healthcare security across the border. the owl and the field mouse a little field-mouse was lost in...
TRANSCRIPT
Healthcare Security Across the Border
The Owl and the Field Mouse
A little field-mouse was lost in a dense wood, unable to find his way out. He came upon a wise old owl sitting in a tree. "Please help me, wise old owl, how can I get out of this wood?" said the field-mouse.
"Easy," said the owl, "Grow wings and fly out, as I do."
"But how can I grow wings?" asked the mouse.
The owl looked at him haughtily, sniffed disdainfully, and said, "Don't bother me with the details, I only decide the policy."
Effective and Efficient Hospital Security ProgramsMost Importantly
A successful program must have a true leader at the helm...
The Soldiers and the Trench
Canada and the US: Major Challenges to Healthcare Security
What drives how the security industry and professional
associations to implement
security solutions?
Diminishing budgets
Regulatory environments
Privacy concerns
Major Challenges to Healthcare Security
Doing more with less
Evolving healthcare environments
Restraint and control restrictions
Major Challenges to Healthcare Security
Improve quality and
control costs
Expansion of security services
requirements
Continual changes in regulatory
environments
Challenges within the healthcare
industry
DO MORE WITH LESS
Focus on Quality AND Control Costs
Across the continuum, medical institutions are being tasked with controlling costs while maintaining the highest levels of patient care, safety, and privacy.
2014: A Big Year for ObamaCare
“We've also got to continue to focus on improvement in quality and safety and
decreases in cost.”
Rich Umbdenstock: American Hospital Association President and CEO since 2007
Quoted in Beckers Hospital Review – September 18, 2013
Where Are We Going?
"If you don't know where you are going you'll never know when you get there.”
International Association of Healthcare Safety and Security (IAHSS) Mission:
http://iahss.org/About/Mission-Goals.asp
Leading excellence in healthcare security, safety and emergency management.
US and Canada: Regulatory Agencies
Differences and Similarities
Regulatory Agencies
United States
The Joint Commission (TJC)National Fire Protection Association (NFPA)Centers for Medicare and Medicaid (CMMS)Occupational Safety and Health Administration
(OSHA)Worker’s Compensation BoardsState and Federal Regulating Bodies
Regulatory Agencies
Canada
Accreditation CanadaHealth CanadaCanadian Centre for Occupational Health and Safety
(CCOHS)Canadian General Standards Board (CGSB)IAHSS Healthcare Security: Basic Security Guidelines
(resource for Canada)Worker’s Compensation Boards of Canada (influencing
aggression behaviors)
Accrediting Bodies and Security
• Evaluate the facility's risk for violence:• Examine the campus• Review crime rates• Survey employees about perceptions of
risk• Take extra security precautions in the
emergency department• Conduct thorough background checks of
prospective employees and staff• Report crime to law enforcement
The Joint Commission's Sentinel Event Database is one of the nation's [US] most comprehensive voluntary reporting systems for serious adverse events in health care.
Canada Health Act
“The primary objective of Canadian health care policy is to protect, promote and restore
the physical and mental well-being of residents of Canada and to facilitate
reasonable access to health services without financial or other barriers."
Canada Health Act
Key Messages of the Act
Silent on how care should be organized and delivered
Focuses on the national Medicare program
Sets the criteria and conditions for successful insured health services
Sets national standards for provinces and territories to meet to secure federal funding
Common Concern
Patient Restraint and Seclusion
IPC and Security
Information & Privacy Commissioner
Personal Health Information Protection Act (PHIPA)
PRIVACY AND SECURITY – PRIVACY MUST BE EMBEDDED IN TECHNOLOGY DESIGN AND
SECURITY TOOLS
IPC and Security
CCTV
Body worn cameras
Sensors
Smart phones
Occupational Health & Safety Legislation
Canada’s General Duty Provision
1. Requires employers to take all reasonable precautions to protect the health and safety of employees.
2. Includes protecting employees from a known risk of workplace violence.
Note: In the US, the General Duty Clause in OSHA includes ‘recognized threats of violence’
Occupational Health & Safety Legislation
Limitations of the General Duty Clause
Workplace violence prevention regulations vary by jurisdictions in Canada BC, Ontario, Nova Scotia and some other jurisdictions have specific workplace
violence prevention regulations Quebec has ‘psychological harassment’ legislation Some jurisdictions have ‘working alone regulations’ (with implications for
workplace violence) Ontario has specific harassment legislation
States within the US vary on related legislation California requires workplace injury prevention plans Florida has laws to protect against certain types of retail violence
End to End Security
Managing Violence in the Workplace
Security management and personnel Human resources
Supervisors of facilities vulnerable to violence
Healthcare Risk Manager Collaboration
Managing Violence in the Workplace
Collaboration should include:
Training employees to identify and respond to violence
Fostering a comfortable safe work environment where employees feel free of perceived threats
Eliminating violence through risk analyses focused on creating a safe and secure workplace
Managing Violence in the Workplace
End-to-End Healthcare Security Programs involve:
Environmental sensitivities Continual efficient movement of patients, staff, visitors Patient transfers and escorts Patient watches (violent individuals, suicide watches, and flight risks) Movement of pharmaceuticals and materials Open access 24/7 in a secure environment Aggressive behavior management Crisis intervention De-escalation techniques Internal/external patrols Appropriate use of force
End-to-End Security
Improved quality and
decreased costs
Reduced liability and
incidents
Reduced risk of injury and
death
Decreased litigation for
security issues
High level security expertise and continual training leads to:
End to End Security
PTSC-Online
Canada-wide Virtual On-line Community
Networks the emergency management personnel and emergency services
Established to continuously improve the safety and resiliency of communities
Data indicates over 16,000 unique viewers have accessed the online system from 300 Canadian communities
http://www.ptsc-online.ca/
PTSC-Online - remove
Emergency management
Business continuity
Critical infrastructure professionals
Emergency services
Volunteer and professional emergency management groups/associations networking
Sharing best practices
Encourages collective efforts as an alternative to individual efforts
End to End Security
Define a definite plan of action Design to prevent accidents and
diseases Requires mandatory inclusion of
policy statement to protect safety and health of employees
States that unacceptable performance of health and safety duties will not be tolerated – including security
Occupational Health & Safety Program (OH&S)
End to End Security
OH&S Program Duties of Management
Conduct comprehensive Risk/Vulnerability Assessments and Workplace Violence Assessments
Provide safe work environment for everyone
Establish, maintain, and evaluate health and safety program
Provide health and safety training continuously
End to End Security
Prepare and Plan for Surge Capacity Create a plan for patient surge Anticipate longer wait times, crowded waiting rooms,
and high anxiety Help facilitate rapid movement of patients and families
to the point-of-care Reduce traffic congestion and anxiety Remove the ‘mob’ mentality Identify and de-escalate situations quickly
Manage access control systems - prepare for restrictive access and lock-down events
End to End Security
Security Officer RegulationsPrivate Security & Investigative Services
Act, 2005 (PSISA)
Regulates the security industry
Establishes the expected Code of Conduct for officers
Sets standards and requirements for security guard license
End to End Security
Security Officer RegulationsCriminal Code of Canada
Security guards may encounter situations that require dealing with indictments, summary or criminal offenses. All offenses must be accurately identified and categorized. Security Guards must perform according to the Criminal Code of Canada in the context of:
Liability Duty of Care Lawful authority Defense of property Defense of persons
http://www.mcscs.jus.gov.on.ca/english/PSIS/Training/SecurityGuardCurriculum/ curriculum_security_guards.html
End-to-End Security
Canadian Centre for Occupational Health and Safety
Due Diligence
Defendants must be able to prove that all precautions, reasonable under the circumstances, were taken to protect the health and safety of workers.
Responsibility on security officer to prove that due diligence was exercised.
End-to-End Security
Management Programs
Effective and Efficient Healthcare Security Programs are:
ReasonableAppropriate for hospital environmentConsider surrounding environmentCost effectiveLogicalJustifiable and defensible
End-to-End Security Programs: Where to Start
Conduct regular facility
assessments
Identify system security
vulnerabilities
Develop recommendations and
action plans
Implement appropriate
actions timely
Security Risk Assessments
End-to-End Security: How to Succeed
Identification of responsible individuals
Firm timetables and dates for completion of
remedies
Monitoring processes for
ongoing evaluation
Continuous repetition of
security assessments
Successful risk assessments must include:
End-to-End Security:How to Succeed
“Privacy is taken very seriously in healthcare, but security is a little harder to sell sometimes because it doesn’t have an ROI that’s easily identifiable. It’s more like an insurance policy.”
Chris Apgar, HIPAA compliance officer for Providence Health Plans, Beaverton, OR.
End-to-End Security:How to Succeed
Enhance security while saving money:
Leverage and collaborate with local law enforcement Collaborate with professional organizations such as
IAHSS and ASIS Provide training venues/opportunities for police Meet regulatory requirements while maintaining
partnership between hospital and police agencies Provide on-going and just-in-time training for local law
enforcement on forensic patients (reference IAHSS)
Canada and USA: Delivering Healthcare Security Services
Our Job? Fully integrate with and support the
healthcare delivery team Deliver end-to-end security solutions Adhere to all regulatory requirements Contribute to successful accreditation efforts Provide optimal security while respecting
privacy and right to access services 24/7 Provide outstanding levels of customer service
as an integral component of security services
…And like the field mouse, good leaders are innovative!
Questions?
Questions?
Lisa Pryse, CHPA, CPP
President of IAHSS
Member of the ASIS Healthcare Council
Division President of Healthcare & Chief of Company Police at ODS
Healthcare Security Solutions
Canadian Centre for Occupational Health and Safety
Vision:The elimination of work-related illnesses and injuries.
How Security Services can help accomplish the vision:Improve workplace safety with credible and relevant tools and
resources Encourage a work environment free of pain, loss or tragedyInsist Canadians have fundamental right to a safe and healthy
working environmentContinue efforts to advance health/safety in the workplaceDeploy programs, services, knowledge, commitment, action
End-to-End Security:How to Succeed
Regulations and Industry Standards Continually Evolve
Ensure security staff are thoroughly trained on appropriate regulatory requirements
Provide interim training as regulations evolve Train on industry standards Update training as industry standards evolve Ensure adherence to compliance
requirements Adhere to all local/federal laws and
regulations