Fighting Intrusion of Violence into Hospitals

Suburban and urban hospitals cope with outside risks, fight back with security measures

Jul. 17--Howard County General Hospital is a typical suburban facility, its administrators proud to be known for the cozy maternity suites, the cancer support programs and sophisticated technology.

But they're not so happy about the kind of publicity the hospital has faced in recent weeks: a midnight brawl in the emergency room that ended in three arrests and three injuries; a suspect awaiting drug charges who slipped out and remains at large.

While rare, such incidents have unnerved patients and staff and highlighted the fact that once-sleepy suburban hospitals - like neighboring shopping malls and schools - now have to cope with complex crime and security issues.

"Today, every hospital is at the same risk of exposure to drug and alcohol abuse, domestic violence and psychiatric patients," said Roger Sheets, president of the Maryland chapter of the International Association for Healthcare Security and Safety. "All of it shows up in your emergency room, and your security officer at the front door has to have a better level of training than being told to say, 'Good morning. How are you?'"

For their part, suburban hospital officials say they offer an appropriate level of security given the risks they typically encounter - the occasional unruly patient, emergency room ruckus or specialized needs, such as those posed by psychiatric units.

"The hospital employs security guards, not police officers," said Mary Patton, a spokeswoman for Howard County General Hospital, who declined a request for an interview with the hospital's security director.

Hospital security experts say concerns have escalated at virtually every institution - urban and suburban - in the wake of Sept. 11 and worries about such issues as bioterrorism. Some states, such as New Jersey, have considered sending in "red teams" of undercover agents and contractors to test hospital security.

"Right now, the federal government is trying to determine how lax hospitals are, and I can tell them ahead of time that they're not anywhere near where they need to be from a security standpoint," said Jeff Aldridge, former director of safety at the University of North Carolina Medical Center at Chapel Hill and now a consultant on health care security. "Hospitals want to be an open, warm atmosphere where people can come bond with a patient, but you can't do that anymore."

More cameras

Security measures include sophisticated camera systems allowing staff to monitor hallways and emergency rooms; intensive training for guards, who may be armed in some cases, and equipment that can lock down all of a facility's doors.

But there remains a gulf between the level of security offered at smaller, suburban hospitals and at urban complexes such as the 500-bed Sinai Hospital of Baltimore, the state's third-largest, which handles 10,000 visitors a day.

Sheets, who directs security for Sinai and the three other LifeBridge Health facilities in the Baltimore area, said the 80 security officers at Sinai carry batons and some of them carry guns. Most of the facility can be locked down electronically.

At 187-bed Howard County General, by contrast, security officers do not carry weapons of any kind and only security supervisors carry pepper spray. Howard County can lock some of its doors electronically, but a spokeswoman would not say which ones. At 260-bed Anne Arundel Medical Center, emergency room doors must be locked manually.

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