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The perception gap.

IN THE HEALTH CARE ENVIRONMENT, the role of each department in the institution should be clearly defined. The role of the security director is no exception. Security professionals Often come into health care from other industries. A survey was designed to test whether the security role in health care is clearly understood by both security directors and hospital administrators. Questionnaires were sent to security directors and administrators at more than 100 hospitals in North America.

The surveys; which were one page (front and back), were printed on two colors of paper. The ivory-colored survey was sent to 118 hospital security directors chosen from the 1990 directory of the International Association of Hospital Security. Approximately 40 percent were chosen from the five-state area surrounding and including Texas. The remaining 60 percent were randomly scattered across the United States. A gray-colored survey was addressed blindly to 118 administrators/CEOs of those same hospitals at the same addresses.

The surveys were sent with a cover letter. Self-addressed, stamped envelopes were included. The return address was a local post office box. A 30 percent response was projected for the combined groups with a greater number of returns expected from security directors.

Responses were received from 144 participants. Of those, 54 respondents were hospital administrators, which represented 45.6 percent of those surveyed. The remaining 90 respondents were security directors and others in nonadministrative roles. This represented a 76.3 percent response from that group. These percentages not only exceeded the expected return rate of 30 percent but also exceeded the 15 percent rate for significance of data.

Of the 118 hospitals, responses were received from both the security director and the administrator in 38 cases, which is 32 percent of the hospitals surveyed.

The survey was divided into four major parts. Section I covered the background data for the institutions surveyed. Item A covered the position of the individual answering the survey-administrator, security director, or other. Item B requested the individual's zip cOde. The zip code identified the area of the country and was important in correlating the information from the security directors and the administrators. Few of the hospitals were located in the same zip code.

Item C covered the size of the hospitals. (See Exhibit 1.) There were six major sections broken down from 0-50 beds up to more than 1,000 beds. The number of beds in a hospital is generally regarded as a yardstick for the overall size of the institution.

Hospital location was covered by Item D. (See Exhibit 1.) The breakdown was by urban, suburban, or rural. A hospital's location can help determine the level of security necessary for adequate protection. Item E asked whether the facility used Proprietary (in-house) or contract security. (See Exhibit 2.) Respondents were asked to submit the total number of employees in the security department under Item F. Finally, both groups of respondents were asked to check related duties for which the security staff was also responsible. (See Exhibit 3.) The duties listed included safety, parking, fire protection, emergency preparedness, locksmithing, telecommunications, and "other."

Section II asked respondents to rate the importance of specific job functions for security at their location. (See Exhibit 4.) The Likert scales (a system of ranking items numerically) were a simple one to five rating, with one representing "not important" and five representing "important." The job functions surveyed included enforcement of law and policies, investigations, routine patrol, service calls, crisis intervention, and emergency response.

Section III asked respondents to identify which of the listed related duties were performed by their security staff. (See Exhibit 5.) Respondents were requested to check all that applied. The five areas listed were ID control, key control, requests for information, crime prevention, and monitoring closed-circuit television.

Section IV addressed the criteria for hiring security officers at the respondents' locations. Item A asked respondents to indicate the minimum experience that was necessary to be considered for employment as a security officer. (See Exhibit 6.) Prior experience was defined as security, police, or military. The choices were broken down into none, 0-1 year, 1-3 years, 3-5 years, and more than 5 years of experience.

The second part asked respondents to identify the minimum acceptable education level to be considered for employment. (See Exhibit 7.) The seven levels ranged from less than high school through postgraduate work and specialized education.

The last two parts of this section again used Likert scales. (See Exhibit 8.) Respondents were asked to rate the importance of grooming, people skills, and leadership in their current hiring process. Respondents were then asked what significance they would like these same personal traits to play in their hiring process. It could then be determined if the respondents were satisfied with the hiring criteria as they currently existed.

In summarizing the results of this survey, the first notable item was the response rate. It was gratifying to see that approximately half of the administrators and three fourths of the directors took time to assist in this project.

In looking at the background data, it was not surprising to find that the majority of the hospitals responding were in the range of 201 to 500 beds or 501 to 1,000 beds. Many smaller hospitals do not have a full-time person responsible for security. Those that do are usually in urban settings, which statistically have higher crime rates. Over two thirds of respondents were from urban hospitals.

Few of the hospitals that responded used contract security. The result was so overwhelmingly in favor of proprietary security as to be a major surprise.

Much has been written in recent years about tighter fiscal controls for health care institutions. Security contractors have marketed to hospitals that their services can achieve greater cost savings. This apparently is not a well-accepted factor among the survey respondents. The possibility exists that other institutions that use contract services may not have membership in the International Association for Hospital Security. This may skew the data on this particular topic. However, because of the way in which participants were selected, it is not possible to tell from this survey.

When addressing the section on related duties, the comparison of responses between administrators and security directors yielded several differences. Although the two groups generally agreed on the safety and parking sections, their views on fire protection, emergency response, locksmithing, telecommunications, and the "other" category varied widely.

Emergency preparedness, for example, was noted by 91.1 percent of the security directors. It was noted by only 75.9 percent of the administrators. In the smaller group, which consisted of responses from the security director and administrator of the same institution, 27 percent disagreed on whether the security staff assumed emergency preparedness responsibilities. Locksmithing (65 percent disagreed) and telecommunications (69 percent disagreed) had significant disagreement among the matched pairs of data.

The section using the Likert scales to develop the relative importance of various security roles also had some interesting comparisons. In this area, the administrators once again rated all areas lower than the security directors did. The most important function for administrators was patrol with a score of 4.60, closely followed by emergency response at 4.54. The remaining four functions-enforcement (4.10), investigations (4.19), service calls (4.04), and crisis intervention (4.12) were all significantly lower than the first two.

Among the security directors, emergency response at 4.87 was the number one priority. Patrol at 4.74 was second most important. Enforcement (4.54), investigations (4.45), and crisis intervention (4.46) formed the third layer. Service calls at 4.26 were last.

While emergency response and patrol were comparable, two differences of note were in enforcement and investigations. Both areas rated significantly higher among security directors. It is evident that among administrators the security function should patrol to prevent occurrences and respond when emergencies occur. High visibility enforcement is of lesser significance to administrators.

Five routine duties were addressed in the third section. The administrators and security directors were asked to check which ones were handled by the security staff. The responses varied greatly in almost all the duties. In the overall responses, crime prevention was checked by 92 percent of the security directors and 44.4 percent of the administrators, representing a variance of 46.6 percent. It seems that many administrators are not aware that their security staff is involved in crime prevention, whereas almost all security directors include this as a function of their department. However, among the institutions that had matched responses, the variance was only 20.6 percent.

Monitoring CCTV, on the other hand, had a variance from the total survey of 10.8 percent, while the matched data varied by 18.5 percent or almost twice as much. The significantly higher awareness by administrators could well be attributed to the cost of buying the equipment. These programs are generally submitted under capital equipment requests, which are normally approved by the administration.

The final section of the survey dealt with personnel and the requirements for employment as a security officer. When setting the requirement for prior experience, 58.5 percent listed one year or less, and 30.6 percent listed one to three years of experience. Almost 90 percent of the security officers from the responding institutions started with three years of experience or less.

As the data was being tabulated it became apparent that the survey did not accurately cover this requirement. There were separate responses for no experience and 0 to 1 year experience, which were grouped together in the data tabulation.

The education requirements for security officer applicants were much clearer. Of the responses, 77.8 percent stated a high school degree or equivalent was required. The remainder were divided among seven other categories with "some college" second at 10.4 percent. Clearly, the norm for a security officer at a health care institution is a high school degree and less than one year of experience. Several respondents commented that they would prefer no experience so they could train officers the way they wanted. These results take on more significance when compared to the next topic.

Current and preferred personal traits were discussed using Likert scales. As in other areas, administrators' responses were lower than those of security directors. Of the three traits in the current and preferred parts of the survey, communications (people skills) was rated the highest by both groups, significantly higher than either grooming or leadership. In fact, leadership rated a distant third on all parts of this section. Therefore, the profile of a health care security officer includes a high school education, little or no prior experience, excellent communication skills, and a far lesser requirement for leadership.

Such a security officer must respond to emergencies, handle parking, be involved in safety issues, monitor CCTV systems, and participate in crime prevention and patrol activities. While salary was not included in this survey, it can be argued that the pay scale is modest for the responsibilities required.

The answer to what can be done to resolve these discrepancies between security director and administrator perceptions can be found at the end of the survey. If communications and people skills are the number one item of importance for officers, it can be inferred that such skills are at least as important-if not more so-for security directors. Whereas it is obvious that security directors have a clear sense of purpose for their role, administrators as a group are not equally enlightened. It would be easy to suggest that administrators should pay more attention to the security function in their institution. However, the administrator of a major health care institution has dozens of departments that report to him or her. It is thus incumbent on the security director to communicate with the administrative staff at his or her hospital.

The many and varied roles performed by the security staff should be summarized and reported upward through the chain of command. It is important that the CEO receive a copy of these summaries. Unique and periodic activities that range from training classes to major investigations should be highlighted in memos. These recaps can become the basis of an advertising campaign for the security department. Periodic productivity reports that tie the number of calls responded to with staff hours can be useful in demonstrating the amount of work performed by the staff. The need for additional staff can also be demonstrated in this way.

Sometimes the directors of service departments feel uncomfortable having to sell their services to the staff and administration. Based on the results of this survey, the gap in perception is clearly evident. Hospital administrators are not completely aware of the security staff and its functions, so the only person left to fill the void is the security director. It would be unfortunate in this time of fiscal accountability in hospitals if the security staff were reduced or not expanded because of a lack of clear understanding of the many roles that it plays. Perhaps the role of sales is one that is required but not listed in the job description of today's security director.

About the Author . . . Samuel P. Martin, Jr., is corporate director of security for Lomas Administrative Services in Dallas. Martin developed and conducted the security role perception survey as part of his studies for his MBA, which he recently received from the University of Dallas. Martin is a member of ASIS.
COPYRIGHT 1990 American Society for Industrial Security
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1990 Gale, Cengage Learning. All rights reserved.

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Title Annotation:health care security
Author:Martin, Samuel P., Jr.
Publication:Security Management
Date:Nov 1, 1990
Words:2232
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