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Learning Topic

Security Considerations for Hospitals Health care facilities such as hospitals and clinics must carefully plan to ensure the safety

of patients and staff, facilities, and other assets. In addition to staff and patients, hospitals

are open to access by visitors, physicians, delivery personnel, and other members of the

public. Hospitals also have security sensitive areas, including the newborn nursery unit,

pharmacy, and patient record storage. Patient care areas at greater risk for violence

include emergency rooms, waiting rooms, mental health units, and units for cognitively

impaired.

In this assignment, you will be making security recommendations for three areas of the

Northwest Shelbyville Regional Hospital. As you are creating a map to ensure a safe and

secure environment for staff, patients and visitors, and to mitigate the risk of loss or

damage to property, equipment, or infrastructure, consider the recommendations below.

Securing the External Perimeter and Building Grounds

The outer perimeter of a property is defined by the actual property lines. In securing the

outer perimeter, the goal is to control who can walk or drive onto the property. The

exterior of the hospital should use physical environmental features, walkways, lighting,

and designated activity areas in ways that maximize visibility to make visitors and staff

feel safe and intruders feel uncomfortable.

When designing your map, you may want to consider the following recommendations

from Saxena & Kamal (2018):

Entry points should be in highly visible areas.

Security checkpoints should be provided at all entrances and exits.

Lighting should be installed near entrances/exits for safety.

Vehicular routes should be segregated from pedestrian routes.

Parking spaces for staff and visitors should be differentiated and identified.

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Parking areas should have controlled entrances, and those entrances should be

limited.

Fencing, signage, and landscaping should not block sight lines.

Signage and landscaping should not block or obscure lighting.

Trees should be located so they cannot be used to climb over fences or onto

buildings.

Be aware of creating spaces in which a person could hide.

Securing the Entrance and Lobby

Securing the entrance and lobby of a hospital involves a balance between the need to

keep people safe while maintaining an environment that is conducive to healing and

where patients, staff, and visitors feel comfortable.

Here are recommendations from Saxena & Kamal (2018) and The State of Victoria and the

Department of Health & Human Services (2017):

Minimize the number of unmonitored entrances into the building. Design a well-

defined main entry with signage and rules to direct all visitors to the administration

area.

Use a card access system for entry.

Locate the main point of entry at the front of the building near the administration

area and visitor parking/drop-off area.

Ensure that exits are visible and routes to reach them are clearly marked.

Ensure that each floor has at least two exits.

Provide plenty of windows at main entry to enhance natural surveillance.

Equip secondary entrances with alarms to indicate when these doors are open.

Ensure that entrances have adequate lighting.

Use shatterproof glass in the lobby and lighting for safety and visibility.

Place a waiting area with a bathroom outside the secured area.

Use metal detectors as part of security clearance.

Maintain cameras in lobby areas.

Securing Patient Areas

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Patient areas must ensure safety for patients, staff, and visitors while maintaining an

environment that is sensitive to patient needs for comfort and social interaction and

minimizes unnecessary stress for patients, according to the Joint Commission on

Accreditation of Healthcare Organizations (2009).

As you design your security plan, consider the following tips from the Center for Health

Care Design (2017) and ECRI Institute (2017):

Segregate authorized and unauthorized visitors in patient areas.

Install intrusion detection systems in any areas not continuously staffed.

Place staff areas to provide visibility and direct access to exits and elevators, and

equip them with duress alarms.

Control access to elevator lobbies.

Use "wayfinding" designs that direct patients and visitors to staffed exits

(wayfinding refers to the concept of patients, staff, and visitors being able to easily

navigate a facility) and ensure that wayfinding and other signs do not compromise

direct visibility/sightlines and electronic surveillance systems.

Secure doors and windows and lock staff areas such as lounges and break rooms.

Monitor and control access to patient areas.

Securely store equipment.

Maintain unobstructed exists in patient rooms.

Special Consideration for Maternity Units

The Joint Commission, a nonprofit health care accreditation organization, has established

best-practice guidelines for preventing infant abduction in the hospital (2003):

Attach identically numbered bands to the infant (wrist and ankle bands), mother,

father, or significant other immediately after birth.

Implement an infant security tag or abduction alarm system, such as a bar-coding

system or umbilical clamp, which triggers an alarm, locks doors, and freezes

elevators if the infant comes within four feet of an exit or elevator.

Transport infants in bassinets; don't allow them to be carried or left in the hallway

without direct supervision.

Establish a tracking system to document where the infant is at all times.

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Geofencing is an application that uses the global positioning system (GPS) or

radio frequency identification (RFID) to define geographical boundaries. It sends

reports or triggers alarms when a predefined area, the “geofence" or virtual

boundary, is crossed. Such safeguards can be used to help facilities manage

equipment, workflow, monitor conditions, and track staff and visitors (“Radio-

frequency identification,” n.d.).

RFID infant protection systems are potentially lifesaving tools. The system

includes a small radio transmitter attached to a tag worn on the wrist or ankle of

each baby. Exit points throughout the hospital are electronically monitored with

alarms to detect unauthorized removal of babies (Industrial Engineer: IE, 2005).

Control access to the maternity unit; for instance, keep all unit exit doors locked and

make sure doors are monitored by cameras with a date/time stamp.

Geofencing

Sally Anscombe / Taxi / Getty Images

References

Center for Health Design (2017). Security: Mitigating risk in healthcare facility

design. https://www.healthdesign.org › res_files › Module_SRA_Security_2017_6

1/29/22, 6:23 PM Security Considerations for Hospitals

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ECRI Institute. (2017, May 24). Violence in healthcare facilities. Healthcare Risk

Control. https://www.ecri.org/components/HRC/Pages/SafSec3.aspx

The Joint Commission (2003, October). Root causes: Practical approaches for preventing

infant abduction. Joint Commission Perspectives on Patient Safety, 3(10), 7–

8. https://journals.lww.com/nursing/fulltext/2007/10000/Preventing_infant_abduction_in

_the_hospital.17.aspx

Joint Commission on Accreditation of Healthcare Organizations. (2009). Planning, design,

and construction of health care

facilities (2nd Ed.). https://www.jcrinc.com/-/media/deprecated-unorganized/imported-

assets/jcr/default-folders/items/pdc09_sample_pagespdf.pdf?

db=web&hash=829F1CE9A681AFD9E1BC577867F1C2E9

Radio-frequency identification (n.d.). In Wikipedia. https://en.wikipedia.org/wiki/Radio-

frequency_identification

RFID saves baby. (2005). Industrial Engineer: IE, 37(11), 12. https://search-ebscohost-

com.ezproxy.umgc.edu/login.aspx?direct=true&db=mth&AN=20651879&site=eds-

live&scope=site

Saxena, R. & Kamal, M. A. (2018). The impact of built environment on crime prevention

and safety in schools: An environmental-behaviour design guidelines approach. American

Journal of Civil Engineering and Architecture, 6(6), 260–270. Available under the Creative

Commons Attribution 4.0 International

(https://creativecommons.org/licenses/by/4.0/) license.

The State of Victoria and the Department of Health & Human Services. (2017). Security

and safety at

hospital. https://www.betterhealth.vic.gov.au/health/servicesandsupport/security-and-

safety-at-hospital

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