There was a time several years ago when hospitals were ostensibly immune from most criminal activity. Even when hospitals were located in relatively high-crime neighborhoods, the bad guys had an unwritten code that the hospital was off-limits for crime. Those days have long since faded into distant memory. These days we find hospitals experiencing homicides, domestic violence episodes, sexual assaults and a wide range of property crimes. The problem is that a significant portion of hospitals were designed with the good old days in mind. Many of those who have been victimized by crime on hospital campuses have brought substantial lawsuits against the hospital claiming inadequate security.

 

One of the major pitfalls of older hospitals as well as many of the newer ones is an overabundance of points of ingress and egress. Many administrators, even today, have a desire to maintain a sense of openness. Some of that thinking is beginning to change, but not necessarily as a result of perceived criminal activity. The driving force these days is that threat of pandemic flu and a weapons of mass destruction attack.

 

The challenge then is how to maintain a sense of openness while maintaining reasonable security. The answer is not all that simple. Security is a situational discipline. Essentially that means, one size does not fit all. Every single hospital is unique and is impacted by a differentiated set of threats and risks. Hospitals must consider the potential benefit of conducting a stem to stern security assessment by a qualified security professional. Second, hospitals need to assess, or have a security expert assess, the level of criminal activity in surrounding environs and how that activity is likely to affect the safety of their employees, patients and visitors.

 

There are two useful sources for this information. First, the local law enforcement jurisdiction continually maintains crime data with great specificity. That data can usually pin-point specific addresses as well as defined areas. Once that data is gathered it may be difficult to determine how high or low that criminal activity is relative to a greater whole. For example if the police data shows five stolen cars in the last three years, would that be considered high or low? If you said “high,” High compared to what? If you are planning a new addition and you want to employ suitable security, you should question how high will the crime rate be in five years?

 

The second determination of criminal threat can be obtained by ordering a CapIndex Crimecast Report (www.capindex.com). The CapIndex people are able to provide data regarding the level of criminality by providing numeric scores that allow one to consider the data on a comparative basis. For example the CapIndex will produce a score for your location for Crimes Against Persons as compared with the National Average. This comparative database is useful in discovering the level of threat. Furthermore, the CapIndex will provide projections for various categories of criminal activity for five years down the road.

 

However the hospital decides to control access, in part to be determined by the level of threat of criminality, some secondary and tertiary considerations are also of import. To use a football analogy, SSO believes hospitals should have a “bend, but don’t break defense.” This means that it is a given that people will enter the hospital that do not belong. The hospital’s challenge then becomes control where people go and what they do once in. In addition to securing the perimeter, a number of additional strategies must be employed.

 

First, there must be 100% compliance with the wearing of employee ID badges. Second, there must be secured areas within the hospital such as the pharmacy, labor and delivery, the ER, the surgery suite, etc. Third, all employees must make the goal of a secure facility their personal obligation. Employees must receive security awareness training and learn how to identify and how to interact act with any suspicious persons. Fourth, signage should identify restricted areas. Fifth, each hospital should develop a need-based program for controlling visitors. The term “need-based” implies there are no universal protocols as to how a visitor control program should look. The level of risk, based on a wide range of divergent circumstances will be a determinant factor. Hospital crisis management plans will also require a component that addresses the need for enhanced access management. It may or may not be fitting to reinforce all of these methods with automated locking systems, card access control, closed-circuit television and uniformed security officers.

 

SSO has access to a wide range of healthcare security professionals. We encourage your comments and questions. If there is a topic you would like to see addressed by SSO, please let us know.