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

I think locking down the facility, controlling who is coming into the building and where they're going becomes a critical part of it. Again, I look back on it and I say "ok, this being the case, how much has the hospital drilled to prepare themselves for this? When was the last time they did any type of a controlled ingress drill?" Securing inventory is another critical part. The majority of hospitals have some type of a disaster kit, which is designed to go to the scene of a disaster, but when you are the scene of the disaster, you're going to need that kit for taking care of your own casualties and your own needs. Just like many other pieces of inventory in the hospital, they are of value in the hospital, but they are of equal value out on the streets as well, so you may very well have people coming in just trying to find access to basic items. You may have them looking for household items, you may have them looking for medical supplies, bandaging supplies and all those types of things because they don't have access to them anywhere other than the streets and the streets and the community is demolished.

With emotions running high as they would be in the aftermath of a disaster, what are some of your recommendations to help keep the peace in an otherwise chaotic situation?

This is challenging because this is good people caught in an incredible set of circumstances and emotions do run high, stress runs high and we know that high emotions and stress are preceptors of physical violence. Some type of aggression management training, a healthcare-focused aggression management training that's designed specially for healthcare facilities to deal with this type of risk becomes quintessential. Beyond that, I keep going back to it, but we drill for reality and this is one of those things that your drill should encounter. Drills don't have to be these massive undertakings, but a series of small, bite-sized drills that deal with controlled ingress and hospital crowds can help us to perfect our skills at each component and each spoke on the wheel. So, when an incident happens, we've managed it in small, bite-sized pieces and now we can manage the incident as a whole.

What type of roll would security play in getting doctors and nurses safely to work after a disaster like this?

It's going to depend because security is going to be looked at to play a number of different roles. Transport may be one of them, but again it goes back to your planning. So many times we see plans that talk about the local police being called in to help out. In a case like this, forgot about the local police. They are not available to help you out. They're serving the needs of the community and they've got to prioritize for the greater good of that community. Even though your plan may say the police are coming to your rescue or that the local fire department is coming to your rescue, they're overtaxed at this point as well. Security really becomes more of a dominant figure in the hospital proper. My preference is not to take a security officer offsite to be out running as a transporter. I would be looking for others that could serve in that capacity instead. I want my security officers kept at the hospital focused on security related duties.