Whether private security at an organization or law enforcement in a town, city, or county, the role of these professionals is essentially the same; provide the highest level of safety and security possible while protecting the dignity, rights, and freedom of those that you serve. In addition, “[h]ealthcare security departments derive their missions from the goals of the institutions that employ them” (Patterson, 2010, pg. 2-1). In healthcare organizations, it can be particularly difficult to balance these needs. Healthcare institutions often see people on the worst day of their lives. People are sick, scared, vulnerable and often defensive. Because of this, situations can quickly escalate disproportionately and then just as rapidly decompensate.
Hospitals are safe havens; places of refuge. They are often wide open for you to come in and seek needed care and attention. Once inside, you quite often have nearly complete access to roam the halls and inner sanctums of the institution. You may be sent from the emergency department (ED) to x-ray, or pharmacy, or any other number of departments. People looking for their sick or injured friends and family are often encountered wandering the corridors. However, it is not infrequent that so are rival gang members looking for their fallen friends; or worse, looking for their rivals. Sometimes it is a distraught family member—not unlike the recent Johns Hopkins Hospital shooting that left a doctor gravely wounded and the shooter, and his mother, dead. Possibly even more ominously, it is also becoming increasingly common around the world for terrorists to target hospitals; either as a secondary target or in an attempt to increase the death count from the primary attack. Attacks staged at ED’s world wide are numerous enough over the past few years that a simple Google search will provide dozens of cases—and these are only the most well known.
Despite the inherent dangers that a hospital may face, it simply cannot function in a lock down state. Access can only be marginally restricted—no hospital wants to face a lawsuit from the family of a patient who died because they could not gain access through Gestapo-esque security measures—yet healthcare workers need to feel safe enough, and themselves unencumbered enough, to perform their critical lifesaving tasks. It is a delicate balance between basic security procedures, environmental and design features, increased awareness, and ample training.
Starting at a facility level, hospitals can—and many do—adopt principles of Crime Prevention Though Environmental Design (CPTED). These principles create a safer environment by controlling variables that allow for criminal activity, such as changing the accessibility and desirability for criminal elements. Additionally, many institutions are increasing their use of access control systems, magnetometers, bullet proof glass, safe rooms, and other more overt security features. At the personnel level, facilities are much more commonly requiring background checks as a condition—and in some cases ongoing condition—or employment.
Despite the various potentials for dangerous interactions or criminal/terrorist events at a hospital, the security staff has the responsibility to provide high level security while maintaining, if not enhancing, the workplace atmosphere for the employees; enforcing the rules without impeding on their liberties. This is largely done through a mixture of active processes on the part of the security team. They must present themselves as professionals—especially in a historically conservative field of professionals—as well as take every opportunity to network, build relationships throughout the institution, and gain respect. Their mission is not unlike that of community policing; gain the trust of the community and they will work with you in a partnership for a common goal. It is imperative that the security force not only discusses their agendas, but takes the time to listen to the needs of the employees whom they serve. Building partnerships and relationships with individual units can lead to critical exchange of information that not only benefits both parties, but fosters a mutual respect for the role and function of the other party. The security force can use these partnerships as avenues for exchanging ideas, focusing training, and cultivating the most powerful security tool available; an engaged and well informed staff that understands, supports, and extends the presence and role of security throughout the institution.
By developing a mutually respectful relationship with each department of a hospital—while being sensitive of their particular needs—security can cultivate partnerships that promote the mission of all stakeholders. For security to be truly effective, it requires the respect and participation of the population that it serves. By enhancing training, highlighting the objectives of the security department—and how they are mutually beneficial as well as taking the time to explain why things might be handled in a particular way—security can ensure the completion of their mission while protecting the rights of those they serve.
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Patterson, E. (Ed.). (2010). Basic training manual for healthcare security officers: fifth edition. Glendale Heights, IL: International Association for Healthcare Security and Safety.
