Securing hospitals in times of disaster

A look at how healthcare facilities should prepare for emergency management incidents

Earlier this month, thousands of people were killed and hundreds of thousands more were displaced when a tsunami caused by a massive earthquake struck the coastline of Japan. The crisis worsened in the days that followed after it was discovered that the tsunami destroyed cooling systems used to cool fuel rods at the Fukushima Daiichi nuclear plant.

The danger of a nuclear meltdown has led many lawmakers and other officials to call for a review of the safety of domestic nuclear power plants to ensure that if a catastrophe of this magnitude does occur in the U.S., that the damage and subsequent fallout can be minimized. One of aspects that has been overlooked by many in the media, however, is how equipped hospitals are to handle such disasters.

According to Bryan Warren, director of corporate security for Carolinas Healthcare System, people, even those that are uninjured, often flock to hospitals in times of crisis. It's because of this that Warren says hospital security staffs need to be prepared to handle the traffic management (vehicle and foot) responsibilities that come with the aftermath of a natural disaster.

"It's not just the injured that you are going to have to be dealing with in your hospitals and your urgent care centers," he said. "This (security issue) has been referred to as 'the worried well.' These are people that were no where near ground zero, they were no where near the actual incident yet they are going to show up in your emergency rooms and hospitals and take up valuable time and resources from those that actually need medical care."

Ironically, Warren said that Japan experienced this "worried well" issue in 1995 when Sarin gas was released on the Tokyo subway system. Although only 13 people were killed in the attack, thousands of more people jammed the hospital because they felt they may have been exposed.

"In a catastrophic incident like this tsunami and what we are going through now with the nuclear power plant there... you are going to have a lot of people coming in because they are worried they've been exposed to radiation or something else and a lot of these people simply don't have anywhere else to go," Warren explained.

As a result, Warren says that hospitals need to address traffic and access control issues for the facility's campus, making sure that people are where they need to be and that emergency vehicles can enter and exit without a problem.

Anjanette Hebert, director of security, safety and emergency management at Lafayette General Medical Center in Louisiana, says that one of the most important things hospitals can do to prepare for a disaster is to conduct a comprehensive risk assessment and a subsequent hazard vulnerability analysis. This process, which allows hospitals to rank and prioritize their biggest risks, would involve not just the facility's security director, but everyone that would be impacted.

"From a security perspective, I look at my mission of security in a disaster particularly, is to maintain the safe care environment as much as possible," Hebert said. "We are going to control the access in a way that allows people to get to the point they need to receive care, but we are not going to allow uncontrolled access that can cause chaos and disrupt the staff's ability to provide care."

Hebert said that security managers should also focus on reducing anxiety for people in times of crisis.

"Those of us that have been in security for any amount of time know that anxiety leads to more acting out," she explained. "When people are experiencing a lot of anxiety, it will increase your conflict."

Evelyn Meserve, executive director of the International Association for Healthcare Security and Safety (IAHSS) and former director of safety/security services at CaroMont Health in Gastonia, N.C., says that hospitals should also be proactive and have a plan in place to review and practice on a regular basis to handle patient surges.

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