Healthcare Security
John Williams manager for public safety for Prince William Health Systems
John Williams: A lot of the same things are occurring here and I think that’s really consistent across the country. This is a unique environment that we’re dealing with; we’re asked to be open 24 hours a day, seven days a week, but at the same time we try to balance that with “how do we secure it from unwanted activities?” and sometimes that’s a moving pendulum. You really can’t pick one answer or one process that’s going to work 100 percent of the time. You have to be flexible and innovative. Change is really not an option for us in healthcare public safety; it’s mandate. You have to be flexible. You have to be willing to make changes after,
evaluating the whole set of circumstances against a policy or a proce- dure – what’s really vital, do what’s best for the patient, staff and their family as long as it doesn’t harm anyone else or cause liability. Teaching that to an officer who may have a mentality of “I like things to be black and white. I don’t want a gray area; gray areas confuse me sometimes, gray areas makes things more difficult. The policy says this and I want to do that.” That’s one of the more dif- ficult things to do along with getting them to see the big picture and not just that one little task. Along with that is having our hands tied by federal regulations to some extent. Some regulations really swung the pendulum from one side all the way to the other side rather than trying to find a happy medium. Then we have to worry about crime trends in every hospital, as
they’re a reflection of their communities. Whatever happens outside in your community can happen inside your doors or in your parking lots. Hopefully you’ve done enough to prevent the real serious things from happening. I tell every new employee every two weeks in new employ- ee orientation: We haven’t had any murders, riots or robberies here, but it could happen today. We try to do our best to deter somebody from wanting to do something like that here, but you can’t stop a motivated person who is willing to do whatever it takes to commit their act. Jim McNeil: I concur with my colleagues here about the chal- lenges in healthcare. I did not grow up in this industry; I came to healthcare with a different background. One of the greatest chal- lenges is, as Linda pointed out, trying to balance the need to have an open and welcoming environment with the need to provide security for people, many of whom are quite vulnerable. If people in hospitals are physically in need – some of them have psychiatric problems – they bring all of those issues with them to the hospital along with their family members and others. So it’s a very challenging environment and it’s very difficult to
control access. If you look at how security is provided in most industries, the foundation of it is deciding who can come in and who’s not allowed to come in. In healthcare, for the most part, we don’t have the ability to do that very well. Here, for example, we open hundreds of doors every day to our patient population and so we have to manage the security risks differently than controlling who comes in.
The other challenge is to make sure we don’t lose sight of the things
beyond the day-to-day. We can very easily get caught up in the day- to-day managing the security risk, but we also have to focus on things I would regard as the low-likelihood, high-consequence event – things like an active-shooter scenario or an infant abduction. The likelihood of those things happening is very, very small, but the consequences are very high and so we need to pay attention to those as well.
Linda Fite director of security services for The University of Minnesota Medical Center
Laura Stepanek: What is new in terms of healthcare regula- tions and how does it impact your role? Linda Fite: Just recently we got an alert from the Joint Commission about infant protection and what kind of steps are we taking and there was a fair amount of paperwork to fill out on that. Periodically things like this come forward. And then we always have our HIPPA issues. We have difficulty sometimes working with our local police agencies in that they want more information than we are able to give them. Someone is coming in with a fraudulent identifi- cation card or something; the police may get
involved with
wanting information maybe on the patient’s medical history. We can’t give that without court order. Tony Venezia: Recently The Joint Commission sent out an alert
Michael Parks senior director of security services for Mercy Medical Center
on workplace violence to several healthcare facilities. Recent violence in healthcare facilities has made us rethink our approach to handling acts of violence in hospitals. Tampa General has worked very hard in educating our staff on potential violence. We have encouraged staff to alert security anytime there is the potential for violence in the hospital. Tampa General has implemented a Disruptive Patient policy. This process involves a collaborative effort with clinical, secu- rity and administrative personnel to help identify potential violence, and allows for a process to resolve conflicts before a violent episode unfolds. Michael Parks: Actually, shootings in hospitals are occurring every year in this nation. If you go onto the Internet and start looking you’d be amazed at the number of incidents that range from Tennessee to Connecticut, Las Vegas and Louisiana – many of them are domestic related, and many are fatal incidents. What really concerns us here in Baltimore as it relates with acts of violence where death could result are those incidents that involve prisoner patients at our hospital.
We have all the major correctional holding facilities for the state
of Maryland located here in Baltimore and we annually receive anywhere from 700 to 800 prisoner-patients through our doors. Maryland has suffered more than its fair share of incidents where a prisoner has escaped from the officer guarding them and had deadly results. These are some of the things that we are concerned with here at our campus. A lot of man-hours are devoted each day by our staff to ensure that the police officers and the correctional officers who are guarding these prisoner-patients are doing their jobs to make our campus safe. John Williams: One of the things that happened in about 2004 or 2005 is CMS came out with a new ruling about the use of forensic devices on patients, and that was based primarily on some bad out- comes at some behavioral health facilities where they were used and the patient died. It needed to have some formal federal backing to it, but they swung the pendulum all the way to the other side. Prince William Hospital is part of the 13 hospitals in the national
Healthcare Security • Solutions By Sector • November 2010 5
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