ensuring our employees have a safe environment in which to provide that care. Creating a respectful, safe environment for everyone helps us deliver the best possible experience for our patients, visitors, and workforce."
Training for real life
“Staff need to understand the ‘why’ behind safety initiatives and practice responding to realistic situations,” says Daniel McKernan, assistant director of Safety and Patient Mobility at Montage Health. “Our workplace violence training incorporates real-life scenarios, helping staff recognize common warning signs, understand how situations escalate, and learn how incidents might be prevented altogether.”
Staff are taught to identify behaviors associated with the stress and assault cycle, maintain safe distance, preserve escape routes, and recognize escalating risk before a situation becomes dangerous.
Montage Health has also continued refining its response processes through disruptive behavior workshops, workplace violence committee initiatives, and ongoing staff education about risk assessment and intervention strategies.
Data drives prevention
Several years ago, Montage Health established dedicated reporting structures and resources to encourage staff to document violent incidents, threats, harassment, and other concerning behaviors. Montage Health also developed post-event debriefing tools to support employees and identify opportunities for improvement after incidents occur.
The workplace violence committee continuously reviews trends and mitigation strategies, while daily safety huddles and leadership reviews help ensure concerns receive timely attention. Information gathered from frontline staff helps identify patterns, allocate resources, and implement preventive measures before problems become larger.
“Visibility drives action,” McKernan says, “and action drives a safer workplace.”
A culture where safety comes first
Perhaps the most important change is cultural. Workplace violence prevention has evolved from being primarily a security responsibility to becoming an organizational responsibility. Leadership support, daily safety conversations, enhanced reporting, post-event follow-up, and ongoing investments in prevention have helped make safety a more visible part of everyday operations.
Staff continue to raise ideas through employee forums, including discussions about visitor accountability measures, environmental safety enhancements, and security resources in higher-risk settings. Those conversations help shape future improvements and ensure frontline voices remain at the center of decision-making.
Workplace violence may be a challenge facing healthcare organizations across the country, but Montage Health's response demonstrates that violence is not simply something healthcare workers must accept as part of the job. Through prevention, technology, training, accountability, and a commitment to listening to employees, Montage Health continues building a workplace where every staff member can focus on providing the best possible care while knowing their safety is a priority.
