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Copyright (c) 2025 Abeer Ali Ali Awaji, Fahad Abdullah Mohammad Alhanaya, Arwa Zaidan Alzaidan, Sumayyah Abdu Yahya Hadadi, Ismail Mohammed Abdullah Sahli, Hassan Yahya Ahmed Najmi, Amjad Abdulaziz Mohammed Aljallal, Ghalib Mohammed Abdu Arar, Abdullah Mohammed Ahmed Asiri

This work is licensed under a Creative Commons Attribution 4.0 International License.
Preventing Workplace Violence in Healthcare: Strategies to Reduce Medical Disputes and Enhance Patient Safety-An Updated Review for Healthcare Security Workers
Corresponding Author(s) : Abeer Ali Ali Awaji
Saudi Journal of Medicine and Public Health,
Vol. 2 No. 2 (2025)
Abstract
Background: Workplace violence against healthcare professionals (HCPs) undermines staff safety, erodes trust, and jeopardizes patient outcomes. In many settings, rising legal consciousness among patients and persistent quality deficits intersect with structural, financial, and educational weaknesses to intensify medical disputes and the risk of aggression.
Aim: To synthesize an updated, practice-oriented framework for healthcare security workers and institutional leaders to prevent workplace violence, reduce medical disputes, and enhance patient safety through system, organizational, and frontline interventions.
Methods: Narrative integration of recent analyses on root causes of violence and disputes, encompassing governance and accountability structures, purchasing and payment reforms, regulatory oversight, medical education quality assurance, workforce distribution, institutional safety systems, communication practices, and complaint and mediation pathways. Emphasis was placed on interactions between patient rights awareness, service quality, and trust.
Results: Two proximate drivers—heightened awareness of patient rights and uneven service quality—amplify conflict when grievance mechanisms are weak. Structural factors include distorted competition dominated by public hospitals, fragmented governance with diffuse accountability, payer fragmentation with feeforservice and basic capitation that do not reward outcomes, and medical education expansion outpacing capacity. Media effects are indirect, primarily amplifying postincident norms. Financial toxicity and low institutional trust mediate escalation. Effective strategies include empowering hospital directors with authority tied to multidimensional performance accountability; integrating insurance purchasing and adopting blended payments (global budgets plus DRGs) with quality guardrails and public reporting; tightening medical school accreditation and rightsizing enrollment; deploying comprehensive safety and incidentlearning systems; strengthening patient communication, transparency, and apology practices; and institutionalizing rapid, fair complaint resolution and mediation, supported by targeted deescalation training for security and clinical teams.
Conclusion: A layered, qualitycentered prevention model—aligning governance, purchasing, education, safety culture, and grievance systems—can reduce violence, resolve disputes earlier, and measurably improve patient and workforce safety.
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- Liebman BL. Malpractice Mobs: Medical Dispute Resolution in China. Columbia Law Rev. 2013;113:181–264.
- Feng ZH, Li TT. Guideline for Preventing Violence at Hospitals in China (2011-2012) Am J Med Qual. 2013;28:169–171. doi: 10.1177/1062860612453194.
- Wang Zhenghua. Miscommunication source of conflicts. China daily. 2013
- Xinhua Harbin hospital attacker gets life sentence. [Verified 16 November 2013]. Available at http://usa.Chinadaily.com.cn/China/2012-10/19/content_15832984.htm.
- Wang JC. A study on the countermeasures of medical disputes in psychiatric wards. J Clin Psychosom Dis. 2011;17:377–378.
- Xu GS. Commentary Professional Hospital Violence: The Pain That Cannot Be Borne by Chinese Medical Practitioners. Am J Med Qual. 2013;28:76–77. doi: 10.1177/1062860612451114.
- Harris DM, Wu CC. Medical malpractice in the People's Republic of China: The 2002 regulation on the handling of medical accidents. J Law Med Ethics. 2005;33:456–377. doi: 10.1111/j.1748-720x.2005.tb00512.x.
- 8.Yu DH, Li TT. Facing up to the threat in China. Lancet. 2010;376(9755):1823–1824. doi: 10.1016/S0140-6736(10)62161-7.
- Ending violence against doctors in China. Lancet. 2012;379:1764–1764. doi: 10.1016/S0140-6736(12)60729-6.
- Chinese doctors are under threat. Lancet. 2010;376:657–657. doi: 10.1016/S0140-6736(10)61315-3.
- Liu YL, Berman P, Yip W, Liang HC, Meng QY, Qu JB, et al. Health care in China: The role of non-govemment providers. Health Policy. 2006;77:212–220. doi: 10.1016/j.healthpol.2005.07.002.
- Ministry of Health PRC (MOH) Health statistical yearbook. Beijing: The Ministry of Health; 2012.
- Dong SP, Ma LP, Liang MH. The Experience of Third Party Medical Quality Regulation System: Research Based on Hospital Comment Center of Hainan Province. Chinese Health Qual Mana. 2011;18:9–12.
- Barber SL, Yao L. Development and status of health insurance systems in China. Int J Health Plan M. 2011;26:339–356. doi: 10.1002/hpm.1109.
- Gao TQ, Shiwaku K, Fukushima T, Isobe A, Yamane Y. Medical education in China for the 21st century. Med Educ. 1999;33:768–773. doi: 10.1046/j.1365-2923.1999.00313.x.
- Xu D, Sun BZ, Wan XH, Ke Y. Reformation of medical education in China. Lancet. 2010;375:1502–1504. doi: 10.1016/S0140-6736(10)60241-3.
- Ren XF, Yin JC, Wang BJ, Schwarz MR. A descriptive analysis of medical education in China. Med Teach. 2008;30:667–672. doi: 10.1080/01421590802155100.
- Huang SL, Chen Q, Yan JQ, He XJ. Medical Research in China: Where Does It Go? Am J Med Qual. 2013;28:172–173. doi: 10.1177/1062860612461170.
References
Liebman BL. Malpractice Mobs: Medical Dispute Resolution in China. Columbia Law Rev. 2013;113:181–264.
Feng ZH, Li TT. Guideline for Preventing Violence at Hospitals in China (2011-2012) Am J Med Qual. 2013;28:169–171. doi: 10.1177/1062860612453194.
Wang Zhenghua. Miscommunication source of conflicts. China daily. 2013
Xinhua Harbin hospital attacker gets life sentence. [Verified 16 November 2013]. Available at http://usa.Chinadaily.com.cn/China/2012-10/19/content_15832984.htm.
Wang JC. A study on the countermeasures of medical disputes in psychiatric wards. J Clin Psychosom Dis. 2011;17:377–378.
Xu GS. Commentary Professional Hospital Violence: The Pain That Cannot Be Borne by Chinese Medical Practitioners. Am J Med Qual. 2013;28:76–77. doi: 10.1177/1062860612451114.
Harris DM, Wu CC. Medical malpractice in the People's Republic of China: The 2002 regulation on the handling of medical accidents. J Law Med Ethics. 2005;33:456–377. doi: 10.1111/j.1748-720x.2005.tb00512.x.
8.Yu DH, Li TT. Facing up to the threat in China. Lancet. 2010;376(9755):1823–1824. doi: 10.1016/S0140-6736(10)62161-7.
Ending violence against doctors in China. Lancet. 2012;379:1764–1764. doi: 10.1016/S0140-6736(12)60729-6.
Chinese doctors are under threat. Lancet. 2010;376:657–657. doi: 10.1016/S0140-6736(10)61315-3.
Liu YL, Berman P, Yip W, Liang HC, Meng QY, Qu JB, et al. Health care in China: The role of non-govemment providers. Health Policy. 2006;77:212–220. doi: 10.1016/j.healthpol.2005.07.002.
Ministry of Health PRC (MOH) Health statistical yearbook. Beijing: The Ministry of Health; 2012.
Dong SP, Ma LP, Liang MH. The Experience of Third Party Medical Quality Regulation System: Research Based on Hospital Comment Center of Hainan Province. Chinese Health Qual Mana. 2011;18:9–12.
Barber SL, Yao L. Development and status of health insurance systems in China. Int J Health Plan M. 2011;26:339–356. doi: 10.1002/hpm.1109.
Gao TQ, Shiwaku K, Fukushima T, Isobe A, Yamane Y. Medical education in China for the 21st century. Med Educ. 1999;33:768–773. doi: 10.1046/j.1365-2923.1999.00313.x.
Xu D, Sun BZ, Wan XH, Ke Y. Reformation of medical education in China. Lancet. 2010;375:1502–1504. doi: 10.1016/S0140-6736(10)60241-3.
Ren XF, Yin JC, Wang BJ, Schwarz MR. A descriptive analysis of medical education in China. Med Teach. 2008;30:667–672. doi: 10.1080/01421590802155100.
Huang SL, Chen Q, Yan JQ, He XJ. Medical Research in China: Where Does It Go? Am J Med Qual. 2013;28:172–173. doi: 10.1177/1062860612461170.