Tame The Hot Spots

Security professionals can help keep hospital challenges under control

• By Bruce Czerwinski
• Aug 01, 2016

Hospitals present combined security challenges not found in other facilities. There are potentially thousands of people, patients, staff, visitors and vendors, to protect. Expensive diagnostic and treatment equipment, as well as, pharmaceuticals and supplies need to be secured. And, it needs to be accomplished in a warm and welcoming environment.

This is quite a challenge and just the beginning.

Hospitals never fully close. Virtually every aspect of the facility falls under strict government regulations mandating quality of care, patient satisfaction, cost containment and privacy. Distressed patients and visitors act aggressively toward each other and hospital staff. According to one federal study, healthcare workers account for two-thirds of the nonfatal workplace violence injuries involving days away from work.

The security industry has solutions to help hospitals tame some of their major hot spots. Available systems have helped administrators, who previously viewed security as a cost center, see them as multi-disciplinary tools to document compliance, control workflow and assist with other daily applications.

Here is a look at some of those hot spots and current best practices to help secure them. But first, with any major installation or system retrofit, begin with a risk assessment. This requires an expert familiar with the nuances of the healthcare industry. Most security experts begin outside the hospital and work their way into the main facility.

PROTECTING PARKERS

Parking garages and lots are the first stop for most hospital staff, visitors and vendors. These are one of the more potentially dangerous areas of any hospital campus, or any facility. According to the federal Bureau of Justice Statistics, more than 7 percent of the country’s violent crimes and 11 percent of property crimes occur in a parking garage or lot.

Installing audio intercoms into all ticket dispensing and revenue control systems provides an instant two-way link with the security department. Emergency stations, either towers or wall-mounted boxes, offer immediate audio assistance and help security assess emergencies. These units should be placed near pedestrian entries/exits, stairwells and pay stations.

Surveillance cameras provide real-time video to help the security staff monitor events. There should be enough cameras to prevent blind spots. Cameras are a criminal deterrent, so make them easy to spot, paint them a bright color, and use signs announcing the facility is under continuous surveillance. Monitoring the feed 24/7 may be impossible, but security officers should be watching during shift changes, especially at night. Many hospitals now provide escort services for employees heading to their vehicles.

MANAGING VISITORS

Most hospital access points should be kept locked, funneling visitors into a single lobby entrance. Until recently, hospitals had no idea of who was visiting at any one time, but this is changing as many now install visitor management systems.

Visitors present their government-issued ID, which is scanned through the system to compare the person’s name and address with federal, state and local criminal databases and sex offender registries. Hospitals may add their own watch lists to include disgruntled former employees and people with court orders barring them from contact with a patient or staff member. The system prints temporary IDs indicating which floors/areas approved visitors are authorized to access. The process takes about a minute to complete. Visitors likely to return can receive a multi-day pass containing a barcode to be scanned at the badging station.

PROTECTING THE INTERIOR

Critical areas within the hospital, such as executive offices and data centers, should be restricted to nearly all visitors and employees. Doors to these areas need to be locked. Video intercoms mounted at entries allow staff inside to see and have twoway conversations with visitors before deciding whether to grant access.

Communication throughout the facility is vital to generate a proper response to emergencies ranging from patient medical events to an active shooter. In case of an emergency, paging and voice communication using audio intercoms immediately notify any or all staff.

THE ED

A hospital’s emergency department (ED) may be a dangerous place to work. In 2013 surveys, more than 70 percent of emergency nurses reported being physically or verbally assaulted by patients or visitors, and 75 percent of emergency physicians experienced at least one violent workplace incident in a year.

Many of the same tools applicable to other hospital areas also have a place in the ED. Locks are critical. While the lobby must remain open, the door to triage and treatment areas should remain locked. Visitor management systems track patients and visitors moving beyond the lobby. It is wise to limit the number of visitors accompanying any patient.

Audio intercoms foster communication between staff and security. Surveillance cameras at the entry and in the lobby provide security with a real-time view of the lobby and other non-treatment areas. Metal detectors, manned by a security guard or officer, help keep weapons out of the ED.

Due to the potential for ED violence, panic buttons should be added to staff badges. A press of these buttons sends a signal to the access control system which informs security, initiates a lockdown and alerts other staff members.

LOCATING STAFF, PATIENTS AND EQUIPMENT

To increase efficiency, improve patient care and save money, many hospitals are deploying real-time location systems (RTLS). Think of these as an indoor GPS. They help administrators track equipment, staff and patients using small tags with embedded RFID chips capable of transmitting their own unique identification. The system can be defined to locate tagged patients or objects by unit or floor or even by room, closet or shelf.

These systems help ensure patients are where they need to be for treatment. They save time in locating portable medical devices and drug carts. Historical analytics let supervisors see where staff members are spending their time, allowing for workflow and staffing adjustments, another non-security benefit.

Tags also work well with patients prone to wandering. It provides them the confidence to access common areas while remaining secured and protected from walking into dangerous areas. Tagging each newborn provides staff with bed-level visibility. Should a baby be taken beyond the monitored area, the tagging system triggers an alarm, starts security cameras recording, locks stairwell doors and holds elevators.

SECURING DRUGS

Hospitals must adhere to a host of federal, state and local laws when it comes to securing drugs. Pharmacy directors will already be using automated drug cabinets and locked carts, storage rooms, refrigerators and other containers throughout the facility. Controlled substances are typically stored separately from other medicines.

The security professional can help by controlling access to these areas. Everything from a door to a refrigerator or portable cabinet can be fitted with card readers linked to the access system. This provides a detailed record of who accessed which area/device and when. Each staff member’s credential can be restricted to only those areas appropriate for their jobs.

Access into the pharmacy should be limited to authorized staff members. However, there may be time when a physician or nurse requires access. In that case, a video intercom on the entry will allow pharmacy staff to see and maintain a two-way conversation before granting access. With drug thefts on the rise, many hospitals now also require double identity authentication for pharmacy employees. This typically involves an access card and a biometric authenticator such as a fingerprint or iris scan.

Temperature sensors are important for monitoring the condition of appliances and cabinets storing critical medicines, vaccines, blood and lab samples. These sensors trigger an audible alarm before a minimum or maximum temperature is reached to ensure these items are safe and ready for use when needed.

INTEGRATION

Hospitals are finding integrating the security function over a single network with building systems (HVAC, lighting, water) saves money, creates detailed compliance reports and leads to a safer, more convenient facility.

Here’s an example of how this might work. The fire system detects a fire. An emergency notification is sent to first responders and broadcast over the internal audio intercom system. The HVAC system is signaled to stop delivering fresh air to the area and pressurizes the escape route to help clear smoke. The access system unlocks doors along the route and surveillance cameras are trained on the fire to provide first responders with a live feed. This level of integration requires an integrator with a full-time staff of IT specialists.

This is not meant to look at all the security problems hospitals face. It is intended to give an idea of the depth of knowledge security professionals must bring to a project. The challenges hospitals face will continue to evolve as the numbers of patients and staff members grow and the treatment systems become more complex and expensive.

Hospitals are places where millions of Americans annually go to be healed. As security professionals, it is our job to help create a safe and secure environment where medical professionals can do their jobs.

This article originally appeared in the August 2016 issue of Security Today.