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On 9/11/01 hospital security programs began to adjust to a new reality. Those hospitals that have not made an adjustment place themselves in serious jeopardy. Those security programs that are marginal and have attempted to fake it, may pay a dear price if they do not adjust.
The events of 9/11/01 have impacted security challenges in all industries, including health care. Clearly hospitals will have meet the security challenges as well as the clinical challenges of bio/chemical assaults. Bomb threats now take on an entirely new dimension. Both staff and visitors are more likely to panic in the face of either of these threats.
The media is more likely to dissect, exaggerate, and disseminate security incidents around the country and even throughout the world when they occur. Consider this scenario. According to press reports, in the summer of 2001, prior to 9/11/01, in a suburban Connecticut hospital, a female security guard had her throat cut by a deranged subject. This attack, which occurred near the Emergency Room, was covered by local media and the story faded quickly from view. Fortunately, the security guard survived this attack because of the rapid response of the ER staff. If this attack or a similar events had occurred sometime after 9/11/01, What do you suppose the media reaction would have been?
Clearly security breaches now have the potential to bring harm to any hospital far in excess of their impact prior to the terrorist activity of September. These events are also more likely to result in civil litigation, partially because we have been given notice, which in turn, has pushed the standard of care to a new level.
We know from past experience, that when our society experiences turbulent times, marginally stable and those with incipient psychosis are often pushed over the edge. We also need to be concerned with copy-cat perpetrators. Those deranged individuals who enjoy drawing media attention are also drawn out of the woodwork.
Some Suggested Remedies
Any hospital that has been looking for the justification for a top to bottom security assessment could not find better reasons than those that exist now. There are at least two good reasons to undertake this exercise. First, it will enable your hospital to develop a security program strategy grounded on sound principals and with a definable sense of purpose. Second, those hospitals that tend to react to recent events in a knee-jerk fashion will likely incur excessive dollar costs and minimal return. There are many ways to substantially improve security without spending exorbitant sums of money.
One of the most cost efficient, yet most overlooked remedies, is an effective Security Awareness Program. The essential components of this kind of program is improving security through employee involvement. It is not always necessary to go out and hire additional security officers. Security Awareness Programs, once established, need to be continually fed and nourished, lest they die on the vine. An effective Security Awareness Program will reduce the probability of crime, help to protect assets, and reduce liability exposure.
One of the most common shortfalls that often exacerbates the problems of a marginal security program, is inadequate training. In the more than 300 security litigations that we at SMSI have been retained, training issues invariably enter into the mix, often in a detrimental way. Clearly a review of all policies and procedures as well as the adequacy of all security training, should be undertaken. These programs should reviewed for content as well as effectiveness. Security training should not be restricted to security personnel. Every employee should have security training as part of their orientation protocol. All training must be thoroughly documented in each employees personnel jacket. Furthermore, all training should be site specific and those receiving training must be tested on the content of the program in order to ensure learning has taken place. When appropriate, this training may need to be bilingual.
Next to training, the next most common shortfall to rear its ugly head in security litigation is inadequate, and/or inaccurate documentation. The need for thorough documentation applies to training classes, incident reports, daily activity logs, and witness statements, to name just a few. Proper documentation produces a wide array of benefits. Professionally produced security reports, preferably as a result of a computer based incident tracking system, are less likely to be challenged in court plus they enlace the credibility of the security organization. Thorough documentation also provides the basis for sound decision making regarding the components and objectives of your security program. It allows for the effective allocation of limited resources and insures that necessary cou course adjustments are made in the face of changing and evolving trends.
If your hospital is using contract security personnel, it does not mean the hospital can abdicate responsibility for the adequacy of the security program. Ultimately, each hospital bears full responsibility for the course and scope of their security program. Frequently, when things go wrong, there is finger pointing between the hospital and the security contractor. Hold Harmless Clauses, contained in many security contracts, provide no guarantee that the hospital will not be held financially culpable for claims of negligence.
Hospital security programs are , and should be, unique to each facility. The world and this country have unfortunately become more dangerous over the last several weeks. Hospitals must adjust to that reality. There are a wide array of effective remedies that have little or no significant budgetary impact. Knee jerk remedies are usually not the best answer
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