The Borne Security

Hospital workers provide an effective approach to pediatric security

• By Owen Roberts
• Aug 08, 2007

Holzshu and his team, one of just two certified private police forces in the state, have a lot to keep an eye on. WakeMed, located in Raleigh, N.C., is an expansive private, not-for-profit, multi-facility health system. It operates two full-service acute care hospitals, two hospitals providing skilled nursing care and outpatient services and three facilities providing outpatient rehabilitation services. More than 1,000 physicians form the medical staff at the 752-bed hospital system.

Comfort and Security
Part of this expansive operation is a women's pavilion and pediatrics unit. WakeMed has the only inpatient unit dedicated to pediatrics in Wake County, where child life specialists work to make children feel more comfortable during their hospital stay. The specialists educate patients about procedures, provide strategies for pain management and initiate therapeutic play. The facility itself, located on the fourth floor of the main hospital, features a playroom, a salt-water aquarium and an outdoor roof-top play area. Each patient room is private and equipped with a small refrigerator for parents' convenience, as well as a pull-out cot for parents to spend the night with their children.

Comfort is a key ingredient to managing pediatrics patients. From a security perspective, they're a unique group to deal with, mostly because they are so mobile.

"Infants are non-ambulatory, but that is not the case with a lot of pediatrics patients," Holzshu said.

Hospitals have worked hard to outfit obstetrics and neonatal wards with protection technology that thwarts baby snatching or switching. But many are still working to tighten security when it comes to pediatrics patients, who can be just as young, helpless and vulnerable as a neonatal patient.

The industry is aware of the situation.

"Newborns who leave the hospital, but must come back for medical reasons, do not return to the obstetrics ward, they become pediatrics patients," said Diane Hosson, vice president of marketing for Xmark® Corp., an Ottawa, Canada-based company that supplies infant and pediatric protection technology. "At this time, we are working with many hospital experts to establish industry guidelines to assist hospitals in determining what kind of infant and child anti-abduction protection should be in place in the pediatric departments, because we know hospitals want to have the same standard of care and security for all their young patients."

Indeed, when a child's hospital bed is unexpectedly and inexplicably empty, it doesn't matter if the child went missing from obstetrics or from pediatrics—it's still a missing child. For security, drawing the line between the two units is artificial and potentially dangerous. That's borne out by statistics from the National Center for Missing and Exploited Children, which says about 800,000 children—more than 2,000 each day—under the age of 18 are abducted annually. Fortunately, a very small number of these (around 100 all year) are the sensational tabloid-newspaper type of abductions, where a total stranger abducts a child. Rather, about one quarter of all abductions are by family members, which are tougher for authorities to identify.

And children have other features that make securing them a challenge. For one, they're curious.

"It's one thing to put a small device on a baby," Holzshu said, "but 13- or 14-year-olds are much more curious about wearing tags and where they can go in the hospital.”

An Active System
Holzshu and his team spend time educating parents and patients about the technology, establishing boundaries. The hospital itself makes it easier for patients by having installed different-colored carpeting to indicate "out of bounds."

"The patients are instructed to stay away from the blue carpet zones," Holzshu said. The carpet color is a strong visual clue and helps deter false alarms.

In fact, false alarms are seldom heard at the WakeMed pediatrics unit—less than one a month by Holzshu's count. It helps that a police officer is dedicated to the pediatrics unit, providing a constant reminder about security. Holzshu is convinced the officer's presence and the facility's dedication to technology help promote an atmosphere of security around the pediatric unit.

But little is left to chance. All pediatrics patients who are deemed at risk are outfitted with Xmark's Hugs® protection systems, to deter any would-be abductors. Hospital officials and Holzshu's team work with social service workers to determine potential problematic patients and take several steps to ensure their safety. This includes the Hugs device and certain physical location measures, such as making sure the patients are placed in beds near a nurses' station and away from doorways or stairwells. Eight doors are monitored via CCTV and connected to the Xmark system, so any transgression can be instantly noted and action can be taken. The system locks down the elevators if security is violated, and officers are dispatched.

"We went the Hugs route because we wanted an active system," Holzshu said.

The system sends a signal about every two seconds from the tag to the central receiving unit, so those monitoring it know immediately of a patient's whereabouts, rather than just when an alarm sounds. But true alarms are infrequent; in fact, in Holzshu's four years with WakeMed, there has not been an abduction. And he's convinced the facility's commitment to security keeps that track record intact.

"Abductors are looking for hospitals with the fewest features," he said. "We think that if they look at WakeMed, they'll quickly go away."