Recent OSHA figures show that close to 75 percent of nearly 25,000 assaults and other workplace violence reported annually in the United States happen in a healthcare setting, and healthcare workers are four times more likely to be the victim of a violent workplace event than any other private-sector employee. If you want to know what is proverbially keeping your healthcare customers up at night, this statistic is the one.
“There are many contributing factors that are placing more stressors on our patients, visitors and staff,” says James Romagnoli, VP of Corporate Security for Northwell Health. “When these stressors are coupled with the stress and anxiety surrounding the serious illness of a loved one, or an end-of-life scenario for a friend or family member – it manifests into a workplace violence situation.”
“States are getting more involved in establishing parameters for workplace violence prevention programs, but it does not seem to be enough to stem the trends, and violence is still underreported,” says Frank Pisciotta, CSC, president of Business Protection Specialists, an independent security consulting firm focused on healthcare. “The healthcare industry continues to suffer from increasing acts of lethal violence. (My company) has on file more than 425 instances of hospital shootings since 2009 – while comprehensive, the list is not all-inclusive.”
Workplace violence rates, especially in healthcare sector, are incredibly high, and according to a 2017 AHA study on the costs of workplace violence, millions of dollars are lost not just on the immediate effects and response to events, but also for issues such as workers’ comp claims, turnover rates of staff and the replacement costs of highly skilled healthcare professionals who do not want to work in what they perceive as an unsafe environment.
How do security integrators help their hospital and healthcare security department clients stem the tide of violence? Pisciotta warns that it is easy to gravitate toward the sexy new technologies that can be found on show floors at security trade shows; however, “what should not be lost in all of this is making sure foundational programs such as staffing, access control, visitor management, and command and control are working. Establishing and monitoring program performance metrics in these key areas will help administrators assess their security needs and provide support for a budget.”
Access Control and Visitor Management
“It is necessary now to identify any and all persons in the facility,” says Romagnoli, who has been with Northwell for two decades and served as an NYPD detective for more than 20 years. “A security director must install a HIPAA-compliant visitor management system as well as electronic access controls and optical barriers. These measures, if socialized properly to staff and the public, will aid in identifying who is in our buildings for a legitimate reason while deterring those who may have untoward reasons from entering a facility.”
Pisciotta and BPS recommends that hospitals ensure they are using a reputable access control product. “In a recent case, a large hospital was using a low-cost access control product which was not able to elegantly handle card downloads without locking up, resulting in the interruption of service to patients and a federally reportable violation,” he says. “Imagine if an access control system locks up and prevents a doctor from getting into an operating room, which results in the death of a patient.”
Lockdowns may also be necessary in a violent incident; thus, Pisciotta says all routinely used external access points should be connected to the electronic access control system to enable rapid lockout should the need arise. Openings not required for entry should be classified as emergency exit only and external door hardware and key cylinders should be removed.
“More and more hospitals are recognizing the need for true access control – not theater – where it becomes possible to ensure that all persons entering, including patient visitors, are accounted for and controlled via the use of visitor management software programs and turnstiles,” Pisciotta adds. This is revolutionary for healthcare, and I expect that trend to accelerate.”
Another technology area on the rise in healthcare security is weapons screening. “Proliferation of weapons that patients bring in is creating a major risk for them and others,” says Bonnie Michelman, Executive Director of Police, Security and Outside Services for Massachusetts General Hospital in Boston.
Adds Pisciotta: “It is difficult to truly know how many weapons are being brought into a facility until you start to screen for them and track statistics on how many are discovered.”
Pisciotta points to evolving screening technologies that are now sensitive enough to detecting items such as razor blades or needles which might otherwise be missed using more traditional wands or walk-through metal detectors. “Emergency departments are typically the first place where metal detection is considered, but more hospitals are also deploying this on main entrances as well,” he says.
Command and Control
Healthcare security personnel must be able to use technology for rapid response to alarms and other incidents, which can occur with little warning and where seconds literally make the difference between success and failure.
“Consider the risk of infant abduction,” Pisciotta says. “While it is very infrequent, this type of situation requires immediate detection, assessment and dispatching of the appropriate response to the right location. This translates to an alarm being linked with video and displayed ideally on a dark screen monitor in a security control room. For hospitals which may not have that luxury, this function might be assigned to switchboard operations.”
Ideally, a hospital or similar healthcare facility should be using a platform that unifies and integrates access control, alarms and video surveillance. Pisciotta says that at least one monitor in a control room environment should be reserved for video call up in event of an alarm. Simple analytics may also be applied to detect incidents in unoccupied areas of the hospital.
“Thinking through and organizing cameras with similar functions into manageable viewing groups and having security staff actively engage the viewing groups for short periods of time will yield far better results,” Pisciotta adds. “For cameras that are purely for forensic purposes, there is very little need to consume real estate on monitors. Those images can simply be recorded. Video management system operators must be trained to detect irregularities and suspicious activities in order to effectively detect problems.”
Steve Lasky is Editorial Director for SecurityInfoWatch Media, which includes SecurityInfoWatch.com, and Security Business and Security Technology Executive magazines. Paul Rothman is Editor-in-Chief of Security Business.