by Ray Gilley, President and CEO
The security needs of healthcare facilities are unlike other types of sensitive facilities in that they are generally open to the public. They’re also located throughout all different types of communities. From government funded county hospitals, to gargantuan metropolitan medical centers, to suburban and rural clinics, healthcare facilities are found everywhere. Also, unlike many other types of sensitive facilities, such as food services, the government’s response to the physical security needs of healthcare facilities has been all but nonexistent.
Most healthcare facilities have traditionally utilized a very open concept when it comes to security. The external security is normally controlled access to employee parking areas, a few CCTV cameras, and maybe a single roving security guard. The internally visible security normally consists of a single security guard at the main entrance. There is typically controlled access between sensitive areas in the building but because of the transient nature of hospital employees within a large area, people often freely transit throughout the buildings without being challenged. Knowing all of this, it’s easy to assume that healthcare facility security is a lot of window-dressing and has little substance to actually protect people.
As of today, most security–related, government funding for healthcare facilities has revolved around grants for protecting digital information to conform to the Health Information Technology for Economic and Clinical Health (HITECH) Act requirements. This means that securing of healthcare facilities falls almost exclusively on the private sector and an organization known as the International Association For Healthcare Safety & Security (IAHSS).
The IAHSS is the only organization solely dedicated to professionals involved in managing and directing security and safety programs in healthcare institutions. IAHSS is comprised of security, law enforcement and safety individuals dedicated to the protection of healthcare facilities worldwide. IAHSS strives to combine public safety officer training with staff training, policies and technology to achieve the most secure hospital environments possible. Additionally, the IAHSS partners with government agencies and other organizations representing risk managers, emergency managers, engineers, architects, nurses, doctors and other healthcare stakeholders to further patient security and safety. (www.iahss.org)
Another marked difference from other types of sensitive facilities is that while terrorism is a concern, the major security-related threat in healthcare facilities is occurrences of street-level criminality.
In 2011, nursing care facilities workers had an injury-incidence rate of 27.2 per 10,000 resulting from assaults and violent acts, seven times the overall private-sector workplace violence injury rate of 3.8 per 10,000 workers. Also, the Bureau of Labor Statistics reports that there were 37 homicides in the health care and social service industry in 2011.
While OSHA recommended that all healthcare facilities have a violence prevention plan nearly twenty years ago, as of today no rules requiring one have been issued.
Because of the criminal dangers associated with healthcare facilities, the day-to-day security responses necessarily need to reflect it. This is primarily achieved through Crime Prevention Through Environmental Design (CPTED).
The goal of CPTED is a reduction of opportunities for crime to occur. This reduction is achieved by employing physical design features that discourage crime, while at the same time encouraging legitimate use of the environment.
CPTED consists of six areas of security:
Defense of Space
While nothing can be done to completely eliminate the danger, the effective use of the CPTED concept can minimize street-level criminality to a manageable level. (www.cpted.net)
While there haven’t been any recent specific credible terrorist threats to healthcare facilities, there were several anti-abortion facility shootings and bombings in the 1990s that resulted in deaths, injuries, and damage to facilities. As it was then, healthcare facilities are still considered a prime target for a multitude of reasons:
Large Footprint Facilities
Open to the Public
Constant Foot Traffic by Non-Employees
Multiple Entrances & Exits
Storage of Dangerous Chemicals & Controlled Substances
Housing of Radiological Machinery
Multiple Parking Areas
Driveways Immediately Adjacent to Entrances
Transient Employee Base
Large, Mostly Unsecured Physical Plant
Traditionally Minimal Security
With all of these in mind, it’s apparent that the main challenge to securing healthcare facilities is balancing the needs of security and the necessity of keeping the facilities as accessible and efficient as possible.
Following the terrorist attacks of 9/11, the federal government published the Healthcare and Public Health Sector-Specific Plan (SSP) as part of the USA Patriot Act. This plan mirrors all of the other SSPs in its structure and provides little detail as to the specific security needs of healthcare facilities.
While all sensitive sectors require a substantial capital expenditure into bolstering security, the healthcare sector will continue to require a dedicated commitment to maintaining current protocols but increasing effectiveness of its security protections. Unfortunately, these costs will likely fall directly on the facility managers with no anticipated new public funding. Should there be a credible terrorist threat or actual terrorist event at a facility there would likely be public funds made available to meet the threat, but until that time the funds will primarily continue to be allotted to digital security only. This requires facility managers to ensure they are getting the most out of their security budget dollars.
The nature of today’s security threats to healthcare facilities is such that facility managers should project an increase in security budgets to combat both street-level criminality as well as potential emerging terrorist threats.
Including security professionals like ISI Security is important throughout the process of planning, implementing, and maintaining of security at healthcare facilities because our primary mission is to ensure that budgeted funds are used in the most effective and efficient way possible.
Copyright © 2014 ISI Security
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