HEALTH | Emergency Department Vulnerability Assessment U.S. emergency departments treat approximately 130 million patients annually, yet only 26% of hospitals have comprehensive active threat response protocols as of 2023 data. Historical incidents including the 2015 Hesston, Kansas workplace shooting and multiple hospital security breaches reveal that ED layouts—designed for accessibility and rapid patient flow—create inherent security challenges that conflict with trauma care urgency. The Joint Commission began mandating emergency preparedness drills in 2016, though implementation varies significantly across rural versus urban facilities, creating inconsistent response capabilities nationwide. Understanding these vulnerabilities matters because healthcare workers face the highest rate of workplace violence among all occupations, yet resource allocation for ED security often lags behind other critical infrastructure sectors.