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Recently, an Emergency Room physician was attacked in a Southern California Hospital. This incident, and similar incidents around the country serve to remind us all that when criminal acts occur in a hospital, media coverage is usually intense. There is an implied incongruity between violent criminal activity and the mission of the hospital. There is also the general impression that hospitals are safe sanctuaries. Anything that flies in the face of this perception has a degree of shock value in the eyes of the public and will therefore always make the six o'clock news.
There are a number of potential adverse consequences that can arise out these kinds of criminal events. One of the most obvious is litigation in the form of premises liability lawsuits. We at SMSI have served as security experts in more than 350 such lawsuits. More than 50 of these lawsuits have involved hospitals. These cases have included several sexual assaults (the most prominent), infant abductions, child molestations, homicides and aggravated assaults, to name a few. Within this universe of lawsuits there are some dominant misperceptions that existed prior to the incident. The more prominent of these misperceptions are listed below.
First, we recently passed, with flying colors, a JCAHO assessment and our Environment of Care Standards were up to snuff. Therefore our security program is adequate. Environment of care standards are minimal standards and will in no way significantly reduce culpability in the wake of a lawsuit. In fact SMSI has never been retained in a hospital lawsuit where the hospital failed to meet JCAHO EC Standards.
Second, if an employee is victimized by a crime, the hospital's exposure to the employee is limited to recovery governed by "worker's compensation" laws. This is generally true, but one needs to be aware of who is actually an employee of the hospital. Hospitals often use a number of contract employees such as housekeepers, dietary personnel, emergency room doctors, pharmacists and facilities personnel. All of these categories of employees can, and do, bring personal injury lawsuits when they perceive that the hospital's security was inadequate.
Third, most employees believe that security is someone else's job. In many of the lawsuits we have been involved in, employees who were in a position to act, and potentially thwart the crime, failed to do so under the belief that security the domain of the security department.
When it comes to security, hospitals are in the unenviable position of having to operate under an extremely high standard of care. All factors being equal, a sexual assault of a patient will have far greater consequences than if that patient was a guest of a first class hotel. Plaintiff attorneys will often try to leverage the hospital's aversion for adverse publicity in the media in their attempt to obtain lucrative settlements.
Once a lawsuit is filed, the security history, as well as police crime data, will be scrutinized for the three years preceding the incident in question. Clinical personnel will be deposed and asked questions about the security program from their point of view. Prior security incidents will be subpoenaed. The hiring and training standards for hospital security personnel, whether proprietary or contract, with be scrutinized. Safety Committee Meeting minutes may be requested. The access management program of the hospital may be critiqued. The badging of staff and visitors will be examined. Even the architectural design of the hospital, as it affects ingress and egress, may be examined.
The good news is that most of the incidents that eventually result in litigation, would have been preventable, even without the vantage point of 20/20 hindsight. In most cases a qualified Security Professional would have seen the breaches before the fact. Every hospital should do a top to bottom security assessment at least every three years. In the interim years, there must be annual updates. Every security incident should invoke a corrective action, which in turn should always be documented. The hospital's Security Awareness Program should ensure that "Security is everybody's job, every day." If contract guards are used, the hospital must be sure they are not burdened by the errors and omissions of the guard company by insuring that the contract language is in the hospital's favor.
In addition a security assessment with pay additional dividends by better protecting assets such as patient property, food products, linens, pharmaceuticals, cash and equipment, such as computers. Feel free to contact Bill Nesbitt at SMSI Inc. at any time. We would be happy to openly discuss any concerns or issues your hospital may be dealing with. We prefer to deal with hospitals pro-actively by trying to mitigate security risks and thereby reduce the risk for litigation. Almost all of our hospital litigation cases have involved hospitals that were being sued for inadequate security for the first time. Reaction is three to five times more costly than pro-action. Contact Info: bill@smsiinc.com or call 805-492-6475.
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