Across America, hospitals (and in particular emergency departments) are seeing increased rates of physical assault. The sources of this are probably numerous, but I suspect the main ones are epidemic drug abuse, frustration over finances, decreased access to mental health care and a general lack of respect for authority and the well-being of others.
Our facility has been facing this issue. And we have made improvements. But I have been consistently stunned by the way administrators are deathly afraid of anything that might, on any level, cause harm to those individuals who assail nurses and physicians. It's a remarkable mentality that always makes attackers into unwitting victims, who need to be protected from the nasty doctors, nurses, security personnel and law enforcement officers who might actually have to touch them (instead of 'talking them down.')
So, for my first thought on things that impede progress, there's this: hospitals that are afraid to protect their staff, due to fears of litigation or negative PR, are impeding the safety and efficiency of those they should treat as precious resources. Namely, the very providers who care for patients, sane, crazy, violent or criminal, rather than sitting in offices, wringing their hands over yet another file-folder of regulations.