More than half of the healthcare workers who participated in a survey feel that their workplace is "unsafe", particularly in state and central government medical colleges.

Led by experts from the Vardhman Mahavir Medical College (VMMC), Safdarjung Hospital and AIIMS, New Delhi, the study highlighted "significant gaps" in the security infrastructure within Indian healthcare settings.

The "Workplace Safety and Security in Indian Healthcare Settings: A Cross-Sectional Survey" published in a recent issue of the journal 'Epidemiology International' underscored the urgent need for improving the prevailing safety and security measures in healthcare settings.

The survey is a collaborative effort of Dr Kartik Chadhar and Dr Jugal Kishore from the VMMC and Safdarjung Hospital along with Dr Richa Mishra, Dr Semanti Das, Dr Indra Shekhar Prasad and Dr Prakalp Gupta from All India Institute of Medical Sciences (AIIMS), New Delhi.

The cross-sectional survey was conducted among 1,566 healthcare workers from diverse medical institutions across India using a pre-tested, self-administered online questionnaire, which assessed various dimensions of workplace safety. Logistic regression was used to find differences among groups.

The survey participants consisted of 869 (55.5 per cent) females and 697 (44.5 per cent) males. About one-fourth (24.7 per cent) of healthcare workers were from Delhi and around half of the them were resident doctors (49.6 per cent), followed by undergraduate medical students, including interns (15.9 per cent).

Responses were also received from faculty members, medical officers, nursing staff, and other supporting staff.

The majority of the respondents worked in government-run medical colleges (71.5 per cent). Half of the respondents worked in non-surgical departments (49.2 per cent) and one-third worked in surgical departments (33.8 per cent).

Results revealed that more than half (58.2 per cent) of healthcare workers feel unsafe at the workplace and 78.4 per cent reported having been threatened on duty, Dr Jugal Kishore, the corresponding author of the study said.

Nearly half of the healthcare workers do not have a dedicated duty room while working for long hours or at night.

The existing duty rooms are grossly inadequate in providing the basic amenities and services such as regular cleaning, pest control, ventilation, room space, and air conditioning, Dr Kishore stated.

A staggering majority of healthcare workers expressed "deep dissatisfaction" with the existing security measures in health institutions across India, he said.

Over 70 per cent felt security personnel were ineffective, and 62 per cent reported the emergency alarm system to be inadequate. Nearly half reported severe gaps in access control, surveillance, and security in high-risk areas like ICUs and psychiatric wards.

Over 90 per cent of institutions lack proper screening for weapons or dangerous objects, and nearly three-fourths reported the absence of secure hospital boundaries. These findings paint a "dire picture of insufficient security" in critical healthcare settings, putting both workers and patients at risk, Dr Kishore said.

"A striking difference in security satisfaction emerged between private and public medical colleges, with state government institutions showing the highest dissatisfaction," Dr Kishore said.

Over 63 per cent of respondents in state government medical colleges were unhappy with the number of security personnel, with a four times higher likelihood of dissatisfaction compared to private colleges.

Nearly 70 per cent criticised poor emergency alarms, access control, and security in high-risk areas, where dissatisfaction was more than 3.5 times higher.

"While central government colleges fared somewhat better, they were still up to twice as likely to experience dissatisfaction compared to private institutions," Dr Kishore elaborated.

Besides, an alarming 81.3 per cent of healthcare workers reported witnessing violence, yet nearly half (44.1 per cent) felt these incidents were handled poorly.

About 80 per cent of respondents didn't know who to contact in case of an emergency, and over 70 per cent lacked a clear, confidential process for reporting security concerns.

To address these challenges, the study recommended strengthening security in high-risk areas, increasing the number of security personnel, improving duty room conditions, and implementing clear violence-handling protocols.

Regular security training and collaboration with national agencies to advocate for legal frameworks were also suggested.