Hospitals, especially those open to the public, present a unique challenge for security professionals. Unlike a private office or facility, hospitals are home to a regularly shifting population of visitors, patients and staff, where emotions often run high and emergency situations must be quickly addressed. Hospitals often have specific security protocols in place to protect their staff, patients and visitors. Contracted or proprietary full-time security force and designated medical staff should have received specialized training on the nuances of protecting hospitals. This training usually emphasizes de-escalation; the ER is not the area to have a firefight.

A Hospital Security X Factor: In-Custody Patients

While hospital security programs address a variety of topics and possible scenarios, among their greatest challenges are patients who arrive in custody. These could be individuals with mental health issues who require assistance because they wish to harm themselves or others or incarcerated individuals from correctional facilities. In fact, many hospitals have contracts with correctional facilities. The majority of these individuals do not intend to commit acts of violence, but it is still imperative for hospitals to “prepare for the worst” and develop a security program that accounts for their needs while keeping all staff safe. These situations require special measures, beyond those mentioned above, to ensure a safe and secure environment.

Four Key Issues with Hospital Security for In-Custody Patients

  1. Visitor Management: It is vital to understand and identify who has a legitimate purpose for entering the facilities – and who does not. Progressive policies such as expanded visiting hours and long visitor stays in patient rooms may reflect a compassionate approach to care, but they also complicate visitor management. This is particularly important when accounting for in-custody patients, who must be escorted at all times – if only to ensure they do not escape custody, or worse, inflict damage upon anyone in or outside the hospital.
  2. Compartmentalization: In-custody patients must be treated and tested in separate areas. These individuals should also have protection during transfers to other facilities. While it can be unsettling to see police personnel in a hallway escorting an individual, this practice ultimately makes other patients feel safer and ensures the hospital has greater control over its environment.
  3. Weapons: While firearms and less-lethal weapons are usually prohibited in a hospital environment, exceptions are made for law enforcement professionals, especially those who may be escorting a patient. It is important that the hospital’s security personnel be aware of the presence of weapons in their facility, have a clear policy regarding the carrying of weapons and ensure that escorts provide identification so armed unauthorized individuals are not permitted into the complex.
  4. Mental Health Situations: In a recent study by Mental Health America, one out of every five adults with mental illness reported that they were not able to receive the treatment they needed for reasons including lack of insurance or limited service coverage, unavailability of specific treatment types and insufficient monies to cover costs. This means the onus of mental health treatment often falls on hospitals. While mental health treatment is an essential service, those requiring it need to be monitored by escorts as well. Moreover, a hospital may place an order of protection on a patient, meaning they cannot leave the hospital until they have undergone sufficient treatment. Even if patients do not wish to leave the facility, relatives and friends could attempt to “free” them if the patient were without escort.

Steps Hospitals Can Take to Evaluate Their Security and Better Manage Risks Associated with In-Custody Patients

Healthcare facilities find these issues challenging to address because of resource allocations and the need to develop protocols for myriad circumstances. However, planning for security does not have to be an overwhelming task. Below are steps to guide leadership in preventative tactics to secure their hospitals:

  • Determine if not only security staff but also hospital staff understand and are aware of strict protocols around patients, including when to identify potentially violent in-custody patients. To gauge this, consider using an automated survey tool.
  • Review and update the operational policies relative to visitor management and security guard services’ role in ensuring in-custody patients are properly managed.
  • Evaluate access control measures, including any possible escape routes and access control to and from areas designated for in-custody patients.
  • Assess the reliance on technology and determine if the technology is actively assisting the security mission. If not, consider developing a monitoring plan that fits the hospital’s needs, such as intrusion detection systems for critical areas or closed-circuit television systems.
  • Implement training for hospital staff on security protocols and specifics such as de-escalation techniques that may be helpful when security staff cannot be immediately reached.

These recommendations can also apply to smaller private practices, medical office buildings and other health-related spaces. The ultimate goals are to ensure safety for those in the most vulnerable of positions and promote a compassionate atmosphere for healing as free as possible from the risks of violence.