Methodist Security Testimonial

September 3, 2010

Mr. Schell (HSS CEO),

I am writing this letter in recognition of your security team at our facility.

Methodist Specialty and Transplant Hospital (MSTH) is an acute care facility in San Antonio, Texas. I have been the Director of the Emergency Department for 1.5 years. While I have multiple years of experience as a Director and Emergency Department nurse, I have found that this ED is particularly challenging. There are several specialties offered at our hospital that are unique to our city and profession of Emergency Medicine. We have a nationally recognized transplant program as well as a dedicated 74-bed behavioral health department.

When I first came here, the amount of concerns for safety that were voiced by staff, physicians and ancillary departments was alarming. The focus and frustration voiced by staff in regards to their perceptions of “unsafe working conditions” was apparent and placed very high on my priority list. There had been physical injuries, verbal altercations and an extremely high amount of restraint usage. The schedule was literally built assuring physical strength would be available on the floor.

I began discussions with administration and made some superficial changes, increased visibility of security officers, provided education to staff and physicians, etc. The goal was that, within one year, the hospital would provide 24 hours of off-duty Sheriff’s officers. This information was shared with our staff and physicians. The information was extremely well received and the perception was we were making huge progress.

Needless to say, when I was informed of the problems we were having with the Sheriff’s department I was in a state of uncertainty. So, when HSS came to my office and informed me that they were going to station a security guard in the ED, I was visibly reluctant to this offering. (HSS Program Manager) Mustafa Rhimi even had the self-assurance to inform me, “My goal is for you to not want a Sheriff’s officer, much less need one.” I was taken aback at his confidence and was very aware of what his team would be up against. I got to work on the email to staff and physicians as to the “new” next steps.

HSS first walk-through in the ED was comprised of an ED Physician verbally informing them of his dismay, coupled with the true feelings from staff in regards to the “switch” from the initial “promise” of a Sherriff’s officer.

The months that followed are difficult to put into words, because I am not completely sure when the transformation occurred; nor can I express the changes… in our hallways. I can only summarize the last six months that your officers have been in our department and provide you with a typical day in the Emergency Department.

Your officers assure that everyone on staff knows they are here and on duty, they round each room to assure there is nothing out of the ordinary. They touch base with the team to assure they have any pertinent information on patients in the department. They observe all patients/family members as they walk into the department to determine a possible threat level. They introduce themselves to patients and family members, not only out of courtesy, but to also reinforce their presence. They establish a relationship with the patients quickly and have a non-threatening, but firm demeanor to each interaction. I have visually even observed a guard feeding a restrained patient, I have seen them de-escalate multiple situations; many times with minimal physical interactions. In addition, your officers come to our meetings, are involved with Process Improvement teams and are always looking to see if they can contribute, help or assist in ANY way.

We recently had a consulting group visit our ED and at the Executive Summary, in front of all Senior Leaders, they questioned; “are you aware that your security officers wipe stretchers down and help prepare rooms for the next patient?” This amazed them and they attested that. in all their years of consulting, they have never seen such a team approach to care.

In closing, the physician who was somewhat hostile eventually sent a letter to the CEO of the hospital acknowledging what a huge difference they have made in our department. When I ask my staff, “what is working well,” by far the response has been “security.” Over and over again, I have praised the work that Mustapha and his team have done to make this a safe environment. It has allowed the staff and physicians at MSTH to focus on what we do best, clinically care for our patient population. We work in a safer environment and would like you to recognize Mustapha Rhimi and his amazing team.

Thanks to your team, we do not want an off-duty Sheriff’s officer in our Emergency Department, much less “need one.”


Carla Moreno RN, Director Emergency Services
Methodist Specialty and Transplant Hospital