Key Considerations

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.

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