Key Considerations
What stakeholders expect in securing a medical facility
Medical centers are unique facilities in that they can
be diverse in their security needs (depending on the
use of the building) yet share similar requirements.
For example: behavioral health locations benefit
from a selection of doors and openings that protect
patients from self-harm. Meanwhile, a labor and delivery unit must
have accountability for the safety and security of newborns. The two
locations require very different solutions for doors and access control,
yet both need to ensure patient records, medicines and valuable
materials are stored in accordance with laws and regulations.
Having both specific and shared goals is what makes medical centers
quite unique to security. Rarely are two buildings alike, yet they
all have common needs, requirements and goals. As such, all medical
centers share one best practice for planning security: consider the
specific needs of the people who will use your building, involve multiple
stakeholders invested in the facility’s success, and then plan for
their unique safety and security requirements.
Specific Considerations
Some example considerations for medical centers include:
- Do patients in an overnight care center or emergency room have
confidence that their smartphones, tablets and other personal devices
will be safe if they leave them unattended?
- How often is a particular opening being left ajar for employee
breaks? Does anyone know who might be accessing the hospital
through that door?
- How does a medical center protect clinical, professional, administrative
and environmental staff from suspicion of diverting supplies?
- What visitor tracking and patient protection procedures are in
place to ensure safety for everyone—even in the case of a possible
epidemic or weather-related crisis?
- What access control system ties satellite facilities or doctor’s offices
to a main hospital or care center?
- What compliancy issues must we meet that apply to every medical
center and healthcare facility? Are we meeting the requirements
for HIPAA laws and fire code?
Consideration of these factors—and many other facets of medical
center life—provoke a host of thoughts about security, convenience,
patient, visitor and staff safety.
To be sure you are addressing all these needs when developing a
security plan for a healthcare facility, there are a few steps that can be
taken to ensure the right questions are being asked.
Full Involvement
The above questions and concerns are weighty topics that require
input from virtually every department in a medical center, hospital
system or provider network. Thus, the first step in planning for security
in this complex environment is to identify the stakeholders and
decision makers invested in the outcomes. This includes those working
in compliance, the delivery of care or the successful protection of
people and assets.
No longer are decisions made in the vacuum of a single department
or within the confines of a single hospital or healthcare office.
Every department has recognized that decisions made in one area of
the hospital system may affect every other area.
So, when planning for security in a healthcare facility, who should
be at the table?
Resilience officer. One of the most important components of security
in healthcare facilities is the ability of a location to withstand a
major storm. Resiliency includes infrastructure, security and staffing
but begins with ensuring the location can withstand a major storm
and ends with ensuring critical assets remain protected in the aftermath
of an event.
Patient experience officer. Often referred to as the “CXO” or the
Chief Experience Officer, this role is seeking ways to improve the
patient experience across the board. This impacts virtually every
department in the hospital, and is absolutely critical because funding
is often dependent on patient experience (HCAHPS or Hospital
Consumer Assessment of Healthcare Providers and Systems) survey
results. In terms of security, this means making sure people not only
feel well cared for and safe inside the hospital, but are also comfortable
with the storage of their personal belongings.
Human resources. This role goes far beyond recruiting and onboarding
of staff. In terms of security, this department is likely to be
in charge of credentialing, security training and staff safety. Ensuring
they are up to date on the critical systems in a security installation
is vital.
Security. An obvious inclusion, yet it is important to remember
that this is the heartbeat of the hospital when it comes to protecting
people and systems.
Operations. Those in charge of administration and clinical operations
will have a significant impact and investment in terms of
security decisions. Securing pharmaceuticals, supplies, equipment,
and monitoring access control to these locations will all be critical.
Planning, design and construction. The built environment is critical
for healthcare in terms of design, comfort, ingress and egress, as
well as the functional and safe movement of people. Further, determining
zones of access will be important in a plan.
Compliance department. Compliance spans everything from life
safety regulations such as NFPA (National Fire Protection Agency)
and other Authorities Having Jurisdiction (AHJs), critical guidelines
and compliance elements including the Americans with Disabilities
Act, and HIPAA (Health Insurance Portability and Accountability
Act). Including them in security planning is a must.
Security System Design
Now that you have brought the correct team to the table, what do
you discuss? Consider these the key components to a security system
design in a healthcare facility.
Define the users of the system. This includes clinical staff, general
public and visitors, patients, those with disabilities, and other populations
within the hospital. Identify an estimated budget and determine
the areas of greatest concern.
For hospitals or multiuse facilities this will include broad areas
such as the nursery or ICU. Specific locations will be universal across
most facilities, such as medication stations, the pharmacy, supply
cabinets, exterior visitor entrances, employee entrances, linen storage,
nurse servers, patient rooms, staff lockers, stairwells, etc.
Be sure to assign the frequency of use for high traffic or low use
areas and document locations in the building that are subject to fire
and egress codes such as NFPA, ICC, IBC, AHJs and others. In a
retrofit environment, it is common that hospitals and healthcare facilities
have employed pin code type devices that do not provide audit
trails. Often the codes for these doors are either written nearby or go
unchanged through staffing changes. This does not follow compliance
guidelines and these locations would be suitable for re-evaluation.
Assign levels of security for different locations such as general
access, high security, and lockdown areas. Consider energy efficiency
and sustainability requirements. For example, doors can contribute
to significant energy loss from the building envelope. Thus, the main
physical barrier in nearly all security solutions plays a major role in
this area.
Last, but not least, consider building in infection control with optional
antimicrobial coatings or other protections.
Scalable Security Solutions
Once these factors have been identified and agreed upon by the stakeholders,
selection of devices and platforms can begin.
The market for healthcare security today is robust, and there are
many options. That can seem daunting, but in reality, the number
of technologies means it is now easier than ever to tailor the access
control capabilities of each opening to match exact security needs.
Healthcare facilities can implement varying degrees of access control
at each opening—be it a loading dock on the building perimeter
or a cabinet door in a patient room.
Wireless solutions are now diverse enough that they can be used
across standardized Wi-Fi networks or on proprietary wireless setups
to meet concerns of increased security or avoid difficult installation
barriers.
Today’s access control systems allow for a bevy of credentialing
options along with simple and efficient user management systems.
The days of rekeying entire locations or facilities are gone. The very
highest standard of security is now available with cloud-based management
software.
Remember, successfully layering security in this manner requires
input from all stakeholders to identify risks, applicable codes and
regulations, sustainability goals, aesthetic preferences and budgetary
concerns.
It is best practice for healthcare facilities to
partner with integrators to achieve these goals
and it is critical for integrators to work with trusted
manufacturers who offer ongoing support and
partner in the success of securing your facility.
This article originally appeared in the July/August 2018 issue of Security Today.