Healthcare

 

 

https://sm.asisonline.org/Pages/Securing-Service--How-Security-Is-Helping-The-Children-Of-Camden-County.aspxSecuring Service: How Security Is Helping Camden County’s ChildrenGP0|#3795b40d-c591-4b06-959c-9e277b38585e;L0|#03795b40d-c591-4b06-959c-9e277b38585e|Security by Industry;GTSet|#8accba12-4830-47cd-9299-2b34a43444652017-11-09T05:00:00ZMaria P. Emerson, Maria Franchio, Dana Gussey, and Paul Sarnese<p>​The environment in which children grow up can shape their behaviors and influence their health, studies show. The social and economic features of a community can have major implications on mortality, general health status, disabilities, birth outcomes, mental health, injuries, violence, and other important health signs, according to a brief published by the Robert Wood Johnson Foundation Commission to Build a Healthier America.​</p><p>Camden City in Camden County, New Jersey, is directly across the Delaware River from Philadelphia, Pennsylvania. Although it is surrounded by some of the wealthiest communities in New Jersey, it’s ranked the poorest and most crime-ridden city in New Jersey. Neighborhood Scout—an online research group—ranked Camden City as the fourth most dangerous city in 2017. </p><p>This is because with a population of 70,309 people, Camden City had 1,895 violent crimes in 2014—meaning the city averaged 25.66 violent crimes per 1,000 residents. That rate is six times higher than the national average of 3.8.</p><p>Additionally, Camden City is among the poorest cities in the nation. The unemployment rate is 30 to 40 percent, with a median household income of $26,000. In 2011, a <em>Rolling Stone</em> report found that a quarter of a billion dollars was being made in revenue from about 175 open-air drug markets, but the annual tax income was only $24 million.</p><p>Virtua is a large healthcare system serving southern New Jersey that provides care through three hospitals (Virtua Marlton, Virtua Memorial, and Virtua Voorhees), three health and wellness centers, two long term care and rehab centers, three medically-based fitness centers, 16 mobile intensive care units, and a variety of outpatient health services. Virtua also has two satellite emergency departments.</p><p>The healthcare system’s mission supports health, wellness, and accessibility to all. Beginning in late 2013, Virtua began making strides to promote the health and well-being of the children in Camden City when the Early Intervention Program (EIP) became a comprehensive agency in Camden County.</p><p>EIP provides a variety of therapeutic and support services to help infants and toddlers with developmental issues. As part of the program, practitioners—including physical therapists, occupational therapists, speech-language pathologists, social workers, special education teachers, behaviorists, and teachers—help children from birth to age three overcome delays.</p><p>During 2011, 2012, and most of 2013, most of those in Camden City who were eligible for EIP had difficulty receiving timely services. Services are considered timely when they start within 30 days of a plan being written. Camden City’s national reputation as a high crime area made it difficult for healthcare providers to ensure their own safety, limiting their ability to respond to requests for services through EIP.</p><p>In 2013, more than 200 children in Camden County waited more than 30 days for their services to start—waiting an average of 48.39 days with a longest wait of 121 days. This not only affected families in Camden County, but also held up other children on the list for services because if the first child on the waitlist was from Camden City, he or she had to receive services before other children further down the list could receive services. With no practitioners available, the number of children served decreased over time while the wait time for services increased.</p><p>The security department of 19 full-time employees and several part-time employees assigned to the Virtua Camden campus provides routine and emergency services to the entire campus, as well other services: producing ID badges, managing beepers, managing the lost and found, receiving package delivers, handling patient belongings and valuables, and providing nuclear medicine escorts and vehicle assistance.</p><p>When the notion of providing security escorts to EIP staff was proposed, the security department rose to the challenge. Each officer volunteered to be available for patient visits, realizing how important it was for young children in Camden to receive the EIP services.</p><p>To set up a security escort, EIP staff would call the security department—at least two days before the service was needed but no more than five days in advance—and provide the date the service was needed, the pick-up time, and the drop-off time. EIP staff also shared their cellphone number so they could be reached.</p><p>The security department then logged the information into an Early Intervention & Home Care Security Escort Form that included the practitioner’s name, cell phone number, and estimated start and end times. Then, from a list of available officers, the department would contact officers to fill the security escort—preference was given to non-overtime per diem, part time, and pool officers. If a security officer was not available, the department would contact the EIP manager. </p><p>When practitioners arrived on campus, the assigned security officer would travel with the practitioner—in his or her personal vehicle—to the appointment location. The officer then stationed themselves outside the location, unless specifically invited to enter, to respond to any signs of distress and protect the practitioner’s vehicle. </p><p>The value and success of the security escort program continued the EIP’s growth. Within a few months, the security escort service expanded as the department became critical in supporting the EIP. In December 2013, the department provided 20.75 hours of security escorts per month and the average wait time for children waiting for services dropped from 48 days to 12.</p><p>By October 2014, the service had expanded to provide 83.50 hours per month, and continued to grow. A mother and her child were also invited to share their experience with the EIP at a holiday staff meeting and the difference the service made to her family.</p><p>The mother explained that children only have a small window of time to receive early intervention services because when they reach 36 months of age, they are no longer eligible to receive services. By reducing the wait time for services, the security department was able to ensure more children were reached, and their needs were identified and addressed.</p><p>In 2015, the security department saw a decrease in the number of calls it was receiving for escort services. Department leadership contacted the EIP leadership to discuss the decrease, and found that EIP staff had become more comfortable providing services within Camden City without a security presence. The EIP staff said they felt welcomed by the residents and that the residents knew they were providing valuable services to the children of Camden. </p><p>Meanwhile, the number of services that the EIP provides has continued to grow in Camden County—increasing from 284 in 2012, to 294 in 2013, 4,123 in 2014, 6,302 in 2015, and 7,978 in 2016.</p><p><em>Maria P. Emerson, MA, CCC-SLP, is the director of the Virtua Early Intervention Program. Maria Franchio, PT, is AVP of Virtua Rehabilitation Services. Dana Gussey is a public health major at Stockton University and an intern in the Virtua Safety Department. Paul Sarnese is the AVP of safety, security, and emergency management for the Virtua Safety Department. ​</em></p><p><br></p>

Healthcare

 

 

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https://sm.asisonline.org/Pages/Culture-of-Caring.aspxCulture of Caring<p>​<span style="line-height:1.5em;">Hospitals are open environments, which is chiefly what makes them welcoming to people in need of care. But that feature also means that security must be a top priority to protect both caregivers and patients. Baptist Health Care in Pensacola, Florida, is a community-owned, nonprofit healthcare network that services northwest Florida and southern Alabama. With six locations, including three hospital campuses, the healthcare organization is constantly seeking ways to improve its environment of care, says Mike Viola, director of support services. “Patients specifically are here because they don’t feel well or they need healing, so we need to maintain a healing environment,” he says, “and there is a need for security in that healthcare environment to maintain safety and order.”</span></p><p>Viola tells Security Management that the Gulf Breeze campus, which includes Baptist Health Care’s largest hospital, has a strong security posture. There is a central monitoring station where security cameras are observed around the clock. There are callboxes around the perimeter for anyone who may run into trouble or have an incident outside the facilities. In addition, the hospital contracts with a guard service provider to provide a constant security presence. The hospital is also accredited by the Joint Commission, a regulatory group that certifies healthcare facilities and conducts a review of security management plans.   </p><p>With that in mind, when the previous guard service provider’s contract was running out at the Gulf Breeze Hospital campus, Baptist Health Care launched a request for proposal (RFP) process to find the right candidate to start a new contract. It worked with MedAssets, a healthcare performance improvement company, to develop the RFP. </p><p>Viola says Baptist needed a service that would be cost-effective, given tight budgets. But it was also critical that the company it chose understood the unique needs of a healthcare environment and was a good fit for its culture. “We weren’t dissatisfied or displeased with our contract provider [at the time], but we were looking to enhance and improve the level of service we received,” he says.</p><p>During the RFP process, MedAssets approached ABM about vying for the contract. Viola says that ABM stood out among the three companies Baptist ulti­mately interviewed. “ABM was a very good fit with our culture,” says Viola. “They had the level of experience we were looking for, and they were confident in the healthcare security industry.” In April of this year, ABM began its contract to provide guard services at the Gulf Breeze campus. </p><p>To familiarize incoming officers with its culture, Baptist Health Care has an onboarding process for new security personnel that includes online learning modules and classroom training. “The security officers, if they showed up on post without truly understanding our culture, we would have a disconnect,” says Viola. In addition, security officers in Florida are required to undergo separate, state-run healthcare security training. Some of the ABM officers at Gulf Breeze are armed and must undergo additional training. While some officers carry guns, Viola says Baptist Health Care has looked into nonlethal weapon use, such as Tasers, but it has not deployed such devices.</p><p>One value-add that Viola says ABM provides is its own proprietary security technology, called OfficerPulse. The software, which is installed on tablets carried by officers and in patrol vehicles, provides the guards with real-time information about the campus they are protecting and a log of activity. From this portal, guards can also complete reports, and pins can be dropped via a GPS map on locations where service is required. </p><p>In addition to its proprietary software, ABM introduced Gulf Breeze Hospital to FAST-PASS Visitor Management Solutions. The system provides instant visual verification of known visitors and alerts the security desk when a visitor comes in so they can be properly identif­ied and receive a temporary badge. Viola says that this visitor management solution is a great fit for the hospital, which goes down to a single point of entry at the emergency department entrance after-hours. </p><p>Viola adds that the emergency department is one part of the facility where added security measures are in place. The hospital is located in an urban environment. “We utilize our partnership with our local law enforcement agencies and use those off-duty officers for a presence, most often in the emergency department,” he says.</p><p>One challenge faced by the officers is patients or visitors who carry weapons—Florida is a concealed-carry state. Although Baptist Health Care has installed metal detectors to help deter this potential threat, often a weapon is discovered long after the person has been in the facility, such as during the diagnostic process. </p><p>“It’s very important that our officers know how to respond to that and use the appropriate level of response, and to not overreact,” says Viola. He notes that law enforcement–and sometimes family members–become involved to help remove the weapon from the premises. </p><p>Another aspect of ABM officers’ duties is de-escalation training, which helps them properly defuse a tense situation. Viola says that the behavioral health department is a common setting where this training is put to use; but it can be seen anywhere in the hospital at any time, depending on the situation. </p><p>“You’re dealing with patients that are all different backgrounds and medical issues and visitors too, and you have to control the entire environment,” notes Viola. </p><p>Slip and fall incidents are common around the perimeter of the campus, especially in the parking lot. When such accidents happen, Viola notes that the guards are the first ones on the scene. Af­ter an officer reports an incident, he or she must undergo a root-cause analysis process so that future situations can be prevented or handled even more efficiently.</p><p>Viola says that investing in its officers is investing in its healthcare network. That investment paid off recently when ABM officers successfully escorted a recently terminated employee off of the hospital grounds. </p><p>“Security officers are the eyes and ears of the organization. They’re often the first people that a patient or visitor sees when they arrive on campus…so they truly are ambassadors to our hospital,” he says.   </p>GP0|#cd529cb2-129a-4422-a2d3-73680b0014d8;L0|#0cd529cb2-129a-4422-a2d3-73680b0014d8|Physical Security;GTSet|#8accba12-4830-47cd-9299-2b34a4344465
https://sm.asisonline.org/Pages/Guns-and-Healthcare.aspxInfographic: Guns & Healthcare<p>​<img src="/ASIS%20SM%20Article%20Images/guns-healthcare-infographic-FINAL.jpg" alt="" style="margin:5px;" /></p>GP0|#cd529cb2-129a-4422-a2d3-73680b0014d8;L0|#0cd529cb2-129a-4422-a2d3-73680b0014d8|Physical Security;GTSet|#8accba12-4830-47cd-9299-2b34a4344465
https://sm.asisonline.org/Pages/Responding-to-Violence-in-Healthcare.aspxResponding to Violence in Healthcare<p>​</p><p>Violence in healthcare settings—especially in hospital emergency departments—is on the rise. A well-trained security team working in concert with the medical team can help manage this increasing violence.</p><p><strong>The problem.</strong> In February 2017, The Joint Commission, a healthcare accreditation organization, reported, "Anyone in a health care facility can become a victim of violence. Since January 2010, The Joint Commission has received 201 reports from its accredited organizations of violent criminal events. Excluding the 16 reports of shootings…the database includes 118 reports of rape, 32 reports of homicide, 28 reports of physical assault, and seven reports of sexual assault." More than half of the incidents were patient-on-patient violence; six of the physical assaults were patient-on-staff violence.​ </p><p>While healthcare workers make up less than 10 percent of the U.S. workforce, there are nearly as many violent injuries in the healthcare industry as in all other industries combined, Alexia Fernández Campbell reported in a December 2016 article in <em>The Atlantic.</em> She also cited a 2015 study, where 76 percent of nurses at a private hospital system in Virginia said they had experienced physical or verbal abuse from patients in the previous year. </p><p>According to The Joint Commission, "A recent Occupational Safety and Health Administration report on workplace violence in healthcare highlights the magnitude of the problem: while 21 percent of registered nurses and nursing students reported being physically assaulted, more than 50 percent were verbally abused…in a 12-month period. In addition, 12 percent of emergency nurses experienced physical violence, and 59 percent experienced verbal abuse during a seven-day period." </p><p>The California Division of Occupational Safety and Health adopted standards requiring hospitals to establish workplace violence prevention plans to protect healthcare workers and other facility personnel from aggressive and violent behavior. To identify risks, to report them, and to annually evaluate them are normal safety requirements in at least 16 U.S. states. </p><p>Joint Commission standard EM.02.02.05, EP 3 calls for hospitals to clearly explain how personnel are to respond to violence in their management plans. Specifically, "The Emergency Operations Plan describes how the hospital will coordinate security activities with community security agencies." Hospitals are to include preparation for emergencies such as an active shooter situation. </p><p><strong>Training.</strong> When the incident rate of aggression is high, the security team can be trained to use advanced confrontation techniques which enable them to manage the most aggressive patients. Of course, security officers work under the supervision of medical staff, and they should use only defensive techniques to control patients. </p><p>Training for de-escalation and other responses to aggressive behavior is provided by such companies as Crisis Prevention Institute, MOAB Training International, and AVADE. It is important for the trainer to address the healthcare facility's security management plan during the sessions. </p><p>Security officers can learn verbal judo and simple defensive techniques in as little as four hours; however, those working in high-incident areas will benefit from longer training sessions. Costs usually include a student workbook, the trainer's fee, and the student's wage. </p><p>At one facility where more than 20 patient watches occur each day, the staff is subject to potential violence. The immediate availability of highly trained security specialists helps to keep the area as safe as possible. The security team finds weapons, places aggressive patients into restraints (on medical authority), and occasionally assists police with responses to violence in the hospital. </p><p>The training of the security specialists at that facility focuses on use of the AVADE (Awareness Vigilance Avoidance Defense Escape/ Environment) defensive techniques. This training shows how a 120-pound person can quickly take down an attacker weighing more than 250 pounds. Size of the security officer is not as important as the quality of the training. </p><p>Proper training can not only improve the security response but also help prevent injuries to security, staff, and patients. When medical staff observe a demonstration of a physical response by a well-trained security officer, confidence in the whole security team is enhanced. </p><p>Securitas has five area trainers who provide de-escalation training and emergency department response team training at a large healthcare system. In class, the trainers address the safety issues of the environment, position of staff, responses to aggressive behavior, and restraints. After such training, the medical staff and the security staff work much more efficiently together. Additionally, the trainers provide security awareness training for all staff for normal security issues such as identity theft, safety in parking lots, and other personal safety issues. </p><p><strong>Response.</strong> Techniques for responses to aggression usually address early identification of violence or escalation of violence so that efforts to de-escalate could prevent a crisis, such as an assault. Security teams working in the emergency department are in position to identify the escalation of unacceptable behavior. When intervention is needed, the security team and medical personnel should work together as a response team. </p><p>Typical incidents to which security may respond are: a person with a severe behavioral health disorder who becomes combative; a dementia patient who walks away from healthcare, is lost, and does not communicate coherently; and a drug seeker who threatens medical staff when specific drugs are not prescribed. All of these examples may result in injury to the medical staff if physical intervention does not occur promptly. Security officers may attempt to de-escalate and control the patient so that the medical staff are safe to continue their work. </p><p>In one situation, police responded to de-escalate a behavioral health patient. When the situation appeared to be safe, the officer left the facility. While walking out of the building, the patient attacked the officer and removed his weapon. The security supervisor quickly took hold of the patient and removed the weapon from the patient. With the help of other security officers, the supervisor controlled that person until the police arrived, and arrested the assailant. This is just one of many examples in which the security staff, using physical skills authorized by post orders, successfully responded to an incident. </p><p>Fortunately, in most incidents where the security team responds to assist medical staff, the situations are resolved satisfactorily through verbal persuasion, and the aggressive person is escorted away. Security will conduct an investigation, record the details of the incident, and make notifications as required by policy. In those rare situations that demand a police  response, the security team manages the situation and provides police information. </p><p>One key for success is that the security team understands the medical protocols and that the medical team understands the security protocols. In other words, they must work as a team to keep the environment safe. In a monthlong study at one hospital, there were 59 CODE Gray calls—requests for security response to an aggressive person. In 30 of those instances, physical restraints were applied on request of medical staff. </p><p>Early reporting of an escalating situation and early involvement of the security team is critical for reducing risks. The security team can manage the aggressive persons, de-escalate them if needed, and move them either back to medical care or away from the conflict area if the medical team has completed any treatment. The security response helps to reduce risks to medical staff, helps to keep them safe, and saves them time from working with potentially aggressive persons. And finally, the security team reports back to the medical team after situations are resolved. </p><p>Teamwork and proper training help a security team to manage critical incidents of aggressive behavior that occur almost daily in healthcare. </p><p><em>Lee Cloney, CPP, is region director of training and development for Securitas Security Services USA. He is a Certified Healthcare Protection Administrator (CHPA) and serves on the ASIS Foundation Board of Trustees.​</em></p>GP0|#3795b40d-c591-4b06-959c-9e277b38585e;L0|#03795b40d-c591-4b06-959c-9e277b38585e|Security by Industry;GTSet|#8accba12-4830-47cd-9299-2b34a4344465