Since September 11th, security concerns for
healthcare institutions have become a bigger and bigger challenge. Unlike an
airport or nuclear facility, hospitals do not have the freedom to just increase
security due to raised threat levels because marketing is more difficult for a
hospital.
What I mean is this: there
needs to be a certain confidence in the hospital on the part of the patient and
a high level of security can damage that confidence level. After all, if you have two hospitals in your
city, one in a bad section of town where police officers roam the E.R. driveway
and the other is a pristine community hospital settled in a higher end
community near the mall, which facility do YOU drive to at 3 am?
Another challenge on the part of hospitals is the
socio-environmental change that established health care facilities face as the
population landscape evolves. Language
barriers, neighborhood decline, increased crime rates in older communities,
over-crowded emergency rooms due to population growth and even economics all
pose new threat challenges that are almost too much for a hospital to address
while trying to maintain a high level of care.
According to studies, the Emergency Room is the most
vulnerable area of a hospital. Let’s face it: at 3 a.m. in Triage Room 1 we
have a possible overdose patient with his fiancée who is higher than a kite. In
the waiting room is a growing crowd of those who were at the same party. In Triage Room 2 we have the 12 year old boy with an appendix issue, but he is
accompanied by his divorced parents who cannot keep from yelling threats at
each other. Of course in Triage Room 3
Grandpa just passed away and the 8 family members have now gone bezerk… you see
the problem.
Life in an E.R. can be crazy on a normal night so try to imagine a
flu outbreak, one or two patients in police custody and perhaps some severe
weather tossed in.
In July 2009, the Emergency Nurses Association released some
scary findings claiming that more than half of emergency nurses polled had been
physically assaulted on the job and 25% had been victims of violence more than
20 times in the past 3 years!
A group of hospital administrators told pollsters in a recent
survey by AlliedBarton Security Services that they feel their facilities are
more vulnerable today than in past years, but still worry about security
measures damaging their reputation and patient confidence.
According to these studies, hospital administrators are
concerned about projecting a negative image, but I want to ask the question, AT
WHAT COST?
I am the first to be irritated at the airport when I am
running late and behind some idiot with three carry-ons loaded with nail
clippers and large shampoo bottles, but as I sit on the plane itself and look
over the barb-wired runways, I am reminded of the day that changed everything
and I am glad TSA tore that man’s bags apart.
Touring public schools, I have to admit I feel better being
in a building that has held my drivers license at the front desk. I feel safer
at an elementary school than I do at WalMart, that’s for sure.
Would I mind increased and more visible security at a
hospital? Absolutely not. Why? Because we live in a changing environment where
climate change no longer refers to just meteorological phenomenon but to the
change in our social structures, economics and politics one would be a fool to
ignore that we are living in a new and dangerous time.
So, what has me on this subject?
Last night I drove my wife to the local hospital with labor
pains apparently 20 minutes apart.
Arriving at the hospital, we noticed immediately that the emergency room
had approximately 20 people milling about in it. For a hospital this size, this was a decent
crowd for 9:30 on a Saturday night.
The hospital "closes" at 8:00 p.m.
As we entered, there did not seem to be any
crucial issues; most of those in the waiting room were sniffling,
sneezing or holding their stomachs… a flu night.
As we approached the desk, the woman at the desk (the only
employee visible in the room) quickly guessed why we had come.
“In labor?”
We informed her that we need to go to the Birthing Center and
she quickly called upstairs to let them know their night was not going to be a
quiet one. Once done notifying the folks upstairs, she proceeded to check us
in. Drivers Licenses, emergency phone contacts, birth dates, the works. She then instructed us to go to the Security
Desk to be escorted upstairs, but the desk, which was 20 feet away, was empty.
The perplexed woman said she had no idea where the security
guard was and, with a remote control, buzzed us through the glass double doors…
With no directions and new signage not completely installed
due to the recent remodeling of the hospital, we were quickly lost in the maze
of hallways. After 5 minutes we had encountered not one employee, custodian or
nurse. It seemed the more we walked, the more lost we got. Soon, we were in a
hallway with little lighting but we found an open door, a desk and a phone.
Picking up the receiver, I dialed “0”. The switchboard
operator laughed when I told her I was lost and calling from inside the
hospital. I asked for someone to come and get us, but the operator just
instructed us to find and elevator and go the next floor.
I will make this story a lot shorter than it really is…
We ran into a nurse who spoke in broken English that gave us access to a back elevator but claimed she did not know how to get to the Birthing Center from our location.
We walked through the hospital after hours for another 20
minutes. We walked through the Nuclear Medicine Department, through the
Outpatient Surgery wing, in and out of offices, explored two floors of hallways
and rooms before we jumped on another elevator and took it to the parking lot.
All concern of labor pains and the impending birth had left
us; we wanted to see just how bad this really was…
That was 9:30 last night. As of 4:00 p.m. today, nobody from
the hospital has contacted us to find us. After 18 hours, that hospital’s
records show us checked in and on our way upstairs. The birthing center never called to see why
we did not make it, the Emergency Room never called to see where we were, and
we left though an unmarked door after passing through fire doors marked “Locked
after Hours”.
In case you are wondering, we went to a different hospital.
How confident would you be in taking your child to that
hospital in the future knowing that their security was so poorly managed? With this as the option, wouldn’t you rather
have a metal detector and RFID system in place when you entered a
hospital? At what point are we going to
start looking at our present day world and start making changes across the
board even if they make us uncomfortable?
In these studies I have read, hospital agreed that one of the
most important characteristics of a good security program is that the security
officers feel responsible for customer service and patient satisfaction. As it
turns out, there are many hospitals that struggle with finding the balance
between gently escorting patients and beating down a shooter in a security
guard, so the choice is more often to find the gentle, low-key approach as the
only option.
A great marketing choice…but what if last night my wife and I
had actually been there for terroristic purposes? What if we had been looking to kidnap a
patient, steal equipment or leave an incendiary device? We certainly would have had the time! In fact, according to hospital records, we
are still in there!
There is a lesson to be learned here, and I am afraid it goes
much further than hospitals. Perhaps we
should look at the danger of exceptions…
Maybe we were allowed in only because the guard was in the
restroom. Maybe we were buzzed in because the E.R. Admitting nurse was
overwhelmed. Maybe we gained access
because we look like a “nice couple”.
Maybe none of those reasons would explain away a shooting or
a bombing incident during an investigation nor would it return lost lives.
Maybe we should talk about the high school in Central
Illinois that recently battled the heat wave and high temps in classrooms by
propping their entry doors open throwing their security protocols out the
window? Maybe we should look at the
increased number of church shootings and lack of trainings amongst faith-based
entities…
Maybe we should just start re-thinking all of it, and then
perhaps we should be a bit more willing to give up “comfortable” for “safer”.
Just something to start you all thinking… I’ll let you all
know if the hospital ever starts looking for us.
