Since the pandemic, there has been a spike in assaults on healthcare workers around the country. Studies show that nurses who took care of COVID-19 patients were twice as likely to experience verbal and physical assaults, but even before the pandemic, healthcare workers and those who work in social assistance were five times more likely to experience workplace violence than other workers.
The pandemic has worsened the already concerning mental health crisis nationwide— a key cause of aggression in healthcare settings and beyond. The American Psychological Association recently reported an increase in demand for all behavioral health treatment areas since COVID hit, including anxiety, depression, trauma, obsessive-compulsion, substance/addiction abuse and sleep-wake disorders.
As a result, hospitals and healthcare facilities have had to increase their security measures to protect the well-being of patients and staff members alike and restore the overall safety of the facility.
Risks Associated with Healthcare Facilities
Hospitals need to be consciously aware that those coming into their facilities are typically burdened in some way. Most patients and visitors are responding to an emergency of sorts and are entering in an anxiety-ridden state. There are also anxieties around waiting for diagnoses, administration of medications, restrictions on mobility if someone is bound to a hospital bed, and dissatisfaction with the hospital services.
To minimize anxieties, healthcare facilities should send detailed pre-admission instructions for patients who have planned procedures or recurring appointments. Instructions should include details about where to park, who to interact with, what they’re allowed to bring, and PPE requirements.
Additionally, both security personnel and healthcare workers need to be aware of patients suffering from some form of diagnosed mental illness because they often exhibit unpredictable behaviors that can manifest violently. These cases tend to be the most severe. Many hospitals have become “receiving facilities” for individuals that have been involuntarily committed for a psychological or psychiatric evaluation, with a large number of these committed individuals coming from the homeless population.
What Areas of Healthcare are the Most at Risk and Under Protected?
Contract security organizations train their security officers to look out for attempts to enter a facility that is closed, unresponsiveness to verbal commands, weapon possession, and large gatherings of people trying to enter at the same time. For example, if a guest is pounding on the door of a facility after hours or if they are nonverbal once greeted by a security officer or staff member at the entry point— that could signify suspicious activity and should be flagged for security to monitor. Emergency departments in particular need close surveillance.
It is also important for hospitals to secure areas of the facility that are usually underprotected, including storage units for goods, medical devices, and surgical equipment. They house expensive materials yet offer easy access considering staff needs them at hand. If not properly secured, these technologies and tools are at higher risk to be stolen.
Healthcare facilities that house public businesses, such as privately-owned restaurants or boutique cafes, face additional security risks. This public-facing, retail businesses may be advertised publicly, providing uninhibited access points to the facility that could be a security risk.
In all of these situations, healthcare facilities should conduct a physical security assessment that includes a floor-by-floor and unit-by-unit review of their operating procedures. From there, a security team can identify any deficiencies and provide recommendations for physical or technological barriers to reduce risk.
Security Measures and Training for Security Personnel and Healthcare Staff
Security officers and other employees at healthcare facilities should receive proper training so that they are cognizant of all of these risks. Security in hospitals is a governed practice by state requirements and The Joint Commission.
At the core of it, training should focus on an empathic approach because that usually diffuses escalated situations. Officers assigned to healthcare facilities benefit from practical orientation in non-violent crisis intervention or management of aggressive behavior as part of the regimented training to work in these environments. Site-specific training is also imperative so that officers are familiar with the ins and outs of the facilities they will be in charge of securing. Additional support is sought through collaborative training programs with healthcare administration to address facility-specific expectations around patient interaction, engagement, and customer service delivery. Technological enhancements are also introduced to function as a force multiplier in providing robust response capabilities.
In addition to all of the training, common roles security officers take in a healthcare facility include controlling and confining the number of visitors entering, escorting patients safely in the hospital, and aiding helipad or ambulance teams through the facility.
It is highly recommended that healthcare settings engage in proactive education and exercise around proactive non-violent crisis intervention. The ability to recognize the escalation of a situation from the onset of expressive anxiety and to effectively de-escalate the potential for acting out or violent behavior is essential.
It’s also crucial that healthcare workers be educated around general situational awareness. Hospital employees are well-natured people who will do things like hold the door open for any guest without realizing that could be a key security challenge.
The Dangers of Underreporting in Healthcare Settings
Too often, security personnel are engaged in response when the incident has already escalated to a level that requires physical intervention, potentially leading to injuries to responders and the acting-out individual.
Underreporting is all too common in healthcare settings and typically occurs through complacency or acceptance that a certain behavior has become the anticipated norm. Healthcare facilities use the term “near miss” to measure incidents that potentially could rise to the level of a reportable incident that may require interaction by their administration or risk management team.
For example, if a certain patient strikes a nurse, they would be encouraged to report it as a “near-miss” incident. So, there wasn’t a need for further intervention, but it was significant enough to be noted. If there are enough of these reports, a security officer would do a walk-through with a clinical staff member to collect data on how many similar incidents occurred and how a certain floor’s demographics have changed (i.e., how many patients it’s held since the last scan). That way, preventative measures can be implemented to reduce further risk.
Underreporting also occurs when staff finds the process to report too cumbersome or they are not followed up by any type of mitigation. Underreporting also occurs culturally in facilities that discourage their staff from reporting “too much,” which could lead to regulatory agency, governmental, or corporate resource interventions.
Security officers should encourage healthcare workers to report even seemingly “small” incidents so that critical incidents can be prevented, and mitigation efforts can be put into place.
Investing in a Security Plan is More Critical Than Ever Before
Given the pandemic and its restrictions, plus the surgent of mental illness, hospital and healthcare settings have become one of the more challenging environments to work in. We’re finding that hospitals and healthcare workers have become targets for violence and crime.
These facilities have to be more security-conscientious than ever before and need to know how to best invest in a security plan. Effective workplace safety is critical for our healthcare workers, which means they need tailored training on crisis intervention and overall situational awareness to ensure that they are protected. Again, hospitals need to be aware that folks coming into the facility typically are rarely there for celebratory reasons, but instead, to respond to an emergency or crisis of sorts.
Although there are times when a situation escalates to the point where reinforcement is necessary, using de-escalation techniques and approaching distressed patients and visitors empathetically is always key. When it comes down to it, everyone in a hospital or healthcare setting is there to be cared for and looked after.
