Tom Smith, CHPA, CPP, has worked in the healthcare security field since 1981, having held several progressively senior positions in a variety of healthcare facilities. PalAmerican Security recently had the opportunity to speak with Tom who is President and Principal Consultant of Healthcare Security Consultants Inc., which assists healthcare organizations in developing and maintaining reasonable, appropriate, cost-effective, and defensible security programs across the United States.
From your experience working first in the healthcare system and now with your company, Healthcare Security Consultants Inc., is it your sense that the healthcare security industry is progressing in the right direction?
I certainly believe the healthcare security industry has progressed in the right direction, which I’ve witnessed over the course of my career. I began working in a small community hospital in 1981, spending several years there before moving to a large inner-city medical center, and then to a healthcare system with multiple locations in the university and community hospital settings. I’ve noticed that there is currently much more engagement from senior leadership ranks in terms of what security measures are being taken and which best practices are effective. There is also an enhanced level of professionalism amongst those who are providing security and safety.
Hospitals are forging ahead with their programs and are challenged to do things as economically as possible while still maintaining quality. This is where organizations like the International Association for Healthcare Security and Safety (IAHSS) are helping the industry move forward and set new standards. IAHSS is enhancing security for hospitals around the world by publishing guidelines, providing education, resources, and leadership. Through the dedication of IAHSS and its members, the American Hospital Association and nursing professional associations are now working alongside one another.
I have also witnessed an enhanced regulatory effort attempting to address security concerns and this has resonated across the industry, requiring organizations to adjust policies and procedures. The IAHSS guidelines that utilize proven best practices in all areas of hospital security help address these legal and regulatory concerns.
From your experience with many different healthcare organizations across the country, what should they and healthcare security service providers be doing to best prepare frontline Security Officers to function effectively in the challenging and complex healthcare environment?
I think it ultimately comes down to three focal points: hiring the right people, focusing on training and development, and creating a customer service-oriented environment.
#1 – Hire the Right People:
The first and most important element is hiring the right people for the security team. Some organizations will look to hire a retired Police Chief to operate their hospital security function. In some occasions this works out well, but the goals of running a healthcare security program vastly differ from the goals of a policing program. The objective of hospital security professionals is proactively preventing violence and crime rather than focusing on prosecuting or investigating after a crime. Healthcare security requires a focus on de-escalation skills, not a focus on criminals. The goal is to get people treated quickly and effectively, in a safe environment.
#2 – Training:
What makes a healthcare facility successful is its people. Its leadership team needs to be trained and steeped in professional development. The frontline Officers must also undergo professional development and training for each level of the security organization. There are a variety of opportunities available through IAHSS and local colleges and universities that are helpful to both frontline and leadership security staff.
#3 – Customer Service:
You must know your customers, both inside and outside the organization, and build trust across teams to ensure good working relationships. The security function needs to have a relationship with the Emergency Department and legal staff, as unplanned and challenging things are going to take place. If the only time these teams are coming together is after an incident, that makes it very challenging to work together. That trust and understanding needs to exist before there is a major incident.
Clearly violence is the biggest security-related issue in healthcare today and, by most accounts, incidences of violence continue to rise. From your perspective, what measures and initiatives have proven successful in helping to mitigate the risk of violence?
I believe that security starts in the early stages of designing a healthcare facility. Hospitals are always renovating, and new facilities are being constructed or moving departments and service lines. There is tremendous opportunity for a security professional to have an early opportunity in the initial phases of renovations or new construction to build in security design concepts as early as possible. This can truly have one of the biggest impacts in reducing violence.
Secondly, hospitals must have processes in place to mitigate and prevent violence in the first place. This means implementing an effective violence prevention program and ensuring that employees can consistently and easily report violence and threats. Response plans are important, but I like to place my focus on proactively preventing issues. Not to minimize response plans and the importance of practicing them, but I place emphasis on preventing incidents ahead of time.
The reporting aspect is also very important. When I conduct an assessment, I often find that there are up to three or four places people are supposed to report violence (such as an OH&S risk management system, employee incident report, and directly to the security department), making this type of reporting system challenging and complex when gathering incident details.
A simple, consistent system for managing employee reports of violence is crucial. Employees are less likely to report if the system is unclear or they are required to undertake a complicated process. The response protocol also needs to be established; employees need to know that their concern has been heard and an appropriate investigation or follow-up action is being conducted. Follow-up is vital to making employees feel safe and heard.
How do you go about designing a secure healthcare environment when that environment must also be open and accessible to support the quality care of patients?
There is an excellent design guideline that has been developed by IAHSS. It was developed by a team of subject matter experts from around North America. The guideline includes design best practices for high-risk locations, such as the ED, behavioral health units, women and children’s areas, ICU, etc.
I encourage Security Directors to be on the design committee and be aware of what’s going on in the planning stages. If you are renovating an ED, the Medical Director and Nurse Manager need to be informed of the emergency department design guidelines to determine which features they want to remain after the value engineering phase. Ideally, the Security Director is also a part of this process; when all these parties collectively agree upon the security features it is much more likely that the facility will be designed correctly in the first place (e.g. designing entrances/exits properly), rather than having to later mitigate the potential for violence in other ways.
- - - - -
PalAmerican is grateful to Tom Smith, one of the most renowned healthcare security experts in the industry, for taking time away from his independent consultant role to share his views with us.
PalAmerican COO, Don MacAlister, added “Tom’s comments in this article strongly reaffirm our PalAmerican healthcare security program framework as industry-leading and in alignment with healthcare security best practices. His observations on preparing Security Officers to work in these complex and demanding settings, as well as his emphasis on design and prevention as key elements of a workplace violence strategy are strongly reflected in the programs we deliver to our clients across the US and differentiate us in this competitive market.”
Learn more about PalAmerican Security.
For more information about Tom Smith, CHPA, CPP, please visit Healthcare Security Consultants Inc.