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Hospitals have traditionally done a poor job of protecting assets. There are many reasons for this phenomena, not the least of which is tradition. That may sound silly, but many hospitals, to this day, maintain a na•ve view of the need for asset protection and when they do acknowledge some theft, it is often perceived as an outside threat.. The best evidence for this perspective is found is asset storage areas. Most hospitals would be unable to even detect a loss because of loose inventory control systems and there is never a forced entry.
What do we mean by, assets?
Anything from pens and batteries to laptop computers. Also included patient valuables, employee property, and even medical equipment such as EKG equipment and endoscopy equipment. Many hospitals are loosing significant amounts of cash, especially from gift shop operations and cafeterias. Some employees have been able to knock down $100 per day of tax free income and never get discovered. When they are discovered, it is often by accident or through an informer, but rarely as the result auditing.. Hospitals are loaded with ÒmerchandiseÓ we could all use from time to time. There are a wide variety of food products and the utensils to cook with. For the bed and bath we have sheets, towels, scrubs and baby blankets. For the home office, one can find printer paper, toner and/or ink jet refills, pens, batteries, and note pads. There are a number of household products available including cleaning supplies, toilet paper, mops and brooms, vacuums, paper towels, and buffers. If you are a handyman, you will find electrical and plumbing supplies, a wide range of hand and electric tools, as well as various nails, nuts, and bolts. If you have a head ache or like to gat a buzz on every once in a while, the drugs are free. If you were to view your Hospital as a big general store, the best thing about this store is there is no check-out stand.
If you think these suggestions are hyperbole or an exaggeration, think again. We have seen, in practice, every example alluded to here and much more. You can be sure that some of these practices are going on in your hospital. How much do these internal losses impact cost-per-patient-day ratios? Its hard to say, especially when most hospitals are not close to getting their arms around this problem. It suffices to say that there is significant opportunity to bring real dollars to the bottom-line.
There are studies that indicate that hospitals are losing as much as $3500 per bed per year. If you dispute this number, cut it in half; its still a great deal of avoidable loss. Another study found that, on average, 30% of hospital employees will steal and/or commit some form of fraud. This finding tends to line up with most businesses.
Which employees are committing these acts of dishonesty?
This answer may surprise you. Most employees who engage is this type of behavior are fundamentally honest and view their pilfering and acts of fraud as an entitlement, at least at the onset. When these individuals are caught, on rare occasions, they will sincerely rationalize their behavior. They will say ÒEveryone else is doing it.Ó ÒThat why they donÕt pay us much; itÕs a fringe benefit of working here.Ó Sure there are some fundamentally dishonest employees who bring a life of crime to the job. There are also criminals who walk into the hospital looking for easy pickings. However, accumulatively, the rationalizing employees account for more total dollar loss than the latter two categories.
What can be done to reduce this problem and deter this behavior in the future?
The good news is that the remedies needed to mitigate these problems, usually, is very inexpensive. First, the size and scope of the problem must be determined by conducting a top to bottom security assessment. Not only must traditional security methodologies be examined, but inventory control protocols, purchasing protocols, and conflict of interest policies must be studied. All thefts, even small ones must be reported and recorded in a computer based incident reporting system . Computer based systems allow an investigator to better isolate the precursors to crime: motive, means, and opportunity. Every theft or act of dishonest should be investigated. The original incident report should than become an investigative file. The file should remain open until the case is solved , no matter how long that takes. The employee handbook should set forth predetermined disciplinary policies and consequences for dishonest behavior.
Every hospital should invoke the least costly and most effective of all mitigating methodologies, a Security Awareness Program (SAP).
If your hospital does not have a SAP, start one today. If your hospital does not know how to start a SAP, find someone who does or call SMSI. Because the volume of internal theft is perpetrated by basically honest employees, SAP can be highly effective. Remembers the preconditions for criminal behavior are motive, means, and opportunity. Most security programs, rightly so, try to reduce opportunity. The initiation and promulgation of a SAP can effectively impact the motive factor.
Depending on the severity of the problem at your hospital, once you know, some traditional security measure may still be required. For example, after a theft from a locked office, when was the last time your hospital experience a forced entry? We know hospital key-control programs are out of hand. Sometimes the prudent use of CCTV can significantly reduce loss exposure, especially is those areas that have reduced manpower after normal business hours. If you have any specific questions on this topic, feel free to call or email Bill Nesbitt. (805/492-6475 or HYPERLINK "mailto:bill@smsiinc.com" bill@smsiinc.com)
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