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New Security Technology.

Hi-tech works, but no better than the staff or the management system that uses it

"AND," CONCLUDED THE SPEAKER, "If you follow the suggestions I have outlined this afternoon, you will have no trouble complying with the current regulations relating to patient oriented dietary programs." The seminar director thanked the speaker and suggested to the nursing home administrators that they might want to rest a bit and freshen up before attending the conference dinner and evening social event.

Bill and Frank were long time friends and administrative colleagues in the nursing home business and enjoyed the chance to get together and share their management problems at these annual meetings. The best time was after the formal sessions as they relaxed near the hotel pool, nibbled on the veggie tray, and talked old times. Frank observed, however, that Bill had seemed preoccupied during the afternoon session, and when he tried to discuss the points made by the speaker, it was clear that Bill's mind had not focused on the message of the day. Frank knew he had to get Bill's attention or it was destined to be a dull evening. He chose his current favorite subject -- security.

"Bill," he said, "I implemented that security plan I told you about last year and you would not believe the extent to which it contributed to my positive fund balance. How did your new security program go? Have you determined your return on investment from the new locks and CCTV systems you installed?" The questions got Bill's attention alright, but not quite in the direction Frank had in mind.

Bill leaped to his feet! Filled both hands from the veggie tray and between vicious bites on carrot and celery sticks voiced his displeasure at the very mention of security. "Frank,"he said, "have you lost it? Are you putting me on? Return on investment from security! The money I spent on security was like sand in the rat hole.

"Look," he exclaimed, "I installed the CCTV, and assigned the receptionist to monitor it. Then I had to put money into new carpets and could not afford the new locks and key control system. I figured the camera would do the trick. Besides, you know how these consultants can over-respond to problems. But don't talk to me about making money on security -- it's all down hill."

Frank knew he had brought up the wrong subject but couldn't resist the next question. "What happened Bill, is your mood today related to a security problem?"

"You bet it is," responded Bill. "I received a call just before the afternoon session. An employee we fired came in a rear door, used a key we failed to recover, assaulted a resident, removed a very valuable ring from her finger and left before anyone realized what was going on -- or what to do. Shortly thereafter, the woman's son came for a visit and has threatened a lawsuit and a visit from the press. He has also asked that I be dismissed because I was attending this meeting instead of home tending to business."

"Sounds bad," Frank remarked. "But how did the assailant get by the CCTV?"

"The receptionist was out to lunch," Bill replied in a tired voice, "and we had not instructed her relief about the duty to monitor the system."

Frank's last comment was a though the kept to himself: "Perhaps it's my oldfriend Bill who is 'Out to Lunch' on security."

We hope Bill and Frank remained good friends, and that a good night' s sleep put Bill in a better mood, but his problem was not untypical of those faced in a variety of business and service organizations. By merely asking the question regarding return on investment in security, Frank transformed the terms of the security debate from a management problem of costs to a management opportunity for profit or asset enhancement.

The long term care facility that manages security as a cost center, when faced with finite resources, will find it very tempting to cut security costs in favor of traditional revenue-producing investments. Trading locks for a new carpet made sense because it may have reduced environmental noise and provided a more pleasant atmosphere for current and prospective residents.

However, the loss of the locks as part of a systems approach to security made the rest of the system a poor investment. The resulting assault and theft will likely jeopardize the current and future customer base. It may also result in a catastrophic loss in a negligence suit, and damage the career of an administrator who failed to control future events when it was in his power to do so. And, definitely not to be overlooked, the resident customer and her family suffered the most direct physical, financial, and psychological losses.

So what is to be done? How do we turn security into a profitable management opportunity?

The first step in any nursing home planning process is to analyze the current situation and determine how our institution and institutional life should be organized in the future. Other critical questions include: What resources do we have? What do we need? How can we get what we need with what we have? More to the point here, how can we provide security and obtain marketing, enhance our public image, and improve customer satisfaction with the resources available?

In applying security technology to long term care facilities, the question of effectiveness of lock systems, door alarms, closed circuit television (CCTV), electronic sensor devices, and other high tech devices is often raised. The simple answer is that they are indeed effective, and will be more so in the future as new technology develops and new configurations unfold. The long-term care industry need only express its problems to the technology trade and new solutions will be forthcoming.

Today, for example, we can use electronic tethering technology designed to monitor the whereabouts of criminals or to monitor adults who wander away from supervised housing and into harm's way. Magnetic locks are used extensively to secure fire exits against unauthorized entry and still maintain effective evacuation plans. Miniaturization of closed circuit TV makes visual two-way communication cost-effective and enhances the safety and security of residents.

Technology used to stop shoplifting in retail stores could be used to stop theft of personal items from residents. While traditional key control systems are very expensive and nearly impossible to maintain, electronic access control systems can effectively eliminate the problems of lost and misused keys.

If these devices are used to free residents from their fears, protect them from crime, and to prevent other forms of abuse and exploitation, management can expect a handsome return on their security investment. Unfortunately, however, it is not just a question of technological effectiveness that provides the core issue of an effective security program. There are questions having to do with internal risk factors and staff competency.

One of the driving public policy issues regarding long term health care is the matter of physical, financial, and psychological abuse by caregivers, including family and institutional providers. In the nursing home setting, if technology is used only to protect against the outside world, and internal policies regarding staff employment, training, and supervision are ignored, security becomes a shame and a recipe for disaster.

Likewise, if security technology and procedures are used to restrict, restrain, demean, and regiment the behavior and lifestyle of residents, the basic mission of the long-term care facility is compromised. A simple example is requiring the removal of wedding rings by all residents because the home experienced this type of theft from a few residents.

As to staff competence, clearly, someone must be charged with the security management responsibility, but this does not mean that they and their subordinates must be solely responsible for delivery of the security mission or function. Our organization, for example, has developed a security philosophy that encourages those assigned to security roles to be managers of the security function, rather than the sole deliverers of security services. Essentially, this means that all members of the health care team are also members of the security team. Training all employees how to effectively respond to security threats, the practical reasons for modern access control systems, and how the quality of professional skills and social relations on the job can be enhanced by security are all important aspects of security management.

Other aspects of effective security management include:

-- Selecting vendors who provide equipment meeting testing standards established by recognized standards organizations, such as Underwriters Laboratory or Factory Mutual. The manufacturer's compliance with such standards indicates not only commitment to product performance, but the financial resources required for product testing and listing and, presumably, long-term product support.

-- Training employees until they feel comfortable with the equipment before putting it online. For example, key pad access control systems can become counter-productive if false reports are generated due to lack of training and practice with the system.

-- Realizing that CCTV monitoring is most effective when the equipment is able to alert the control center to the need for attention -- eg, CCTV systems that respond to motion. If constant surveillance is required, training I should focus on means of staying alert and interpreting what is viewed. Management should expect to rotate personnel every hour or two to maintain effective monitoring.

-- Training all employees, especially new ones, on taking an active part in the facility' s loss prevention program. Demonstrate how effective loss prevention will enhance their own safety, as well as improve job satisfaction and the rewards that come from working in a truly secure facility, such as salary and benefits due to increased business.

-- Emphasizing the role of human judgement as a necessary supplement to technology. Failing to challenge people, including other employees, for not displaying the proper ID or for being in unauthorized areas can well negate the usefulness of technological monitoring. Ignoring unusual arguments between a resident and a visitor may lead to situations of personal and financial abuse that could result in a loss to the facility itself due to negligence.

-- Recognizing that technology can assist, but not replace, such loss prevention procedural matters as employee selection, supervision, training and discipline, as well as individualized plans for resident security.

In sum, security for any type of facility can be divided into technological and procedural categories, but it is not a question of picking one or the other. Management has to find the proper mix of these two categories for the particular facility. The "return on investment" is that residents will enjoy a safe and secure environment, with an enhanced quality of life, and where responsible others can be confident that their loved ones do not reside in an institution -- but in a home.

Richard Mellard, when authoring this manuscript, was a Loss Prevention Specialist with the National Crime Prevention Institute of Louisville, KY. Previously, he was Captain of the Wichita, Kansas Police Department and Chief of the Liberal, Kansas Police Department. Wilbur Rykert, PhD, is Director of the National Crime Prevention Institute and is on the faculty of the University of Louisville School of Justice Administration. He served formerly with the Michigan State Police.
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Title Annotation:security management on nursing homes
Author:Rykert, Wilbur
Publication:Nursing Homes
Date:Mar 1, 1993
Words:1857
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