module 1version date: march 20071 hospital security module 1

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Hospital SecurityHospital Security

Module 1Module 1

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Do not figure out where to drive the bus and then get people to take it there. Instead, get the right people on the bus (and the wrong ones off the bus) and then figure out where to drive it!

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Put the cart before the horse. There are many considerations in choosing who to get on the bus!

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Rational for having security:– Moral responsibility

• Obligation to manage our environment to minimize possibilities.

– Legal responsibility• Obligation with patients is contractual and we assume certain

responsibilities. This is greater when a patient is unable to care for themselves

• Florida District Court of Appeals stated that even security measures proven to be inadequate and warranting compensatory liability demonstrate efforts sufficient to ward off a claim for punitive damages

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Rational for having security:– Regulatory agency compliance– A safe environment maintains good public and

employee relations

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First principal in Hospital Security Management:– YOYO!– Scene size is disproportional

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Do you remember the large scale event in 2001 and its devastating effect on hospitals?What was the event?The Terrorist attack on the World Trade Center is Incorrect! Anthrax scare?

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In 2001 seventeen hospitals were affected by twenty-seven inches of rain which fell on Texas.– 5 hospitals were forced to conduct total evacuations– All 5 were above the flood plain– 2 were level-one trauma centers

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Texas Floods (one hospital’s events)– At 1am the power went out– At 3 am the generators went under water– At 6 am the evacuation began. – The evacuation took 36 hours

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– At what time do you think the looting began?• Narcotics, electronics, furniture……

– At what time do you think the first sexual assault of a patient occurred?

– At what time do you think the first infant abduction attempt occurred?

– At what time do you think…….

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Impact on Security– Oklahoma City Bombing

• 168 dead, 759 injured– Tokyo Subway

• 12 dead, 5,500 injured– Texas Flood

• 5 hospitals completely evacuated– Katrina

• Family Issues• 11 hospitals – 1,749 patients – 7,600 refugees

– High School Gym Occurrence

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Events effecting hospital security can be naturally occurring, human related, technological or involve hazardous chemicals.– In everyday haz-mat incidents, only 18.5% are

treated at the scene– In everyday accidents, 80% triage themselves to a

hospital

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Events effecting hospital security can be naturally occurring, human related, technological or involve hazardous chemicals.– In disaster times health care workers automatically

respond to their hospital to help• They typically cause parking problems• They typically do not know what door to enter through

(rationale to maintain a standard lock schedule)• They do not know where to go so they go to the E.D.• They……

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As you see, there are security problems across the board that we have only touched on identifying and solving.

Where do we start?

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Hospital SecurityHospital SecurityWHEPP– Op-9: Security

• Create a plan based upon a HVA• Response plans should include pre-planning and plan

implementation elements• Pre-planning should be based upon a Risk Assessment• Implementation should include lock-down procedures

– Op-9 is included in your handout and has an excellent security checklist attached to it.

– A summary of the review of WHEEP Op-9 is included in your handout.

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Hazard Vulnerability Assessment– Pick up a copy of the state’s HVA– Pick up a copy of your region’s HVA– Conduct your own HVA

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Conduct your HVA– Think in terms of Security and pick two of the highest

rated areas. – Focus on the security aspects.

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Create Your Plan!– There are two types of people who believe in

security plans. Those who know they are necessary for regulatory or compliance reasons, and those who know they will eventually be used.

– Which are you. It makes a difference in the development of the plans.

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Regulatory or Compliance– Many facilities are not Joint Commission Accredited

• NFPA 1600• CFR• OSHA• NIOSH• State Laws• Others……

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– NFPA 1600• On July 22, 2004 the 9/11 commission recommended that

NFPA 1600 be adopted by all hospitals. It further recommended that insurance and credit-rating industries look closely at a company’s compliance with the this standard in assessing its insurability and creditworthiness. The Commission believes that compliance with the standard should define the standard of care owed by a company to its employees and the public for legal purposes.

• The standard discusses Mitigation, Preparedness, Response and Recovery efforts and plans.

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NIOSH– Develops standards, guidelines and recommended chemical

exposure limits– Part of the CDC under the control of the Department of health

and Human Services– Conducts research and evaluates workplace hazards and

stressors– Given the same entry rights as OSHA, but cannot issue

citations– Worked with the International Association for Hospital

Security and published hospital security guidelines

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Create Your Plan!

– Internal Disaster Plan– External Disaster Plan– Lock Down Plan

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Internal Disaster Plan– Mitigation– Preparedness– Response– Recovery

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Internal Disaster Plan– Mitigation

1. Conduct annual Hazard Vulnerability analysis.

2. Conduct and resolve safety / security issues with the Risk Assessment Program.

3. Maintain working relationships with federal, state and local emergency planning agencies.

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Internal Disaster Plan– Preparedness

1. Provide continuing disaster response training and awareness through hospital-wide orientation programs, computer learning modules and department training sessions.

2. Maintain trained Emergency Response Units (Security, Fire Brigade, Decontamination Team and Staff Assistance Team).

3. Participate in community-wide drills and conduct in-house drills per federal, state, local regulations and guidelines to assess preparedness and to target opportunities for improvement.

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Internal Disaster Plan– Response

1. Initiation - Anyone witnessing or receiving notification of an internal disaster will obtain vital information (disaster type, location & approximate number of victims) and forward this information to the Emergency Department.

2. Announcement - When the decision is made to activate the internal disaster plan, the Switchboard Operator will announce three times: “D-Alert---Please Report to Your Assigned Areas”

3. Initial Response - Staff appointed to the Security function should lock down the hospital per the “lock down” policy.

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Internal Disaster Plan– Recovery

1. Psychosocial - Depending on the extent of the disaster, the Disaster Control Team will coordinate debriefing sessions with staff, physicians and volunteers and assist those with needs as appropriate. The hospital also maintains agreements with our Employee Assistance Program provider to provide future assistance.

2. Loss of Utilities - In the event the hospital should lose electrical power or city water, agreements are maintained with organizations necessary to maintain operations and assist with recovery efforts.

3. Supplies and other needs - The hospital maintains Memorandums of Understanding and agreements with appropriate agencies to assist in recovery efforts.

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External Disaster Plan– Mitigation– Preparedness– Response– Recovery

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External Disaster Plan– Mitigation

1. Conduct an annual hazard vulnerability analysis.

2. Utilize the Hospital Incident Command System (HICS).

3. Maintain active participation on the Local Emergency Planning Committee (LEPC) and other similar community committees.

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External Disaster Plan– Preparedness

1. Maintain a reserve of supplies as necessary to provide for the potential loss of supply lines.

2. Conduct organization wide drills to assess opportunities for improvement.

3. Conduct staff training on preparedness.

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External Disaster Plan– Response

1. Initiation - Anyone receiving notification will obtain initial information regarding the type of disaster and an approximate number of victims and will forward the call to the emergency department.

2. Announcement - If a decision is made to activate the disaster plan, the following announcement will be made three times: “D-Alert — Please Report to Your Assigned Areas” 

3. Initial Response - Security designees will secure all exterior doors.

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External Disaster Plan– Recovery

1. Psychosocial - Depending upon the extent of the disaster, the Disaster Control Team will coordinate debriefing sessions with staff members, physicians, and volunteers, and assist those individuals with needs as appropriate (fuel, cash loans, food, etc.). Agreements will be maintained with our EAP provider to assist as needed.

2. Loss of Essential Utilities - In the event the hospital should lose electrical power or city water, agreements will be maintained with organizations necessary to maintain operations and assist with recovery efforts.

3. Supplies and other needs - The hospital will maintain memorandums of Understanding and agreements with appropriate agencies to assist in our recovery efforts.

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Lock Down Plan– Mitigation– Preparedness– Response– Recovery

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Lock Down Plan– Mitigation

1. Plan within the hospital and with federal, state & local authorities for threatening or violent situations.

2. Maintain effective communications with protective service agencies transporting potentially violent individuals or high profile cases to our facility.

3. Provide training and equipment to better prepare the hospital for an event.

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Lock Down Plan– Preparedness

1. Train staff in awareness and recognition of potentially violent situations.

2. Provide hands on staff assistance training to bring a physically violent situation under control in a safe and efficient manner.

3. Utilize door locking and personal surveillance techniques.

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Lock Down Plan– Response

1. The decision to lockdown will be based on current events.

2. Staff appointed as security will obtain the master key ring and will physically walk the exterior of the building locking and checking each door.

3. Doors leading to the lockdown area will be closed and locked or closed and staffed by designated personnel.

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Lock Down Plan– Recovery

1. The hospital or lockdown area will resume normal operations when the threat or event has ended.

2. Communication of the “ All Clear” will be to all departments.

3. Provide for physical and psychosocial needs of patients and staff with hospital Pastoral Care Department and contracted Employee Assistance Program services.

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What you need to do:– Devote time!– Read the regional HVA– Conduct your own HVA

• Pick one or two and focus on security– Implement disaster plans with security function

spelled out.• Internal / External / Lock-down

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QUESTIONS