Using Space Syntax Analysis to Measure Patient Aggression Risk

Area of Science:

• Urban planning and architecture
• Criminology and sociology
• Healthcare facility design

Background:

• Healthcare workers face high rates of workplace assaults, with poor environmental design contributing to aggression.
• Emergency departments are particularly vulnerable settings for patient and companion-driven violence.

Purpose of the Study:

• To evaluate space syntax as a tool for identifying aggression risks in emergency departments.
• To explore interventional opportunities and environmental design strategies to mitigate Type II violence.

Main Methods:

• Utilized five visibility graph analysis (VGA) measures: visibility, control, controllability, mean visual depth, and occlusivity.
• Applied VGA to three U.S. hospital emergency departments, analyzing original and modified layouts.
• Incorporated theories such as Rational Choice Theory and Crime Prevention through Environmental Design (CPTED).

Main Results:

• Significant differences in VGA measures were observed between different layouts and between original and modified designs.
• Architectural features, even minor ones, impact visual access and exposure, as measured by space syntax.
• Alcove-style staff areas were linked to reduced visual control, while central workstations in smaller zones improved control over patient areas.

Conclusions:

• Space syntax analysis is a valuable tool for pinpointing aggression risks within hospital environments.
• The study demonstrates the utility of space syntax in identifying opportunities for intervention and improving safety through design.