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.
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.
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.
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
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
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
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.
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.
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.