At the Frontline: Healthcare security expert Steve Wilder

Former Director of Safety and Security for Provena Health discusses the importance of planning for worst case scenarios

Earlier this year, SIW spoke with several hospital security managers following the crisis at Japan's Fukushima Daiichi nuclear plant to discuss how healthcare facilities should prepare for emergency management incidents. Sometimes, however, hospitals themselves can become the scene of a disaster.

On Sunday night, a half-mile wide tornado struck the town of Joplin, Mo., destroying or damaging thousands of buildings including the city's hospital. Six people were killed at St. John's Regional Medical Center and more than 100 people were killed by the twister overall.

In this "At the Frontline" interview, Steve Wilder, president and COO of security consulting firm Sorensen, Wilder & Associates and the former director of safety and security for Provena Health in Kankakee, Ill., discusses the steps healthcare facilities need to take to help mitigate their risks when disasters strike.

How do you handle situations in which the hospital itself is the scene of a disaster rather than treating the victims of one?

At that point, the hospital becomes a victim and their focus starts to shift. When it's an external incident and the hospital is a resource to the community, their focus is on making sure they can match the community's demand. But, when a situation occurs like in Joplin, at that moment when the hospital is taken out by a tornado, the hospital can no longer be a resource to the community and really all focus then turns on taking care of themselves. From people that I've talked to that are down there and folks that have been involved in that situation, the stories of heroics that are coming out of that hospital now are just unbelievable.

What are some things you have to take into consideration when you have a mass evacuation at a hospital?

Coming up with a menu or punch list is really hard to do. You've got to have previously done some type of a hazard assessment of vulnerability assessment to really identify what you're greatest needs are going to be. That then becomes the basis for your preparedness drills. One of the weaknesses we still see when we're visiting client hospitals is that the drills do not go to the extent that they need to. A lot of times we're still seeing drills that are being done to meet regulatory requirements as opposed to really helping to identify their level of preparedness so that when the real event occurs like in Joplin that they really have drilled for reality and not just for a passing grade on a regulatory score.

If you were a security manager of nearby hospital, how would handle the overflow of patients and visitors from the hospital that was impacted?

The first thing I would be doing is locking down my facility. You're going to have people trying to get in at every access point on the perimeter of that building. You're going to have people trying to get in through remote doors who are in need. And these, in most cases, are honest, good, salt of the earth people who are suddenly dealing with something that they could have never imagined in their lives and they're looking for answers and they're looking for help. They may be coming in trying to find supplies, equipment or things that they need for basic necessities of life at that point. So, we've really got to secure the perimeter of the building first and foremost. We've got to make sure there is one point of access into the building. Depending on the size of the building, you may designate multiple points of ingress, but in doing so you still want to make sure you've got those properly staffed and properly secured so that you're doing adequate screening on everybody that is coming into the facility.

What types of measures can you put in place to mitigate the risks posed by those that might try to take advantage of the situation?

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