As a child, Superman was my hero. In fact, my career aspiration was to become Superman. It was not until I began leading a security team in a Level 1 trauma center that I had an epiphany. I calculated that about 90% of the time Superman was actually the mild-mannered, professional reporter, Clark Kent, who was described as selfless, upright and all-American. He tirelessly worked to make the world a better place exhibiting grace and humility. When trouble arose, Clark would locate a telephone booth, change into the Superman cape and manage the situation. Once it was rectified, Superman would change back into his Clark Kent persona and head back to work. He never took credit for saving the day. He just went about his normal day as a reporter. In my view, well-trained healthcare security officers are, in fact, “Superman” every day.
Former UCLA basketball coach, John Wooden once said, that “the true test of a man's character is what he does when no one is watching.” But how many of us actually live by it? In healthcare security, impactful actions are frequently taken by those who are working when no one is looking. They do not seek fame. Their style is “getting stuff done.” It is sometimes easy to complain and “tweet” about violence in the workplace. It is much more difficult to be a part of the solution as a member of the “boots on the ground.”
Among many other things, it is the uniformed security officer who each day balances empathy with regulatory and legal requirements as he or she approaches that violent patient. It is the security officer in uniform who calms the crying child or assists the lost visitor in locating his vehicle. It is that uniformed security officer who is consistently the first person to arrive on the scene outside the hospital and perform life-saving CPR on a visitor until emergency responders arrive. That same officer not only ensures the security of a deceased patient when released from the hospital but the dignity of that person and the family as well.
In 2022, my healthcare security team dared to find a program and solution that mirrored our philosophy of patient-centric care while tackling the increasing threat and challenge of workplace violence inside our nation’s hospitals. We found that answer with Vistelar, a licensing, training, and consulting institute focused onhelping organizationsimprove safety through a systematic approach to workplace conflict management.
The cornerstone of their program is built on compassion, treating people right, and showing dignity, respect, and empathy. This foundation of non-escalation coupled with industry-best de-escalation principles and tactics allowed us to achieve tremendous results in driving safety within our organization. The program, along with other initiatives, was piloted at 13 locations and resulted in a 38% reduction in assaults and injuries in a nine-month period.
The most important tool we all have is communication. According to George J. Thompson, Ph.D., author of Verbal Judo – The Gentle Art of Persuasion, “all people want is to be treated with dignity and respect, asked rather than told to do something, know why they are being asked or ordered to do something, given options rather than threats and given a second chance when they make a mistake[GK1] [n2] .”
Patient Privacy is a Paramount Concern
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a federal law that requires the creation of national standards to protect sensitive patient health information from being disclosed without the patient’s consent. Each healthcare institution may set up unique policies and procedures, but they must conform to HIPAA guidelines. With evolving technology, healthcare environments are required to remain updated with HIPAA and ensure that Protected Health Information (PHI) remains protected.
For medical personnel and healthcare security officers, HIPAA compliance training teaches how to recognize PHI, proper uses and disclosures of PHI, how to keep PHI secure, and how to report a breach of PHI.
Staff & Public Safety
It is important that crucial conversations occur between the healthcare organization leadership and the patient-care and support teams. These conversations aid in developing a plan to guide clinical staff, security officers and even external partners as they comply with HIPAA and other regulations in protecting their patients.
Nurturing a safety- and security-oriented culture in healthcare environments is critical to the overall organization. There is synergy derived between a safe and secure clinical environment and a productive workforce. That synergy extends to a gratified patient population. To establish this synergy, several internal and external partnerships must exist. Although security officers may provide that first line of defense in facilitating a safer healthcare environment, the culture of security needs to encompass all healthcare staff, licensed practitioners and external partners.
The healthcare organization’s safety message should be relevant, consistent and ongoing. Healthcare leaders must commit to building and sustaining a culture of safety. Healthcare providers ask patients and families to trust the medical care team to do what is in the best interest of the patient. Consideration is given to staff and public safety, patient privacy and quality of patient care.
Touchpoints in Healthcare Security
Healthcare Security personnel routinely face challenging events during their daily work, which includes interacting with a wide range of people in all manner of emotional ranges across the following areas:
- Emergency Departments, are often the focal point of violent and traumatic events. An officer working in an emergency department may be the first person encountering an individual suffering from life-threatening illnesses or injuries that are brought to the ED by ambulance or private vehicle.
- Trauma Responses - Officers may be required to provide escorts or “patient watch” services for trauma patients. In addition to staffing posts at ambulance bays, officers may escort clinical teams to and from helipads, or providing provide crowd control at the trauma bay. In any event, the officer may be privy to medical interventions during or after the call.
- Child Treatment Areas - It is not unusual for security officers to patrol clinical spaces that primarily function as neonatal, pediatric, or adolescent treatment areas. While most of these patrols will be routine, the nature of these areas means that the most vulnerable patients will encounter them.
- Decedent Care - Many healthcare organizations have either onsite pathology departments or morgues where officers may be required to tour or provide support for escorting mortuary affairs or government agency representatives.
- Behavioral Health Areas – For healthcare organizations with adult or pediatric inpatient or outpatient behavioral health populations, officers may be required to respond to patients exhibiting various concerning behaviors.
- Exterior Patrols - Exterior tours, particularly at night, are a common security officer responsibility, and the support they provide for visitors, staff, and others is apparent.
Ensuring the appropriate levels of security in a hospital in 2023 is a far more complex initiative than even a decade ago. For example, today’s healthcare security training differentiates between “behavioral health” and ”developmentally disabled.” By law, “developmentally disabled” patients, who can be challenging and difficult to understand how to manage their conflicts, are not defined as “behavioral health” patients. The Centers for Disease Control and Prevention (CDC) defines developmental disabilities as a group of conditions due to an impairment in physical, learning, language or behavioral areas.
“Trauma-informed care shifts the focus from “‘what’s wrong with you?” to”what happened to you?” reports the Trauma Informed Care Implementation Resource Center. “A trauma-informed approach to care acknowledges that healthcare organizations and patient care teams need to have a complete picture of a patient’s life situation — past and present —to provide effective health care services with a healing orientation.” Today’s healthcare security professionals are trained in trauma-informed practices to reduce avoidable care [GK3] and excess costs while improving patient engagement, treatment adherence, and health outcomes.“Clark Kent” Security Heroes: Real Stories
Healthcare Security Officers are key members of a healthcare’s patient care support team and frequently find themselves in the role of initial responders to traumatic and sometimes dangerous events. Despite this, I’ve borne witness to hundreds of “Clark Kent” security officer heroics over the years.
In July 2022, a patient arrived at a hospital Emergency Department with a cough, cold sweats and back pain and was waiting in the lobby to be called back for evaluation. While waiting, the patient complained of chest pain which caught the attention of an Allied Universal Behavioral Health Security Officer who called the clinical staff to inform them. The patient was immediately triaged with an EKG completed four minutes after the initial complaint of chest pain. The physician approached the patient to begin the medical assessment and witnessed the patient going into cardiac arrest. The patient was resuscitated and transferred to a critical care unit. The actions of the Behavioral Health Security Officer, a.k.a. “Clark Kent,” resulted in a positive outcome for a patient experiencing a critical medical event in the waiting room.
At another hospital in December 2020, at another hospital, a staff member contacted the security department to report a female standing outside of the hospital’s education building who appeared to be in distress. The Allied Universal hospital security manager proceeded to the Education Building and located the woman who seemed to be using the hospital’s wall to hide. The hospital security manager observed that she was shaking profusely and appeared terrified but initially refused assistance. However, the security manager continued to stay with her and was able to convince her to accompany him inside the warm building. Once inside, she told the security manager that she was fleeing from her husband, who had a pattern of abuse and had just threatened her minutes earlier, prompting her to leave the vehicle in which they had been riding together.
The security manager proceeded to obtain a description of the woman’s husband and the vehicle that he was driving. He assigned a security supervisor to dispatch the mobile patrol officer to the parking lots to begin a search for the vehicle. The security manager then began coordination with clinical staff to request a domestic violence counselor to respond and speak with the woman. The security manager worked to arrange for the woman’s son to meet her at the hospital in a safe manner so as not to alert her husband in case he was still in the area.
As the event continued to unfold, the mobile security patrol officer located a vehicle that matched the description given by the woman driving up and down in front of the hospital several times. The security manager contacted security at adjacent businesses and requested their assistance in locating the vehicle.
The woman was at the hospital for several hours and received assistance from a professional domestic violence counselor. When the distressed woman finally left, she was escorted out by the hospital security officers and expressed immense gratitude for the help she received and the concern that was shown by the security manager and his staff.
The woman sent a four-page handwritten letter to the security manager at the hospital and relayed that her friends and family were convinced that he had been planning to kill her and her son, but was ultimately unable to do so due to her taking precautions suggested by the hospital staff.
In Game 6 of the 1947 World Series, the seemingly unknown Al Gionfriddo is put in left field and he snatches what was thought to be a sure three-run homer by Joe DiMaggio, causing the shocked DiMaggio to kick the dirt and Gionfriddo help seal the win for the Brooklyn Dodgers. Jack Lemmon’s character in the 1989 movie classic Dad described the play as saying “In America, anything is possible if you show up for work.”
Every day, these unsung healthcare security heroes show up for work and with no fanfare and get the job done.
References:
Source: Bulletin of the American College of Surgeons. “To protect and serve: The ethical dilemma of allowing police access to trauma patients” By Katherine C. Ott, MD, Douglas Brown, PhD, Ira J. Kodner, MD, FACS, Kathryn Q. Bernabe, MD and Jennifer Yu, MD. Published October 4, 2017.
Source: “Verbal Judo – The Gentle Art of Persuasion,” by George W. Thompson, PH. D and Jerry B. Jenkins.
