Don’t Let Failure to Foresee Lead to a Sexual Assault

February 8, 2017 | Strategic Insights for Health System


​Sexual assaults in psychiatric units of healthcare facilities likely occur more frequently than commonly thought and often feature several common variables, according to an article in the January 2017 Journal of Healthcare Risk Management. To assess the role risk management can play in preventing foreseeable attacks, the authors reviewed four case studies and identified five common "critical" factors in enabling sexual attacks: a care environment in which men and women were allowed to comingle; the presence of blind spots or poor visibility from the nursing station; lack of video surveillance; staff not always following policies and procedures; and the insufficiency of customary 15-minute staff check-ins on psychiatric patients (because attacks may not take that long to occur). The authors classified these factors as "failures of foreseeability," because they involve environmental or human performance factors. They offered five suggestions for reducing risk of liability for failure to foresee and mitigate risk of harm: First, prevent male and female patients from comingling, because 90% of sexual attacks involve men attacking women. The authors acknowledged that this recommendation is controversial; tradeoffs are necessary, they said, because a sexual attacker will often look for a vulnerable target. Facilities that do allow male and female patients to interact should know that in the event it is prosecuted, the likelihood a sexual attack will be deemed foreseeable is "obviously heightened." Second, maximize visualization of patients from a nursing station, and search for blind spots from which attackers could strike.

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