How secure are Australian emergency departments?

To ascertain the level of security arrangements in Australian EDs.

A postal survey to the directors of all Australasian College for Emergency Medicine (ACEM) accredited EDs in Australia. A score based on the ACEM design guidelines for EDs was given. A maximum score of 12 correlated with compliance with the 12 specific ACEM recommendations. Questions regarding satisfaction with security and occurrence of a major incident within the prior five years were included.

There was an 88% response rate to the questionnaire. Of the respondents, 63% were unhappy with the level of security in their ED and 81% reported the occurrence of a major incident within five years. The average score out of 12 was 8.39 (SD 2.4). A total of 7% scored 12/12 and 21% scored 6 or less. There was no difference in scores when the ED were grouped by age, locality or annual attendances.

The vast majority of Australian EDs do not comply with all ACEM recommendations on security and most department directors are unhappy with the existing level of security in their departments. This is of concern in light of the negative impact of violence on the well-being of ED staff.