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What impact do the warnings provided by Homeland Security have on your hospital? Is it likely that your hospital will become the object of a terrorist attack?
The answer to the second is "no." It is not likely your hospital will be attacked by terrorists. However, it is more likely that your hospital will experience a terrorist-like event either by design or by happen-stance. For example, a bomb threat will carry more impact in the wake of 9/11 than before. Hospitals are finding that disgruntled employees and employees entangled in domestic disputes may produce security events that look like terrorism by design. Anyone wishing to create major disruption as well as ensure media coverage can guarantee success by using a terrorist ruse.
What do warnings from Homeland Security have to do with this?
The series of warnings from Homeland Security, and those sure to come in the future, have the net effect of providing legal notice. Any entity that has been warned of impending, albeit nonspecific security incursions, has a duty to heed those warnings and take corrective action.
If the hospital is sued in a premises liability case for inadequate security, in order to prove negligence, it must be shown that the event was foreseeable. The warnings from Homeland Security facilitate the proof of foreseeability and /or provide notice. If a warning from Homeland Security specifically addresses the root cause of a security incident , a case could further be made that notice was given which will increase the exposure of the hospital.
The point is that every hospital that has failed to reassess their security in total and made the appropriate adjustments, will be unduly exposed to greater liability because the standard of care has changed since 9/11.
Consider this hypothetical example. Suppose a patient is brutally assaulted while in his or her bed. Further assume that this hospital has little or no visitor control program. Assume employees do not fully comply with the ID Badge program. Assume there is little or no security awareness training. Also assume that this hospital has never experienced this kind of assault in the past.. Assume there is a haphazard, poorly designed electronic security program. Assume the hospital is over 15 years old and is therefore not designed for today's security threats.
All other factors being equal, excepting the additions of the events of 9/11 and the subsequent warnings from Homeland Security, this hospital now has significant exposure. Any security expert worth his or her salt would be able to successfully criticize the security program if it could be shown that no relevant adjustments were made after the attack on America.
Hospitals that fail to reassess their security posture are asking for problems. Remember, once a security incident occurs, it is too late. The clock stops, and everyone begins to look backwards. Hospital security plans must not only plan for bio/chemical events but also must adjust to these new realities. The events of 9/11 affect infant abduction prevention programs, ER security, employee training, orientation programs, and access management programs.
The bottom line is that we now have a new Standard of Care. Additionally, hospitals may be required to place less reliance on Police support. There is a significant possibility that police officers will be preoccupied if terrorism comes to your town.
There are a wide range of potential remedies, many of which do not have major budgetary impact. Make sure that your next security assessment considers these new realities. All hospitals must re-evaluate their access and visitor control policies and those policies must be clearly defined. Initiate a Security Awareness Program (SAP). Every employee must be trained in how and when they should be involved. Be sure that any security assessment and the resultant security program inculcates CPTED (Crime Prevention Through Environmental Design) principles. Be sure that individuals who are most likely to receive threatening calls (bomb threats, retribution, etc.) are thoroughly trained. The ability to authenticate threats is more important than ever. All employees should receive a primer in how to be good witnesses. Take full advantage of any intelligence that may be available from local police jurisdictions. Sit down with local police agencies in order to gain a full understanding of what they will and will not do in an emergency. Consider, before the fact, how and when information will be disseminated to the media. Be sure your security plan has contingencies for managing large influxes of people on short notice (crowd control techniques).
Because of the increasing demands that may be placed on security personnel, consider if this is the time to move toward security automation. If you are not comfortable in this arena, have an independent security consultant recommend the appropriate upgrades. The consultant should be able to protect the interests of the hospital by developing an RFP (request for proposal). The consultant should also be helpful in the vendor screening process as well as project management. The Security Consultant can also develop RFPs for contract security guard services.
The events of 9/11 seem to have produced varying degrees of response predicated, in part, on geography. Anecdotally, there appears to be a more pronounced adjustment to these new criteria in the northeastern portion of the country, with greater pockets of complacency as we move west. Over the next year or so, security derived litigation will eventually force more uniform responses from coast to coast.
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