The shooting that left a doctor in critical condition Thursday at Johns Hopkins Hospital in Baltimore is only the latest example of a rising trend of violence in health care settings, experts say.
"Once considered safe havens, health care institutions today are confronting steadily increasing rates of crime, including violent crime," said an alert issued in June by the Joint Commission, a national accrediting agency.
A text message poll of 100 emergency room doctors, conducted by Truth On Call for msnbc.com on Thursday, found that 59 percent of doctors said violence in the health care setting is a growing concern; 41 percent said today's shooting was an anomaly.
Since 2004, the number of assaults, rapes and murders reported to the Joint Commission rose steadily, with the greatest number of reports in the last three years: There were 36 incidents nationwide in 2007, 41 in 2008 and 33 in 2009.
According to the Joint Commission’s voluntary reporting system, there were 256 assaults, rapes or homicides of patients and visitors at American health centers since 1995, with 110 of those acts occurring after 2007.
That number is likely far lower than the actual number of incidents because violence in health settings in often underreported, the group said.
Violence is often perpetrated by staff, visitors, patients — and intruders, the agency warned.
In Thursday's shooting, the gunman, identified as 50-year-old Warren Davis, reportedly hid inside his mother's hospital room, Room 873, on the eighth floor of the Nelson building, the main tower of the Baltimore hospital.
During a standoff with police, Davis shot and killed himself and his mother, Jean Davis, because he was reportedly distraught over her condition. A hospital coffee shop worker said employees told her that Davis was upset because his mother had become paralyzed after treatment.
A key to preventing violence in hospitals is controlling access, said Russell L. Colling, a health care security consultant who contributed to the Joint Commission report.
"The roots of violence need to be investigated and evaluated beginning at the unit level," Colling wrote. "Nurses and other health care staff should question the presence of all visitors in patient rooms and not assume that someone is a family member or friend."
Details of the Thursday shooting will reveal more about how the shooter entered the hospital with a weapon and what prompted his action, said Jane Lipscomb, a professor at the University of Maryland School of Nursing in Baltimore who studies hospital violence. While a shooting may be an extreme act of violence, Lipscomb said hospital workers are frequently exposed to verbal and physical threats.
"I think health care workers have always recognized that they could be at increased risk," Lipscomb said. "We're starting to speak out, to say, 'Hey, this shouldn't be a condition of employment.'"