Healthcare

 

 

https://sm.asisonline.org/Pages/Senior-Safety.aspxSenior SafetyGP0|#cd529cb2-129a-4422-a2d3-73680b0014d8;L0|#0cd529cb2-129a-4422-a2d3-73680b0014d8|Physical Security;GTSet|#8accba12-4830-47cd-9299-2b34a43444652017-07-01T04:00:00Zhttps://adminsm.asisonline.org/pages/mark-tarallo.aspx, Mark Tarallo<p>​Sadly, reports of seniors suffering from neglect and inadequate care in U.S. assisted living facilities are still common. One recent bombshell report, however, focuses on a more horrifying finding: some vulnerable seniors in U.S. nursing homes are being sexually abused by the people charged with caring for them. </p><p>The study, <em>Sick, Dying, and Raped in America’s Nursing Homes</em>, is a CNN Special Report, and it finds that the problem may be more widespread than is generally acknowledged. More than 16,000 complaints of sexual abuse have been reported since 2000 in long-term care facilities—which include both nursing homes and assisted living facilities—according to federal data sources, the report says. Currently, about 1.6 million residents live in roughly 17,000 nursing homes across the United States.</p><p>The findings are quite troubling, but not surprising, says Julie Schoen, deputy director of the National Center on Elder Abuse at the University of Southern California’s Keck School of Medicine. “This is a part of elder abuse that nobody wants to talk about, and it needs to be addressed,” she says. </p><p>The findings in the report come from various sources. Some information comes from civil and criminal court documents filed against nursing homes, assisted living facilities, and their workers. Other findings come from federal inspection reports filed by state health investigators; such reports are filed for the more than 15,000 nursing homes that receive U.S. government funding, such as Medicare and Medicaid reimbursements. CNN also conducted interviews with experts, regulators, and victims’ family members.</p><p>“The stories found in these reports range from sad to sickening,” the report’s authors say. Of the instances examined by CNN, the majority dealt with cases in which residents abused other residents. However, at least a quarter were allegedly perpetrated by aides, nurses, and other caregivers, and those cases tended to be far more serious forms of sexual assault. A smaller portion of the incidents involved facility visitors or unknown assailants. </p><p>But even with all this research, CNN reporters say it is hard to pin down a fully accurate statistical picture of the extent of the problem. “Despite the litany of abuses detailed in government reports, there is no comprehensive, national data on how many cases of sexual abuse have been reported in facilities housing the elderly,” the authors find.</p><p>For example, the 16,000-plus number of complaints only captures cases in which state officials who advocate for facility residents were involved in resolving the complaints. The actual number of all complaints may be considerably higher.      </p><p>The report also found that, between 2013 and 2016, the federal government cited more than 1,000 nursing homes for mishandling or failing to prevent alleged cases of rape, sexual assault, and sexual abuse at their facilities. But again, complaints and allegations that don’t result in a facility citation (called a “deficiency” by the U.S. government) aren’t included in the reporting system. </p><p>And state-by-state statistics reveal “just how few accusations end up being proven—whether it’s because of the extreme hurdles posed by aging victims, the destruction of evidence, or half-hearted investigations by facilities and regulators,” the report finds. </p><p>For example, 386 incidents of sexual abuse have been reported since 2013 in Illinois, but only 59 were substantiated. In Texas, only 11 of 251 reported incidents in the 2015 fiscal year were substantiated. Wisconsin reported that it didn’t have a single substantiated case in the last five years. </p><p>Moreover, many incidents don’t even reach the accusation stage. According to one U.S. government agency estimate, only about one in 14 elder abuse incidents are reported by the victim, Schoen says. </p><p>When incidents are reported, a flawed process can make substantiation unlikely. “Victims and their families were failed at every stage. Nursing homes were slow to investigate and report allegations because of a reluctance to believe the accusations—or a desire to hide them,” the authors write. “Police viewed the claims as unlikely at the outset, dismissing potential victims because of failing memories or jumbled allegations.” </p><p>For some facilities, funding problems negatively impact level of care. In many areas, reimbursement rates from government programs like Medicare are substantially below the actual cost of care, says Richard Meyer, a partner at Browning & Meyer, a law firm that specializes in elder law. </p><p>In those cases, facility administrators are constrained in what they can pay staff, and that limits their ability to make quality hires. If the state doesn’t pay out enough, the quality of care suffers, Meyer says.  </p><p>The abuse problem has not gone unnoticed by state lawmakers in the United States, and a growing number of statehouses have recently been considering and sometimes approving legislation that sets out rules of operation for surveillance cameras—sometimes called “granny cams”—used to monitor residential rooms in senior facilities.  </p><p>As of last year, about six states had passed formal statutes and regulations regarding granny cams, with activity in other states “percolating,” says Jason Lundy, a partner at Polsinelli PC who specializes in long-term care and senior housing. </p><p>Most of these state laws allow the use of granny cams if certain conditions are met. For example, cameras must be visible and all residents of the room must consent to their use, Lundy says. </p><p>However, experts say there are also practical factors that may limit the use of these cameras, such as cost, installation issues, and the reality that some families would rather move a loved one to another facility, instead of installing a camera, if an incident happened. “I’m not so sure they’ve really caught on,” Lundy says.</p><p>While officials, investigators, and medical experts agree that sexual abuse in nursing homes can be challenging to detect and prevent, there is hope that the problem can be reduced. </p><p>Experts recommend five best practices for facility managers and administrators: Investigate all claims, rather than dismissing those from “problem patients.” Preserve evidence, and don’t bathe or clean clothes or sheets when an assault is suspected. Maintain valid reporting systems for all complaints, with realistic substantiation requirements. Train staff to notice and correctly interpret observable signs of an incident. And beef up staff whenever possible, because these incidents are sometimes crimes of opportunity. </p><p>In some cases, family and staff may underestimate the senior’s powers of agency because of his or her age, and thus fail to seriously consult them. But making an effort to engage and actively listen can also help prevent incidents of mistreatment and abuse from occurring. </p><p>“Asking, ‘What would you like? Is that all right with you?’—that’s such a big issue,” Schoen says. “Many of them would love to give their opinion, if given the chance.”</p>

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https://sm.asisonline.org/Pages/Soft-Target-Trends.aspxSoft Target Trends<p>When most people think of Orlando, Florida, Walt Disney World Resort comes to mind. The world-renowned theme park makes Orlando the second most popular travel destination in the United States. But there is much more to the city than Mickey and Minnie Mouse. </p><p>Beyond the complex infrastructure that supports Orlando’s 2.3 million citizens, the city is filled with parks and wildlife, the largest university in the country, and a vast hospitality industry that includes more than 118,000 hotel rooms. And International Drive, an 11-mile thoroughfare through the city, is home to attractions such as Universal Orlando Resort, SeaWorld Orlando, and the Orange County Convention Center, the site of ASIS International’s 62nd Annual Seminar and Exhibits this month. </p><p>Hospitality goes hand-in-hand with security in Orlando, where local businesses and attractions see a constant flow of tourists from all over the world. And at the Dr. Phillips Center for the Performing Arts, which hosts events ranging from Broadway shows to concerts to community education and events, a new security director is changing the culture of theater to keep performers, staff, and visitors safe.​</p><h4>The Living Room of the City</h4><p>Open since November 2014, the Dr. Phillips Center spans two blocks and is home to a 2,700-seat main stage, a 300-seat theater, and the Dr. Phillips Center Florida Hospital School of the Arts. The building’s striking architecture, which includes a canopy roof, vast overhang, and a façade made almost entirely of glass, stretches across two blocks and is complemented by a front lawn and plaza.</p><p>After the June 11 shooting at Pulse nightclub less than two miles south of the theater, that lawn became the city’s memorial. Days after the shooting, the Dr. Phillips Center plaza, normally used for small concerts or events, hosted Orlando’s first public vigil. A makeshift memorial was established on the lawn, and dozens of mourners visited for weeks after the attack.</p><p>Chris Savard, a retired member of the Orlando Police Department, started as the center’s director of security in December, shortly after terrorists killed dozens and injured hundreds in attacks on soft targets in Paris. Prior to Savard, the center had no security director. Coming from a law enforcement background to the theater industry was a challenging transition, he says. </p><p>“Before I came here, I was with an FBI terrorism task force,” Savard says. “Bringing those ideologies here to the performing arts world, it’s just a different culture. Saying ‘you will do security, this is the way it is’ doesn’t work. You have to ease into it.”</p><p>The Dr. Phillips Center was up and running for a year before Savard started, so he had to focus on strategic changes to improve security: “The building is already built, so we need to figure out what else we can do,” he says. One point of concern was an overhang above the valet line right at the main entrance. Situated above the overhang is a glass-walled private donor lounge, and Savard notes that anyone could have driven up to the main entrance under the overhang and set off a bomb, causing maximum damage. “It was a serious chokepoint,” he explains, “and the building was designed before ISIS took off, so there wasn’t much we could do about the overhang.”</p><p>Instead, he shifted the valet drop-off point, manned by off-duty police officers, further away from the building. “We’ve got some people saying, ‘Hey, I’m a donor and I don’t want to walk half a block to come to the building, I want to park my vehicle here, get out, and be in the air conditioning.’ It’s a tough process, but it’s a work in progress. Most people have not had an issue whatsoever in regards to what we’ve implemented.”</p><p>Savard also switched up the use of off-duty police officers in front of the Dr. Phillips Center. He notes that it can be costly to hire off-duty police officers, who were used for traffic control before he became the security director, so he reduced the number of officers used and stationed them closer to the building. He also uses a K-9 officer, who can quickly assess a stopped or abandoned vehicle on the spot. </p><p>“When you pull into the facility, you see an Orlando Police Department K-9 officer SUV,” Savard explains. “We brought two other valet officers closer to the building, so in any given area you have at least four police cars or motorcycles that are readily available. We wanted to get them closer so it was more of a presence, a deterrent.” The exact drop-off location is constantly changing to keep people on their toes, he adds.</p><p>The Dr. Phillips Center was already using Andy Frain Services, which provides uniformed officers to patrol the center around the clock. Annette DuBose manages the contracted officers. </p><p>When he started in December, Savard says he was surprised that no bag checks were conducted. When he brought up the possibility of doing bag checks, there was some initial pushback—it’s uncommon for theater centers to perform any type of bag check. “In the performing arts world, this was a big deal,” Savard says. “You have some high-dollar clientele coming in, and not a lot of people want to be inconvenienced like that.”</p><p>When Savard worked with DuBose and her officers to implement bag checks, he said everyone was astonished at what the officers were finding. “I was actually shocked at what people want to bring in,” Savard says. “Guns, knives, bullets. I’ve got 25-plus years of being in law enforcement, and seeing what people bring in…it’s a Carole King musical! Why are you bringing your pepper spray?”</p><p>Savard acknowledges that the fact that Florida allows concealed carry makes bag checks mandatory—and tricky. As a private entity, the Dr. Phillips Center can prohibit guns, but that doesn’t stop people from trying to bring them in, he notes. The Andy Frain officers have done a great job at kindly but firmly asking patrons to take their guns back to their cars, Savard says—and hav­ing a police officer nearby helps when it comes to argumentative visitors.​</p><h4>Culture, Community, and Customer Service</h4><p>There have been more than 300 performances since the Dr. Phillips Center opened, and with two stages, the plaza, classrooms, and event spaces, there can be five or six events going on at once. </p><p>“This is definitely a soft target here in Orlando,” Savard notes. “With our planned expansion, we can have 5,000 people in here at one time. What a target—doing something in downtown Orlando to a performing arts center.”</p><p>The contract officers and off-duty police carry out the core of the security- related responsibilities, but Savard has also brought in volunteers to augment the security presence. As a nonprofit theater, the Dr. Phillips Center has a large number of “very passionate” volunteers—there are around 50 at each show, he says. </p><p>The volunteers primarily provide customer service, but Savard says he wants them to have a security mindset, as well—“the more eyes, the better.” He teaches them basic behavioral assessment techniques and trends they should look for. </p><p>“You know the guy touching his lower back, does he have a back brace on or is he trying to keep the gun in his waistband from showing?” Savard says. “Why is that person out there videotaping where people are being dropped off and parking their cars? Is it a bad guy who wants to do something?”</p><p>All 85 staffers at the Dr. Phillips Center have taken active shooter training classes, and self-defense classes are offered as well. Savard tries to stress situational awareness to all staff, whether they work in security or not. </p><p>“One of the things I really want to do is get that active shooter mindset into this environment, because this is the type of environment where it’s going to happen,” Savard explains. “It’s all over the news.”</p><p>Once a month, Savard and six other theater security directors talk on the phone about the trends and threats they are seeing, as well as the challenges with integrating security into the performing arts world. </p><p>“Nobody wanted the cops inside the building at all, because it looked too militant,” Savard says. “And then we had Paris, and things changed. With my background coming in, I said ‘Listen, people want to see the cops.’” </p><p>Beyond the challenge of changing the culture at the Dr. Phillips Center, Savard says he hopes security can become a higher priority at performing arts centers across the country. The Dr. Phillips Center is one of more than two dozen theaters that host Broadway Across America shows, and Savard invited the organization’s leaders to attend an active shooter training at the facility last month. </p><p>“There’s a culture in the performing arts that everything’s fine, and unfortu­nately we know there are bad people out there that want to do bad things to soft targets right now,” Savard says. “The whole idea is to be a little more vigilant in regards to protecting these soft targets.”</p><p>Savard says he hopes to make wanding another new norm at performing arts centers. There have already been a number of instances where a guest gets past security officers with a gun hidden under a baggy Cuban-style shirt. “I’ll hear that report of a gun in the building, and the hair stands up on the back of my neck,” Savard says. “It’s a never- ending goal to continue to get better and better every time. We’re not going to get it right every time, but hopefully the majority of the time.”</p><p>The Dr. Phillips Center is also moving forward with the construction of a new 1,700-seat acoustic theater, which will be completed within the next few years. The expansion allows the center to host three shows at one time—not including events in private rooms or on the plaza. Savard is already making plans for better video surveillance and increasing security staff once the new theater is built.</p><p>“We really try to make sure that every­body who comes into the building, whether or not they’re employed here, is a guest at the building, and we want to make sure that it’s a great experience, not only from the performance but their safety,” according to Savard. “It’s about keeping the bad guys out, but it’s also that you feel really safe once you’re in here.” </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/On-Site-and-Cloud-Access-Control-Systems.aspxOn-Site and Cloud Access Control Systems<p>​Back in the 1970s, electronic access control systems were rudimentary by today’s standards. Those early systems consisted primarily of simple keypads for inputting PIN (personal identification number) codes, or ID cards and readers using magnetic stripe or Wiegand technology to grant or deny access while also maintaining a record of user access. There were few choices when it came to options, integration, and vendors.</p><p>Fast forward to today: now access control systems are frequently the main control platform in a physical security system. These evolved systems allow authorized staff to move freely while keeping a facility or an area secure—and they do much more. Network connectivity allows integration with security subsystems, as well as with business and operational systems such as retail and HR functions. Open architecture designs allow for compatibility with multiple technologies. Smartphones are becoming a mainstream tool in access control systems, and they can sometimes be used in place of an access card. </p><p>Even the most basic access control solution provides some level of tracking, auditing, and reporting. The combination of advanced functionality, flexible features, and integration with other systems allows current systems to provide in-depth information that far exceeds the capabilities of earlier systems.</p><p>Considering these many sophisticated features and functions can be a challenge for the end user, who must not only select an access control system but also determine how and where it will be managed and which solution best meets the organization’s financial and operational needs. Because physical security is vital to the protection of people, premises, and assets, it’s a decision that requires understanding of the technology and the applications. Following are a few examples of the options available for managing an access control system and where they are best suited.</p><h4>Credential Type</h4><p>In addition to incorporating biometrics and other advanced access credentials, today’s solutions can support PIN pads, magnetic stripe and/or Wiegand cards, proximity readers, and other technologies that organizations already use. This provides customers with the flexibility to select the credential type that best suits their needs. </p><p>For example, magnetic stripe and Wiegand access cards offer the convenience of embedding user-specific information in addition to access privileges. Because they incorporate embedded wires as opposed to magnetic material and can be used with contactless sensors, Wiegand technologies are less susceptible to extreme temperatures and other hostile environments. Cards used in systems that require contact with readers suffer from wear and tear and therefore must be replaced on a regular basis.</p><p>Proximity readers offer tremendous ease of use and the ability to quickly deactivate lost cards and issue new credentials. Because no contact is required between card and reader, credentials don’t suffer from the wear and tear common with magnetic stripe and Wiegand systems. </p><p>PIN pads are often employed for single-door applications, and their lower cost makes them attractive to organizations with limited budgets. They are extremely easy to use but also less secure, because users can easily share their codes with others.</p><p>In addition to cost, security level, and system size, organizations must also consider each technology’s ability to work with a range of access control software, as well as the ability to deploy and manage the solution using any or all of the below models.</p><h4>User-Managed on Site</h4><p>In this scenario, the customer purchases or leases equipment from an authorized reseller/integrator, who installs the system and provides training. A service contract may be included in the sale or lease. The customer is responsible for all programming activity on the dedicated PC, including data entry and updating for names, scheduling, reports, backup, and software updates. Depending on the system, badging may also be included. Other than the installation and training and any service agreement, the reseller/integrator has no additional responsibility.</p><p>Systems managed by the user on site are ideal for small to medium-sized businesses, local government offices, sporting facilities, and the like, where one or two individuals are tasked with maintaining the database, software upgrades, and infrastructure maintenance.  </p><h4>User-Managed Cloud </h4><p>Like the on-site user-managed scenario, this version starts with equipment that is purchased or leased from an authorized reseller/integrator, who installs the hardware and provides training. The difference is that the software is in the cloud and is managed, along with the supporting infrastructure, by the integrator or service provider. All backup, software upgrades, system monitoring, programming, scheduled door locking and unlocking, and other vital access control actions are performed remotely by professional monitoring providers. The user may manage only the simple functions of entering, deleting, and modifying names, and possibly badging via a Web portal.</p><p>User-managed cloud systems work well for sites with few or no IT staff—such as franchise locations or property management sites. Each location can handle the day-to-day functions of database maintenance and scheduling via a Web portal, but reports, applying patches and updates, backup, and other group functions are handled in the cloud by the integrator. One useful advantage of this scenario is that the browser application can be accessed at any time and from any device by the user. </p><h4>Remotely Managed Cloud   </h4><p>The user has little or no access to the head end software in this scenario, and all activity is performed by the service provider. Sometimes known as ACaaS (Access Control as a Service), this service is popular with enterprise-level organizations. Hardware can be new or legacy, owned or leased. When modifications are required, the service provider makes the changes. Reports can be run and sent to the end user on a scheduled or as-requested basis. Credentialing is also handled by the service provider.</p><p>Access control systems for several organizations may be hosted in the cloud by the service provider, and the security of the data is ensured with AES encryption. Multilayered filtering and partitioning allows end users to access only their own information (cardholders, access groups, hardware, etc.), while the service provider has full access to all customers’ data.</p><p>By working with a knowledgeable technology partner, such as an integrator or vendor, users will find the help they need to identify which of these solutions best meet their needs. Expertise and experience can help the end user make better and more confident decisions about an access control installation.</p><p><em>Robert Laughlin is president at Galaxy Control Systems. </em></p>GP0|#28ae3eb9-d865-484b-ac9f-3dfacb4ce997;L0|#028ae3eb9-d865-484b-ac9f-3dfacb4ce997|Strategic Security;GTSet|#8accba12-4830-47cd-9299-2b34a4344465
https://sm.asisonline.org/Pages/Threats-to-Health.aspxThreats to Health<p>​<span style="line-height:1.5em;">Joseph Sweeney served as a New York Police Department officer for 21 years and ran his own security company—witnessing the full range of crimes and sticky situations that the Big Apple has to offer—but he never guessed what challenges were in store when he became the director of hospital police at Bellevue Hospital Center in 2010. “You can’t shut the doors and walk away. You have to deal with whatever happens. It’s a 24-7 business, and you can’t turn anybody away,” Sweeney says. “It’s like being in charge of a small city.”</span></p><p>Today, healthcare security directors like Sweeney are in charge of small cities with growing crime rates. According to a 2014 crime survey conducted by the International Association of Healthcare Security and Safety (IAHSS), the rate of violent crime in American healthcare facilities rose by 25 percent from 2012 to 2013, and the rate of disorderly conduct jumped by 40 percent. </p><p>Jim Stankevich, a past president of IAHSS, tells Security Management that the survey results reflect the need for comprehensive physical security in hospitals, especially visitor management systems—a tool that he admits isn’t always conducive to the open environments of traditional hospitals.</p><p>“Every hospital technically should know every person that enters a facility, why they’re there, and where they’re going, whether it be a contractor, vendor, patient, or visitor,” Stankevich says. “The problem is many hospitals are over 50 years old, and they probably have up to 50 entrances on the ground level, which makes it kind of impossible for them during normal business hours to really control that access.”</p><p>Sweeney points out that the hospital industry—even the security aspect—is a customer service business. “There’s an emphasis on the patient experience, and we’re a part of that,” he says. The balance between creating an open, customer-oriented environment and keeping those customers safe is a challenge, Sweeney notes.</p><p>The increase in active shooter scenarios, crime numbers, and the routine threats hospitals face on a day-to-day basis all combine to make physical security at healthcare facili­ties more important than ever. Whether it’s at a metropolitan hospital, a network of nonprofit healthcare facilities, or a research-based medical center, security directors have to employ a combination of training and technology to keep their small cities secure. ​</p><h4>Medicine in Manhattan </h4><p>Bellevue Hospital Center was founded in 1736 and is the oldest continuously operating hospital in the United States. In 2013, it housed 828 beds, and more than 115,000 people visited its emergency room. More than 80 percent of Bellevue’s patients are from New York’s medically underserved population.</p><p>Sweeney, who oversees the peace officers stationed throughout Bellevue, says the hospital’s open atmosphere presents a number of challenges when it comes to securing the facility. Many buildings in New York require identification and screening upon entering, but Bellevue’s open environment during daytime hours allows people to come and go freely, he explains.</p><p>“In a sense, we’re the softest target left, especially in Manhattan,” according to Sweeney. “You go to any other building in Manhattan and it’s difficult to get into, but the hospital is the one place that’s open. That’s the philosophy here, and I don’t disagree with that. But it does make it more challenging for security.”</p><p>Hundreds of patients, visitors, doctors, and staff move in and out of Bellevue every day, and Sweeney says one of the most difficult parts of keeping everyone safe is managing the wide variety of people who come and go. </p><p>“These are folks who are outpatients or they’re presenting themselves to the hospital for some type of service, but they have some sort of psychiatric issue, and it’s very challenging to deal with, but we can’t turn them away.” Sweeney notes. “I’d say the biggest challenge for anybody in the healthcare industry is dealing with somebody who’s emotionally disturbed or even just upset—people are sick and dying, their loved one is sick or in pain or dying, and it’s a very challenging environment.”</p><p>Indeed, the IAHSS report found that 93 percent of assaults in healthcare facilities were directed at employees by patients or visitors. This is why Belle­vue’s security officers are thoroughly trained to de-escalate almost any situation, Sweeney explains.</p><p>“We’re a part of the patient experience, and we’re a part of making sure that these people get the care that they need,” he says. “At the same time, we’ve got to keep the place safe.”</p><p>When Sweeney first came to Bellevue, no identification was required to access any area of the hospital. Over the past five years, he’s helped implement restricted access areas within the hospital with the help of access control technology while still committing to providing a positive experience for visitors, he explains.</p><p>“We couldn’t survive without the technology,” he says. “It’s really allowed us to focus our people where they need to be, and that’s important to have a good balance because this is a people business.”</p><p>For example, areas in the hospital with psychiatric patients are equipped with silent panic buttons that alert security officers of an incident. “When you’re dealing with a psychiatric patient, you don’t want to escalate the situation,” Sweeney notes. “You don’t want to call and say, ‘Hey, police, this guy is getting aggressive, come and help me.’ Just saying that makes the person more aggressive.”</p><p>Access control technology also helps keep vulnerable patients safe. Patients in Bellevue’s brain injury unit who are unable to make informed decisions for themselves are fitted with electronic tags, and security officers are notified if a patient attempts to leave his or her designated area. The hospital also uses the tags on infants in the maternity ward to track where they go and automatically lock the nursery doors should someone attempt to leave with a baby. </p><p>When it comes to preparing for out-of-the-ordinary incidents, Sweeney says he puts more emphasis on training security officers to think outside of the box rather than to follow specific protocols for a certain emergency, whether it’s a natural disaster, active shooter, or bioterrorism incident. </p><p>“We have that ‘what if’ mentality, so that if something happens we’re not totally taken by surprise,” he explains. “Those real-life drills of what we’ve done in those circumstances have trained us for the next one.”</p><p>And Bellevue has certainly seen its fair share of real-life drills. Sweeney recalls closing and evacuating the hospital during Hurricane Sandy in 2012, working around power outages and staffing shortages caused by blizzards, and more recently, housing a patient infected with the Ebola virus. </p><p>“A lot of the different things we had to deal with during Sandy, we had already had little pieces happen before, whether it was a telecommunications failure, or a power failure, or elevators knocked out,” he explains. “We’re trained to take each experience, whether it’s a real experience or a drill, and put it in our toolbox and make it adaptable so that when something similar comes along we know how to handle it.”</p><p>And although staff and security were given additional training on how to deal with potential Ebola patients, Sweeney says a lot of the same protocols—creating clean zones and hot zones and suiting up in personal protective gear—were brought over from previous bioterrorism training.​</p><h4>Pittsburgh’s Provider</h4><p>Jeff Francis jokingly calls the University of Pittsburgh Medical Center (UPMC) “one of the biggest companies that people have never heard of.” UPMC is a nonprofit network of 21 full-service hospitals and hundreds of ancillary facilities throughout western Pennsylvania. The hospitals treat more than 690,000 emergency patients annually and have more than 5,100 beds. </p><p>Francis, the security director of UPMC’s facilities, was a police officer in the Pittsburgh region before he joined UPMC a decade ago. Like Sweeney, he says he was surprised by the wide variety of threats that needed to be managed.</p><p>“Hospitals are the confluence of pretty much every risk factor that can exist as far as the propensity of violence is concerned,” Francis says. “In a hospital, you have a lot of controlled substances, you have a lot of behavioral health issues, and a hospital by its nature is a very high-stress environment in terms of patients, their families, and even the staff.”</p><p>UPMC’s security team is made up of more than 500 security professionals, including 130 armed police officers—the organization’s campuses have their own police departments. Francis is in charge of developing and maintaining the infrastructure needed to keep staff, patients, and visitors safe. </p><p>Security is assessed on a facility- by-facility basis, and Francis says he relies on access control and analytics systems to keep each location secure. Some facilities, like UPMC’s children’s hospital and behavioral health facilities, are 100 percent access controlled and have multiple layers of screening, he explains. </p><p>“Every visitor is screened by metal detectors, as well as assuring that you are registered there ahead of time so you have a reason to be there, so we confirm that there is a patient for you to see and a patient is expecting you,” Francis says. “In those cases, everybody gets a badge, you have to check in, check out, and you’re monitored pretty closely.”</p><p>On top of those precautions, the chil­dren’s hospital screens each visitor against a sexual offender registry upon entry. </p><p>Francis notes that finding a balance between protecting vulnerable patients and allowing visitation can be tricky. “We can’t lock these things down like a prison,” he says. “If someone is coming to visit a sick relative in a hospital, they don’t want to be treated the same way as if they’re going to visit a prisoner. So we have to maintain this balance between this open therapeutic environment [and managing] all these risk factors that make hospitals dangerous.”</p><p>Facilities with fewer at-risk patients are more open, Francis says. During business hours, people can walk in freely, and during off hours visitors must sign in and out. </p><p>With such a wide variety of healthcare facilities to secure, Francis relies on data-driven decision making. UPMC hospitals use D3 Security incident management software that tracks not only security and police activity, but also specific statistics, such as the number of people who enter through metal detectors, the percentage of those people who carry in banned items, and what those items are. This type of data allows Francis and his team to address trends in individual hospitals or throughout the UPMC system. </p><p>“Training topics are determined by the types of issues that we’re seeing in tracking,” Francis explains. “We’ll see spikes in certain incident types through our informational analysis, and we know we need to address that through training or other remediation processes.”</p><p>UPMC also uses risk assessment tools on individuals suspected of being a danger, Francis says. “If we have a reason to suspect that this person is prone to a violent act, technology is at the forefront for our risk assessment of that person,” he explains. “Have they been violent in the past? Do they have a criminal record? How many incidents do we have across the system that might involve that patient?”​</p><h4>Research and Recovery</h4><p>St. Jude Children’s Research Hospital in Memphis, Tennessee, is more than just a healthcare facility. The 27 buildings on its 62-acre campus house cutting-edge medical research teams and equipment, a convention center, 67,000 young patients annually, and extended-stay housing facilities for the families of those patients. </p><p>St. Jude is 100 percent donor funded and it treats children with cancer at no cost to the family. Shawn Young, the security systems coordinator at St. Jude, says he tries to be a good steward with the donor money while keeping the unique campus secure.</p><p>The combination of vulnerable patients, visitors, and researchers coming and going at all hours makes access control and visitor management vital to campus operations, according to Young. The entire campus is fenced in, and guests must check in with a security officer. Visitors are encouraged to preregister, and once they’re approved, their credentials are taken, they receive a badge, and are escorted to the correct building. </p><p>More than 600 doors at St. Jude are fitted with card readers, and Young says a staffed control room monitors entry and exit points at all hours. Guards are also present at the three extended-stay facilities on campus. </p><p>St. Jude uses video cameras for both security and treatment, which can be challenging in hospital environments due to the Health Insurance Portability and Accountability Act (HIPAA) privacy laws. Doctors and technicians use live video feeds to keep an eye on patients who need extra supervision. “We’re not recording any of it, but it’s really the first time in the history of the hospital that we’ve actually used video for any kind of clinical care and monitoring any kind of treatment,” Young says. </p><p>In the six years since Young started working at St. Jude, the campus’s video footprint has doubled—more than 400 cameras are coordinated throughout the campus. “We’re large and it looks like we’re going to get even larger,” he says. </p><p>In fact, a new combination research and treatment building partially opened last year. The first floor serves as a convention and collaboration center, the second floor is a traditional surgery and intensive care facility, and higher floors will house a computation biology department and a proton therapy unit—one of 14 in the United States. Young says the multiuse building presented some unique safety challenges, but he’s been involved in the security design from the start. This collaboration allowed Young to lay out the placement of cameras and card readers, he explains.</p><p>“We have a great relationship with our design and construction department, and we’re lucky to be pulled into these before we have a set plan in place,” Young says. “We were involved almost from the very beginning.”  </p>GP0|#cd529cb2-129a-4422-a2d3-73680b0014d8;L0|#0cd529cb2-129a-4422-a2d3-73680b0014d8|Physical Security;GTSet|#8accba12-4830-47cd-9299-2b34a4344465