ENVIRONMENT MATTERS: ASSESSING YOUR EMERGENCY DEPARTMENT
Alan Butler, CHPA | Senior Vice President of Healthcare Security, HSS
This is the second blog in the three-part blog series, Environment Matters, in which we outline our Focused Security Assessment process. To better understand the impact violence has on the healthcare industry, read the first blog post here [link to blog #1]. Stay tuned for part three, where we discuss the necessity of customized violence prevention strategies.
Hiring a reputable consulting firm is a surefire way to evaluate your violence prevention and mitigation strategy against industry standards. We recommend collaborating with a healthcare-focused organization as they will be acutely aware of all the elements that influence the ED as well as its visitors, patients, and staff.
Before meeting with a consulting firm, we find it’s helpful to assess your Emergency Department. This article provides a step-by-step approach to doing just that.
Community and Hospital Factors
Your ED is a reflection of your community. Is there a drug of choice and what are the medical side effects? Are there gangs in your community and how do staff recognize gang members? Is there an influx of homeless people when it gets cold and what issues accompany this patient population? These are examples of questions you and your team should have answers to.
Determine if your ED is a low-, medium-, or high-risk environment. To do this, start with a CAP Index® Score (Crimes Against Person) and evaluate statistics around volume–number of annual visits, peak load times, patients with a primary or secondary behavioral health diagnosis, average length of stay, etc. Next, Create a Risk Stratification Model and position your hospital against similar hospitals. These exercises inform the type of security presence, system integration and training solution the hospital will deploy.
The International Association for Healthcare Security & Safety, Design Guidelines for Healthcare Facilities, views the physical design of the ED as a secured area that serves as an added layer of protection between the healthcare facility, public, and treatment areas. When making design decisions, ask yourself: Does the ED, from door in to door out, work to create a safe staff and patient care environment?
Given the level of patient-generated violence in hospitals and on-going tragic events around the country, today’s healthcare administrators recognize the importance of a security officer presence. Security, and in some cases off-duty police officers, is the first line of defense when it comes to protecting patients, visitors, and staff in emergent situations.
Presence takes many forms, from a 6’9” gentle giant to the 5’2” de-escalation expert. It can also come with highly trained security officers who have approved use-of-force tools such as Tasers or licensed police officers working off-duty in your ED. Regardless of who is working security in the ED, they must be a calm, self-confident, educated, and well trained.
The quality, quantity, and sequencing of security officer training is critical to the overall success of any healthcare security program. Organizations should create a competency-based training program for its security officers. Officers should also be trained to recognize behaviors associated with certain types of at-risk patient populations. Leadership should evaluate the officer’s ability to successfully intervene in difficult situations and arrive at win-win solutions.
Hospital Staff Training
Failure to train staff appropriately is the biggest miss in healthcare security today. Violence threatens the safety of ED staff, patients and visitors in hospitals of all sizes and settings. According to a study reported in The Journal of Nursing Administration, nearly one in four ED nurses experience frequent (more than 20 times) physical violence over a three-year period. What hospitals need in response to this violence is a two-part structured violence prevention and mitigation program that creates an everyday ED Security Management Plan and Aggression Management Training Plan.
Security System Integration
A practical electronic security strategy, when combined with physical security presence and staff training, enhances the overall security posture of the ED exponentially. The integration of electronic security technology in the ED improves the overall effectiveness of security practices. It also enables the ED to be more productive and make better use of security personnel resources. Your Systems Integration Plan should include many, if not all, of the following:
- Access control
- Video surveillance
- Metal detection
- Panic buttons
- Active security status alert system
- Lockdown/restricted access capabilities
- “Safe” at-risk patient rooms
- “Safe” staff drop-back rooms
At first glance, this assessment may seem daunting. We can guide you through this process and propose an actionable list of next steps. Our experts can help you think through what training best suits your facility’s needs and keeps you compliant.
HSS’s Techniques for Effective Aggression Management (TEAM®) training empowers your staff with violence prevention and workplace safety knowledge. TEAM® training can be delivered by a certified instructor or online. eLearning is a convenient 24 hours a day, 7 days a week option that maximizes staff productivity and typically reduces costs by 40%. eLearning is just as immersive and compelling as our live training and a perfect solution for facilities with time and budget restraints.
To learn more about how your facility can benefit from TEAM® training, contact Seth Karnes at 844.477.7781 or firstname.lastname@example.org. We’d love to partner with you to secure your ED and protect those in it.