SHM Converge Scientific Abstract ePoster Gallery-Race and the Utilization of Security Responses in a Hospital Setting

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This retrospective cohort study examined whether Black and Hispanic patients experience higher use of security emergency responses (SERs) and physical restraints in a non-psychiatric hospital setting. The study included 24,212 patients admitted between September 2018 and December 2019. Race and ethnicity were self-reported, SERs were taken from security reports, and patient characteristics came from the electronic medical record.<br /><br />The primary outcome was whether a SER was called during hospitalization. The secondary outcome was whether physical restraints were used during a SER. Researchers used multivariable Firth logistic regression to analyze SER risk and Poisson regression to assess restraint use.<br /><br />Results showed racial inequities in SER utilization. Black patients had a higher rate of SER activation during their first admission than White patients (2.8% vs. 1.6%). In adjusted analyses, Black patients had significantly higher odds of a SER than White patients, with an odds ratio of 1.36 after adjustment for age, sex, mental health diagnosis, substance use history, length of stay, and Medicaid insurance status. Hispanic patients did not have significantly higher odds of SER use than non-Hispanic patients. Patients with unknown ethnicity also had higher odds of SER activation.<br /><br />Race and ethnicity were not significant predictors of physical restraint use during SERs.<br /><br />The authors conclude that Black patients experience disproportionately higher use of hospital security responses, consistent with prior findings in other clinical settings. They recommend further research to determine whether these findings generalize broadly, identify the mechanisms behind these inequities, and test interventions to reduce them.

Asset Subtitle

Emily Murphy

Meta Tag

Author List Adrienne Taylor, Emily Murphy, Evan M. Shannon, Jennifer Hong, Karthik Sivashanker, Kristen Stevenson, Mohsin Ali, Sejal Shah, Yannis Valtis

Category Research

Concept Security Emergency Response

Concept Race and Ethnicity

Concept Physical Restraint

Concept Black Patients

Concept Adjusted Odds Ratio

Distinguished Non-Finalist

Presenter Organization Johns Hopkins University School of Medicine

Presenting Author Emily Murphy

Track Patient Safety

Keywords

retrospective cohort study

Black patients

Hispanic patients

security emergency responses

physical restraints

racial inequities

hospital setting

multivariable Firth logistic regression

Poisson regression

healthcare disparities

Security Emergency Response

Race and Ethnicity

Physical Restraint

Black Patients

Adjusted Odds Ratio