How can hospitals operate safely?
As criminal acts grow annually, medical facilities can no longer be considered safe havens, free from attack and violence. This reality hit home when three physicians were gunned down at the county medical center in Los Angeles in February. The 1,500-bed, county-run facility, one of several within Los Angeles County, had well-trained and well-directed safety officers, most of whom were armed. Still, a deranged man was able to bring firearms and knives into an area filled with patients and medical staffers.
The health care facility's security department can no longer be considered a nonrevenue producing part of the company that can acceptably be underbudgeted and understaffed with those underqualified to do the job. Investigative reporters and civic leaders will no longer remain silent and allow the health care leaders in their community to do nothing about such a blatant problem.
Assembly Bill 508, a California proposal recently signed into law by the governor, specifically addresses hospital security. The Joint Commission for Accreditation of Healthcare Organizations, the nongovernment agency that surveys and accredits hospitals based on certain criteria and standards, has for the first time included minimum standards for security in hospitals. These standards can be found within the Plant Technology and Safety Management chapter of the 1993 Accreditation Manual for Hospitals.
Some health care facilities have made excellent efforts at preventive security. The rest of the health care community must adopt similar preventive policies.
The first step in instituting a successful security force is to select the right individual to direct and manage the security department. Today, public law enforcement experience is insufficient, and properly skilled candidates can be drawn from other segments of the work force. Many educational institutions are now offering private security degrees or programs.
What should health care administrators search for in a security director? It depends on whether that individual will deal solely with security or whether other duties, such as safety, risk management, and hazardous materials management, will be part of the job.
The following criteria should be considered for the security director:
* At a minimum, he or she should have a bachelor's degree in an appropriate area of study. Law, justice, or security administration is preferable. An associate degree in one of these topics is acceptable if it is accompanied by the right experience.
* Supplemental education and special certifications are also desirable. Professional organizations offer ongoing programs. The American Society for Industrial Security offers certification as a Certified Protection Professional (CPP), which covers all aspects of security administration. The International Association for Healthcare Security and Safety offers the Certified Healthcare Protection Administrator (CHPA) designation. If safety is to be a responsibility, the American Society of Safety Engineers offers the Certified Safety Professional (CSP) designation and the World Safety Organization offers the Certified Safety Manager (WSO-CSM) designation. Each organization requires periodic work or study in the field to maintain certification.
* Experience is also an important factor in the choice of an individual to plan and administer the hospital or medical center's security program. Education, combined with a good, real-world track record, especially in health care security, will ensure that the candidate has both practical know-how and textbook knowledge.
The twenty-year police retiree may have notions and habits that are completely incongruous with what is expected in a health care setting. Individual exceptions can be found, but the employer seeking a candidate must be cautious in assessing experience unrelated to health care.
Good senior management is the heart of any organization. A well-chosen security director will pump life into the security program. Next, it is important to secure the flow of security throughout the organization. To do that, strong arteries are needed--the security staff.
Here again, the educational level, the experience, and the emotional stability of the candidate must be thoroughly evaluated. Appropriate training must be ongoing and documented. IAHSS has developed programs for security officer training including a forty-hour basic, a twenty-hour supervisory (both of which are certifications), and a twenty-hour safety training program.
The quality of the security staff will complement the quality of the security director. Quality is that commodity that most managers are beginning to recognize as the foremost objective of any successful company.
The security director must exercise the entire body of the organization to have a healthy program. That means involving nonsecurity personnel in security awareness. The medical staff, the kitchen workers, the housekeepers, the engineers and maintenance crews, the clerks, the volunteers, and administrators should be kept alert to their part in the program.
A staff of twenty security officers will see only a fraction of what the total staff of 1,500 employees will observe. Security awareness programs, therefore, must be presented on a regular basis. Everyone must be a part of the information-gathering and reporting system.
Awareness cannot do the job alone. Physical security procedures must be enforced. Security equipment should be installed to enable the staff to monitor and control access in the facility. For example, CCTV cameras can allow a single person to observe several large parking lots and storing and staging areas.
Hospital administrators should plan capital projects to include access control systems that can be operated from a central computer. All perimeter doors should be protected using technology that relieves the security staff from the traditional locking and unlocking rounds.
The latest trend in hospital security is the use of K-9's. The police have successfully used such trained dogs for several years now. Riverside Community Hospital in Riverside, California, has just begun such a program and it has been well received.
For high-risk areas within the hospital, such as the cashier's office and the pharmacy, access control systems have to be devised. Riverside now has access controls and bullet-resistant glass at these particular locations, as well as in the emergency department's triage desk and registration desk.
Other ways to deter or catch criminals and unstable persons include a photo ID badge program, metal detectors placed in the high-risk emergency area, emergency telephones in parking lots and elevators, infant protection programs for the maternity units, and alarms installed on all perimeter doors.
Times have changed. People have changed. A depressed economy, joblessness, and substance abuse all contribute to the increase in crime. Hospitals are no longer immune to these phenomenon, and hospital administrations are morally obligated to protect their health care community.
Facilities will be liable for failing to act. Investing in more qualified personnel and up-to-date equipment for the hospital security program may involve increased expenses that will be difficult to absorb at first, but the cost of inaction will be much greater.
Gerald L. Bagley, CPP, CHPA, WSO-CSM, is the director of safety and security at Riverside Community Hospital in Riverside, California. He is a member of ASIS.
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|Author:||Bagley, Gerald L.|
|Date:||Dec 1, 1993|
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