Law Enforcement Presence in EDs May Undermine Care: Prashasti Bhatnagar, Esq., MPH

Law enforcement officers’ (LEOs) presence in the emergency department (ED), especially in urban and safety net hospitals, may interfere with patient care and safety, according to a recent study published in JAMA Network.1

In an interview with The American Journal of Managed Care®, lead author Prashasti Bhatnagar, Esq., MPH, at the Urban Institute-Georgetown Law Project, said implementing formalized policy for both LEOs and hospital staff could improve patient experiences and care.

Transcript

This transcript has been lightly edited. Captions are auto-generated.

Your study highlights the need for formalized training for hospital staff and law enforcement. What specific training elements do you believe would be most effective?

Our study discusses formalized policy and implementation, focused training for both hospital staff and law enforcement, as one of those key strategies to navigate law enforcement presence. Some specific interdisciplinary training elements that I would highlight based on the findings of our study include 1) clarity around roles and responsibilities in the trauma bay; 2) explicit legal guidance and boundaries on law enforcement activity in the ED; and 3) practical information-sharing strategies that support efficient coordination across these different stakeholders without compromising patient care.

In this context, formalizing training is really about operationalizing a clear policy infrastructure to protect and support survivors in the ED. That is why this policy-focused training, as a strategy that we discuss in our study, should be implemented alongside triaging interactions to limit unnecessary law enforcement presence and integrating advocates for survivors to help protect their rights so that protections are not just written but actually enforced and upheld for long-term change.

What policy changes or hospital protocols do you think would most improve patient safety and trust without compromising necessary investigative work?

Building on our discussion, policies that clearly define roles, guide relevant and necessary information sharing, and establish clear boundaries on law enforcement access to patients, clinical spaces, and patient property could improve patient safety and trust while still allowing investigations to proceed efficiently. These policies and hospital protocols should all be grounded in a trauma-informed approach that prioritizes immediate medical care and supports long-term healing, safety, and recovery.

One of the key strategies that we discuss in our article related to these policy changes in hospital protocols is triaging interactions with law enforcement. We identified points of collaboration between hospital and law enforcement stakeholders to limit those unnecessary interactions between survivors and officers in the ED, for example, through the potential use of pre-formulated or asynchronous information sharing or designated hospital liaisons for law enforcement. In our findings, we observe that hospital-based violence intervention program (HVIP) representatives are uniquely positioned to serve in this liaison role and can help reduce unnecessary law enforcement presence while ensuring that all required obligations for stakeholders are met.

By placing clear boundaries on law enforcement presence and interactions, triaging really allows hospitals and law enforcement to meet those clinical and investigative needs while actively protecting survivor privacy and well-being. We also discuss integrating advocates for survivors in the ED as another strategy to prioritize care and recovery. I think I would also highlight the important work of multidisciplinary coalitions here, such as HEALIP and the Healthcare Collaborative for Justice, that are really developing and evaluating model hospital policies together on things like patient access, property, and use of restraints, alongside training to support effective implementation. Together, this emerging body of work really offers us some examples of how hospitals can begin to address competing priorities in the ED and operationalize patient-centered protections in emergency medical settings.

References:

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