How ED Policies Can Better Protect Survivors of Violence: A Q&A With Prashasti Bhatnagar, Esq, MPH

Examining law enforcement present in the emergency department (ED) and collecting anecdotal evidence from hospital staff and patients has allowed researchers to suggest formalized improvements that cater to the needs of patients, specifically those who are survivors of violence.¹

In an interview with The American Journal of Managed Care^® (AJMC^®), lead study author Prashasti Bhatnagar, Esq, MPH, a law fellow at the Urban Institute-Georgetown Law project, explained what implementations would prioritize patient safety, dignity, and healing in the ED.

This transcript was lightly edited for clarity and conciseness.

AJMC: What inspired this multistakeholder study on law enforcement presence in the ED, and why is it particularly important now?

Bhatnagar: There is growing recognition that unregulated law enforcement presence in the ED can profoundly shape the experience and recovery of survivors of violence, but very little research has focused on how to effectively manage and mitigate these unintended harms associated with law enforcement presence in the ED. We undertook this multistakeholder study to identify patient-centered and trauma-informed strategies that allow different ED stakeholders, such as clinicians, staff, and law enforcement, to meet their responsibilities while prioritizing safety, dignity, and healing.

I think this work has always been important, and it is increasingly urgent as tensions between law enforcement, survivors of violence, and hospital stakeholders continue to rise in our current times. In the ED, these dynamics can translate into interrupted clinical care, compromised privacy and confidentiality, compounded trauma, and diminished trust in both health care and legal institutions. Bringing together survivors’ hospital-based violence intervention program representatives, or HVIP professionals, who themselves are survivors of community violence as well as law enforcement officers, really allowed us to identify mutually beneficial strategies that can protect patients while supporting clinical and investigative needs.

AJMC: Can you describe the most surprising or unexpected insights you gained from interviewing survivors of violence alongside HVIP representatives and law enforcement officers?

Bhatnagar: I think one of the most important insights from engaging with stakeholders with such complex power dynamics and competing priorities was this shared recognition of strategies that ultimately prioritize safety, survivor care, and recovery. Across groups, we found that there was consensus around limiting or triaging interactions with law enforcement, formalizing hospital and law enforcement training and policies, and integrating advocates for survivors in the ED. This alignment, or this shared recognition, creates a real opportunity for change that is both patient-centered and operationally feasible, balancing the critical needs and priorities of safety, recovery, and operational needs in the ED.

AJMC: How did the differences in data collection methods shape your understanding of each stakeholder group's perspective?

Bhatnagar: Because of those complex power dynamics that I was referring to, we were intentional about matching dating data collection methods to the specific needs and contexts of each group. Conducting interviews with each HVIP representative and survivors of violence who are most directly affected by law enforcement presence in the ED allowed us to approach sensitive and emotionally charged experiences with care, privacy, and flexibility. The interview format also really supported trust building and created space for participants to share nuanced perspectives and experiences in the ED.

On the other hand, focus groups with law enforcement officers really helped us to capture the collective perspectives and dialogue within law enforcement culture while also accommodating the different scheduling constraints of officers. Tailoring methods in this way not only strengthened participant participation and trust but also enriched our understanding of each stakeholder group, their particular needs and priorities, as well as potential solutions that are both patient-centered and operationally feasible.

AJMC: How might law enforcement presence impact patient populations who are already marginalized, and what equity considerations should hospitals address?

Bhatnagar: Law enforcement presence disproportionately and negatively impacts Black patients and other patients from minoritized communities who unjustly experience over-policing, racial profiling, and structural inequities across both health care and legal systems. In the ED, this can really exacerbate fear, mistrust, and re-traumatization, further compounding barriers to care and recovery.

That is why I think it is really important to engage with and learn from survivors’ needs and priorities. To think about equity considerations alongside other stakeholders involved in the ED by incorporating these multiple perspectives, hospitals can develop practical, sustainable, and trauma-informed policies and practices to promote both patient-centered care and community safety.

AJMC: What are the next steps for research in this area, and are there plans to test the strategies your study suggests in other hospital settings or at scale?

Bhatnagar: For us, next steps include continuing to engage with and learn from stakeholders involved in the ED, but also evaluating the implementation and impact of these patient- and policy-focused strategies as they are rolled out across hospital settings to specifically ensure that they effectively improve safety, trauma-informed care, and operational feasibility. Ultimately, the goal is to put clear policies and practices in place that can help ensure that EDs provide patients with safety, dignity, and trauma-informed care.

Reference

1. McCrear S. Law enforcement in EDS: Impacts on survivors of violence, marginalized communities. AJMC^®. January 13, 2026. Accessed January 21, 2026. https://www.ajmc.com/view/law-enforcement-in-eds-impacts-on-survivors-of-violence-marginalized-communities