The sign says HOSPITAL, not HOTEL!

Arriving at some of America’s modern hospitals feels a lot like arriving at the entrance to a grand resort. Beautiful architecture, manicured landscape, and well-dressed valets awaiting to park your car. As you walk in, you may be greeted by a sharp dressed concierge who will politely provide you directions to your destination within the hospital. All in all, so far, a pleasant experience. The problem is, you are not here for medical treatment. You are here to kill your ex-wife who is a nurse on the cardiac care floor. 

You are armed with a loaded and well concealed firearm. Once past the front entrance greeter, you are well on your way, as you have studied the hospital’s map which are readily available on the hospital’s website. You have previously spent the better part of a day walking around the hospital to gather information on which exits may provide the quickest escape. As part of this earlier reconnaissance, you took note that security officers are posted at entry ways, “sensitive” areas such as the emergency department and maternity. There does not appear to be any random roving patrols throughout the corridors and open areas. 

As you continue working your way towards the “employee only” elevators, you notice several employees engaged in deep conversation heading in the same direction. One reaches to swipe her ID in the card reader without missing a word in their conversation. None of them notice you walk right on the elevator along with them. Next stop, the floor where your ex-wife works… 

Likely this scenario could play out at most hospitals. Some are better secured, others, tragically even less. After so many newsworthy tragedies at American hospitals, many organizations have made the commitments and investments necessary to step up their security postures. Few have even evolved their security measures to more closely resemble the security layout of an airport. Certainly, community healthcare facilities and those that have mental health units, have a well-founded need for an escalated level of security. 

“Upgrading” may run the gamut of choices in both technology, and personnel applications. Likely, a healthcare facility (HCF) already utilizes a blend of both to make up its security plan. What may be in place might be sufficient, but most likely needs essential updating and/or replacement. Security staff constantly require training, as they provide security in one of the most highly regulated industries. Changes in standards and guidelines from TJC, CMS, NFPA, OSHA, etc., impact healthcare security policies significantly. What complied last year, may require a revamp in order to successfully pass the next inspection. 

Security Officer training and competencies in healthcare tend to be held to a higher standard than most other industries. As healthcare remains the number one venue for instances of workplace violence in the United States, healthcare security officers are expected to be on the forefront of prevention and education. The security team’s training needs to be top-notch and effective when it comes to a real world and effective approach. What a healthcare security officer learns in training needs to work well in their actual environment. Utilizing the training and certification programs proffered by the International Association of Healthcare Security and Safety (IAHSS) makes a great starting point. These programs are developed by peer professionals and are continually reviewed by a committee of veteran healthcare security leaders. IAHSS programs also consider all regulatory bodies input when developing a new standard. 

When it comes to genuinely elevating the quality of an HCF’s guard force, the 800 lb. gorilla in the room has to be openly discussed. You truly get what you pay for. Whether the organization utilizes a reputable contract guard company, a proprietary force or is comprised of a hybrid model, developing a budget friendly plan to increase their rates of pay will always lead to an increase in quality. An attractive entry-level rate coupled with a seniority/longevity step plan translates to a level of professionalism you will not see among lower compensated security officers. If you are asking a guard to secure an empty warehouse, you can offer a meager rate of pay, but if you are asking them to safeguard the employees, patients, visitors and property of an HCF, you need to plan for a level of compensation in line with today’s security professional. This theory only expands as we examine the pay for supervisors, managers, and directors. Quality at the top directly equates to the overall performance of the guard force. 

Security Technology expenditures have sky rocketed in most HCFs since the theory of reducing manpower costs by supplanting with technology. Indeed, there are physical security features that far exceed human capabilities (“virtual fencing” can safeguard a large perimeter that would otherwise require several posted officers). Recognizing where technology truly assists the organization’s security demands, while still providing a cost-effective solution can be difficult. 

The diversity and range to choose from is massive. The best demonstrative is the exhibit floors of ASIS International’s GSX and ICS East/West. From the perspective of enhancing the security posture of an HCF, the types of technology can be generally described as: 

·        Access control

·        Visitor management

·        Employee screening

·        Vendor control

·        Equipment tracking

·        Video surveillance/management systems

·        Sensitive areas (maternity, ED, psych, etc)

·        Guard post equipment

·        Guard tour tracking systems

·        Radio communications 

Returning to the hotel-like hospitality, most do not want to see the security of hospitals evolve to the level of airports. From a strictly customer service perspective, movement into and throughout the hospital can not be slowed to a level of inconvenience. Nor can screening related wait times yield crowds in waiting areas. Extended wait times in the emergency department have been proven precursors to acts of violence. Yet, reasonable security measures go hand in hand with reasonable service delays. Finding the balance between securing your HCF and providing efficient care is the key.

Michael S. D’Angelo, CPP, CSC, CHPA is the Principal and Lead Consultant for Secure Direction Consulting, LLC., a South Florida based security consulting firm with a special expertise in healthcare. Previously, he was a corporate security leader with Baptist Health South Florida for seven years. He is also a retired Captain from the South Miami, Florida Police Department where he served for over 20 years. He is an IAHSS member and serves on the ASIS International Healthcare Security Council.