Healthcare Security

Solutions for Management, Operations, and Administration

Anthony Luizzo, Bernard Scaglione, Bernard J. Scaglione

• Publisher: Productivity Press
• Year: 2022
• Print ISBN: 9781032105499
• eBook ISBN: 9781000545777
• Topic: Business
• Subtopic: Decision Making
• Index: Business

Healthcare is on a critical path, evolving with the introduction of Obama Care and now COVID-19. How will healthcare and specifically healthcare security adapt over the next few years? What tools will be necessary for healthcare security professionals and all security professionals to meet the demands of the transforming security environment? Security professionals need new tools and programs to adapt security services to the "New Normal." As healthcare emerges from pandemic threats, active shooter and workplace violence will re-emerge and new threats related to civil unrest, fraud, mergers, and further financial struggles will change how healthcare security will function.

Healthcare Security: Solutions for Management, Operations, and Administration provides a series of articles related to the management and operations of healthcare security which will assist healthcare security professionals in managing the "New Normal" now and into the future. It is a collection of previously published articles on healthcare security and general security covering various topics related to the management of healthcare security and provides information on general security operations. It also includes unconventional topics that are necessary in the administration of healthcare security such as auditing principles, fraud prevention, investigations, interview and interrogation techniques, and forensics.

Chapter 1 The Changing Face of Healthcare Security

DOI: 10.4324/9781003215851-1

How has Hospital Security Changed Since 9/11?

Anthony Luizzo and Bernard J. Scaglione

The tragic events of September 11, 2001 brought about the myriad of security-related changes in hospital security. Gone are the days of unrestricted access into hospitals, municipal buildings, bridges, tunnels, and mercantile establishments. In today’s security-conscious atmosphere, hospitals must now screen all persons entering their facilities. Beyond stricter guidelines in controlling ingress and egress and enhancing infrastructure security, the horrific threat of terrorism has put taxing demands on all hospitals across America to be better prepared to medically treat massive amounts of people rapidly. In a 2003 Office of Homeland Security (OHS) publication entitled The National Strategy for the Physical Protection of Critical Infrastructures and Key Assets, hospitals are identified as a key link in the defensive chain against terrorism. The report goes on to mention that hospitals serve as the primary caretaker of emergency services personnel, injured attack victims, as well as serving as a community-wide haven for area residents. Moreover, the report highlights the need for formulating protective strategies to thwart contamination, theft of toxic agents, and sabotage.

Hospital Security Prior to 9/11

Historically, hospitals offered free unobstructed access to inpatients areas. As a matter of course, prior to 9/11 this trend was on the rise, due in large measure to increased competition between hospitals. In fact, many healthcare institutions had or were contemplating establishing a totally free unrestricted access control program.

Hospital Security Post 9/11

Changing times require changing strategies. At the urgency of OHS, healthcare institutions are being asked to begin screening all incoming persons, consider extensive upgrades of electronic technologies (i.e., security television, card access and manual and/or electronic locking systems), and commence purchasing access capturing systems such as turnstiles, magnetometers, and video pass systems. To better protect against sabotage and theft, healthcare institutions are being asked to conduct security surveys of high-risk locations including but not necessarily limited to pharmaceutical storage rooms, parking garages and research facilities that hose critical biological, chemical, and radiological agents.

In addition, other equally critical areas including utility distribution rooms, emergency generators, medical supply areas, gas and oil tanks and oxygen and medical gases distribution points and storage areas should also be surveyed. All storage areas which house pharmaceuticals used to treat victims exposed to radiological, chemical, biological agents must be kept secured and access adequately restricted. Environs that house radiological, biological, and chemical waste must be secured to terrorists cannot gain access to potentially harmful substances.

Finally, teaching and research facilities that utilize radiological, chemical, and biological agents need to be added to the periodical survey list.

Dealing with Identified Threats

The Office of Homeland Security recommends that hospital’s utilize physical security measures such as dead bolt locksets, door alarm contacts, card access technologies, a closed-circuit television (CCTV) to secure and restrict access into these high-risk areas. In addition, OHS suggests periodical monitoring to ensure that these areas are not compromised.

Response to Catastrophic Occurrences

Since 9/11, hospitals have changed their emergency response procedures. Today, when a catastrophic disaster occurs, hospitals restrict access to everyone to adequately screen incoming persons for contaminated agents. From a disaster preparedness perspective, access portals that have historically never been closed are now being shut down, entry doors that have never been locked are now being shunted from the access grid. In emergencies, hospital security operatives are being asked to refuse entrance and/or at the very least screen all persons wishing to gain entry so that they can screen for contaminates, the screening process outside the facility re their whereabouts at the time of the disaster to determine whether the person might have been exposed and possibly infected.

Hospital personnel and security operatives are receiving state-of-the-art training to identify and handle toxic exposures. This training often includes:

• How to effectively screen persons from outside of the hospital?
• How to spot exposed persons?
• How to properly wear “Tyvek” body suits, masks, and knee-high latex gloves?

Furthermore, OHS is requiring all hospitals in the US with emergency room services for injured persons to provide decontamination services for injured persons. This means hospitals must be able to identify certain basic toxic agents and provide decontamination services to patients and emergency service workers before they enter the emergency room for treatment. Hospitals are now required to stockpile certain immunizations for emergency distribution. Drugs needed for chemical and biological exposure are now stored in hospital pharmacies for emergency distribution. Certain hospitals located in strategic geographical sections of the country are being asked to stockpile certain immunizations in environmentally secure housings for rapid distribution to area hospitals.

Disaster Management Training

Since the early 80’s, hospitals have been required to conduct disaster drills annually to test internal procedures in the treatment of injuries sustained during a flood, tornado, or plane crash. Since 2000, hospitals have been asked to drill for mass casualty incidents related to bombs and exposure to chemical, biological, and radiological agents. Handling mass casualty incidents has been on the minds of the federal government since Y2K. Since 9/11, hospitals are required to not only drill on handling mass casualties, but they must also coordinate these drills with area hospitals, local governments, and private corporate entities. Hospitals must have a plan to evacuate their respective facilities and transfer patients to other area hospitals. Further, hospitals must have written legal agreements with area vendors and local police agencies to ensure the delivery of goods and services in the event of a major disaster.

Ten Questions to Ask when Evaluating Security Compliance

1. Is the healthcare institution in compliance with Homeland Security mandates?
2. Does the hospital have a written disaster preparedness plan?
3. Does the plan meet local law enforcement and fire department mandates?
4. Are disaster drills held to test the plan?
5. Are hospital security personnel trained in handling catastrophic occurrences?
6. Is physical, procedural, and technological security adequate?
7. Are storage facilities warehousing biological, chemical, and radiological agents secure?
8. Are storage facilities warehousing immunizations secure?
9. Does the institution have a catastrophic emergency evacuation plan?
10. Are periodical security surveys performed to evaluate facility risk exposures?

A Final Word

Without a doubt, hospital security has dramatically changed since that terrible day in early September 2001. As we journey through the 21^st century, senior hospital security executives are playing a central role in ensuring that all hospital security programs, including disaster protection management follow federal, state, and local legislative mandates. The security executive may very well be the additional eyes and ears corporate America can rely on to help spot and stop future terrorist attacks from immobilizing our healthcare network.

Aspects of Hospital Security: How is Hospital Security Changing in the New Century?

Anthony Luizzo and Bernard J. Scaglione

Hospital security will change dramatically in the new millennium. The 21^st century will bring a myriad of initiatives, including violence reduction programs affecting patients, visitors, and staff; heightened security regarding patient’s medical information; and a shortage of budgetary funds for protection initiatives.

Legislative Initiatives

In June 1995, the Occupational Safety and health Administration (OSHA) published Guidelines for Preventing Workplace Violence for Health Care and Social Service Workers. Their studies concluded that health care workers had the highest incident of assault compared to other professionals. Moreover, the study recommended that hospitals and other health-related organizations consider implementing physical security measures to reduce verbal and physical assaults. In addition, to the federal OSHA guidelines, individual states have legislated the development and implementation of programs to protect workers against violent incidents. This legislation necessitates the implementation of programs to reduce violence in the workplace and requires companies to formulate plans to handle violent situations. Many hospitals have delegated these anti-violence initiatives to the security department. As a matter of course, security personnel are taught to properly respond to disruptive patients, visitors, and staff and are trained to verbally deescalate and physically restrain individuals who become verbally threatening or physically abusive.

Beyond OSHA regulations, the U.S. Congress, along with some states, legislated a patients’ bill of rights in 1996. This federal legislation, known as the Health Insurance Portability and Accountability Act, addressed the need for enhanced protection of patient’s medical information. Among other issues. The Act contained a provision that gave Congress until August 21, 1999, to pass comprehensive privacy legislation. When Congress did not enact privacy legislation by that date, the law required the Department of Health and Human services (HHS) to craft such protections by regulation. The final rule took effect on April 14, 2001. This rule gives patients greater access to their own medical records and more control over how their personal health information is used. The rule also addresses the obligations of health care providers and health plans to protect health information. Hospitals will be required to provide physical security controls for medical information and implement policies to restrict and monitor the distribution and release of medical information. Enhanced protection requisites will most likely mandate that hospital security departments install access control mechanisms and technologies in medical record departments and medical chart storage environments.

In addition, to physical security enhancements, desktop and network computer safeguards and computerized document-tracking systems will be required. By law, covered entities (health plans, health care clearinghouses, and health care providers who conduct certain financial and administrative transactions electronically), have until April 14, 2003, to comply.

Guidance and other technical assistance materials are posted on the HHS ‘s office for Civil Rights website at www.hhs.gov/ocr/hipaa.

Security Budget Issues and Emerging Technology

Hospital security operations will face increased financial hardship in the new millennium due in large part to Diagnostic Related Treatment Groups and Health Maintenance Organizations that limit the amount of revenue hospitals collect on a specific patient illness. These shortfalls will most definitely affect security budgets. To meet the challenge of shrinking security dollars, security departments will have to rely on technology-driven systems. In the new century, the use of electronic resources such as closed-circuit television, access control, and physical security applications will become increasingly more important than the use of security personnel. From a managerial point of view, security administrators will need to be more knowledgeable in security technology and products. Security services will be geared toward the identification and restriction of persons utilizing hospital services, visiting patients, and workers within hospital entities. Security executives must be capable of identifying and reducing access to patient information and provide protective services with a high level of efficiency at low cost.

Establishing a Proactive Security Initiative

Beyond the expanded utilization of security-related technologies, security executives will have to change their mindset from the reactive model of security and law enforcement to the more proactive model of deterring and preventing potential sources of crime. The establishment of a crime and loss prevention capability gives the security department the...

Table of contents

• Cover
• Half Title
• Title
• Copyright
• Contents
• Preface
• Acknowledgements
• About the Authors
• Introduction
• 1. The Changing Face of Healthcare Security
• 2. Security Management
• 3. Disaster Preparedness
• 4. The Security Survey
• 5. Practical Crime Prevention
• 6. Metrics and Data Application
• 7. Physical Security Applications
• 8. Customer Service Initiatives
• 9. Auditing and Forensics
• 10. Fraud Detection and Prevention
• 11. Interview and Interrogation
• 12. VIP Protection
• Index