Meeting Today s Healthcare Security Challenges with Integrated Technologies

Meeting Today s Healthcare Security Challenges with Integrated Technologies Steve Nibbelink, CHPA October, 2013 Our Agenda _ The Hospital Basics _ Impact Organizations in Healthcare Security _ Security Applications in the Healthcare Setting _ Standards, Regulations & Integration _ A Security Director s Perspective, Globally _ The Healthcare Security Director s World 2 The Hospital Basics 3

4 The Hospital The Hospital s Responsibility and Mission The # 1 responsibility and mission of the healthcare organization is patient care! One Definition of Healthcare Security A Customer Service Organization where knowing your customer, is the first step in providing flawless customer service. Security Relationships, Communication and Collaboration 5 Impact Organizations in Healthcare Security 6

Impact Organizations in Healthcare & Security 7 Impact Organizations in Healthcare Security 8 Security Applications in the Healthcare Setting 9

10 Security vs Sustainability Security is an important element in the design of a building, unfortunately in many cases, it is not part of the planning, design and construction Security Increased Lighting to deter crime to create a safe environment (physically & psychologically) Sustainability Decreased Lighting to conserve energy (to save money) to minimize light pollution How would you use RTLS, Video Surveillance, Analytics, Access Control. to support both security and sustainability? Security Trends in Technology _ Security Technology in the Entire Healthcare Facility _ Access Control _ Video Surveillance _ Infant Abduction / Baby Tagging _ Patient Management _ Staff Management _ Intrusion Detection _ Panic Alarms _ Intercom Communications _ Video Intercom Communications _ Emergency Call Communications _ Mass Notification Communications _ Visitor Management _ Asset Management & Tracking / RTLS _ Parking Management _ Smart / Financial / Identification Card The Reality and Message of Technology..... Technology should not provide the message of a less secure or safe environment..... it should be the Force Multiplier to support and help 11 Security Application Emergency Room / Ward _ Physical and Violent Attacks in the Emergency Room / Treatment Area _ Qualitative Implications _ Negative impact on patient care in the emergency room / treatment area _ Physical injury to victims _ Potential for negative PR and significant media exposure _ Liability of healthcare facility and the administrators _ Monetized Implications _ Cost of disruption to patient care _ Hospital liability for injury to patients, staff, visitors _ Cost of managing the media event _ Regulatory reporting costs _ Accreditation costs Emergency Ward, Emergency Department, Casualty Department, Accident & Emergency 12

13 Security Application Emergency Room / Ward _ There are four groups of security measures commonly applied to the Emergency Room to address vulnerabilities. These four groups are: _ Physical Protection _ Security Policies _ Actions to Prevent and React to Adverse Events _ Employee Education & Training _ Types of Emergency Room / Ward Operations _ Hospital Based part of the healthcare facility complex / campus _ Satellite standalone facility (urgent care, first care, quick care, etc) _ Emergency Room Service / Care Designations _ Level 1, Level 2, Level 3, Level 4 _ Adult _ Pediatric _ Burn Security Application Emergency Room / Ward _ Protection of the employees, staff, patients and visitors begins before they arrive on campus and outside the Emergency Room / Ward _ Three major non-technology / psychological measures include: _ Direction Signs _ Door Signs _ Service Window / Counter Signs _ The major technology / physical security measures include: _ Access Control _ Video Surveillance _ Panic / Duress Alarm _ Intercom Communications _ Glazing (bullet resistant) _ Patient & Staff Management _ Asset Management 14 Security in Hospitals Needs / Safeguards Psychological Signage Sign-In Logs Marking / Labeling Aggressive Incident Investigation Policy of Prosecution Conditions of Employment Enforced Disciplinary System Greeting / Staff Acknowledgement Way Finding & Guidance Landscape Design / Architecture Community Outreach Physical Access Control Video Surveillance Visitor Management Fire Safety Intrusion Infant & Patient Protection Identification Badges Barriers Glazing Communication Devices Panic Fixed & Personal Logical Encryption and the Protection of Patient Data Securing Network Systems ID Security and Password Management Asset Management / RTLS Fundamental Lighting Security Relationships, Communication and Collaboration 15

16 Standards, Regulations & Integration Joint Commission Most Cited Issues Hospital (overall) The following Environment of Care (EC) and Life Safety (LS) standards appeared among the 10 most-often cited standards overall during Joint Commission hospital surveys in the first half of 2011. They are listed in order of frequency. LS.02.01.20 LS.02.01.10 LS.02.01.30 EC.02.03.05 LS.02.01.35 The hospital maintains the integrity of the means of egress. Building and fire protection features are designed and maintained to minimize the effects of fire, smoke and heat. The hospital provides and maintains building features to protect individuals from the hazards of fire and smoke. The hospital maintains fire safety equipment and building features. The hospital provides and maintains systems for extinguishing fires. 17 Joint Commission LS.02.01.20 LS.02.01.20 The [organization] maintains the integrity of the means of egress. Questions & Challenges.. Unattended items (other than crash carts and isolation supply carts for patients on contact precautions) left in the corridor for more than thirty (30) minutes will be subject to a citation from a surveyor 18

19 Security Issues with JCI (and others ) + Does the hospital have a written plan for managing the security of everyone who enters the facility? + Does the hospital identify safety and security risks associated with the environment of care? + Does the hospital take action to minimize or eliminate identified safety and security risks in the physical environment? + Does the hospital identify individuals entering its facilities? + Does the hospital control access to and from security sensitive areas? + Does the hospital have written procedures to follow in the event of a security incident? + Does the hospital report and investigate security incidents involving patients, staff or others within its facilities? + Does the hospital orient external law enforcement and security personnel on now to interact with patients, hospital procedures and communications? Integration for Patient & Staff Safety If you had a patient contract MRSA, would you be able to.. + Identify the patient and where he/she has been in the healthcare facility + Identify the other patients who may have been in proximity to the contamination + Identify the staff who may have been in proximity to the contamination + Identify the equipment that may have been in proximity to the contamination + Identify the other patients who may have been in proximity to this equipment + Identify the staff who may have been in proximity to this equipment + Identify the current location of this possible contaminated equipment + Identify the building management systems that may have been exposed + Identify the people and vehicle pathways that may have been exposed + identify and automatically secure all contaminated areas of the facility + identify and account for all patients and staff for lockdown or evacuation 20 A Security Leader s Perspective, Globally 21

22 Crime, Workplace Violence, Security & Risk Occupational Fraud is a major problem as the typical organization loses an estimated 5% of its annual revenue to occupational fraud, according to the 2012 Global Fraud Study (by the Association of Certified Fraud Examiners) Fraud is discovered / detected most by a tip --- 43.3% Workplace Violence is a major problem as the Joint Commission issued in June 2010, Sentinel Event Alert 45... Preventing Violence in the Healthcare Setting Security & Risk is a major problem impenetrable hospital security in an open society represents a particular challenge, and zero risk is not achievable (according to JHU Hospital report on shootings in the healthcare setting, 2012) What is the Risk Appetite of your Healthcare Organization The Risk to Healthcare Facilities A variety of reasons account for the elevated risk to healthcare facilities. Foremost among these is the nature of the workplace itself: hospitals, especially emergency rooms, are open to the public 24/7, and they offer particular allure by way of availability of drugs and/or money. Bryan Warren, CHPA, CPO-I Director, Corporate Security Carolinas HealthCare System, Charlotte, NC, USA The increasing risk to healthcare is the move to provide care in the community (where we have our healthcare workers providing care outside the walls of our hospitals) along with a rise in the clinical acuity (sicker people in our hospitals) and finally, our threat management program (as part of our violence prevention program) is a key to our daily activity. Jeff Young, CHPA, CPP Executive Director, Integrated Protective Services Fraser Health, Vancouver, BC, Canada 23 The Risk to Healthcare Facilities Communication is a large concern as it directly leads to other events that we (as security) have to deal with.such as patient staff and staff security communication. By de-escalating a situation earlier in the process (before it gets out of control), we can then avoid the code black situations (and keep any disturbance at a code grey level). Chris Rasmussen Security Manager St. Andrew s War Memorial Hospital, Brisbane, Australia The primary concerns for healthcare facility risks are: - Lack of clear requirements against suppliers and business partners that provide vital products and services that support the core activities. - Faulty collaboration between the facility management and the hospital organization that leads to expensive and non optimal security solutions. Oskar Nordahl Business Continuity Manager The Karolinska University Hospital, Stockholm, Sweden 24

25 The Risk to Healthcare Facilities The current and emerging healthcare security concerns are. ---the potential active shooter situation in the healthcare environment ---the increasing number of serious incidents of violence in the healthcare setting by patients, family members, staff, domestic violence and the increasing number of forensic patients (situations) ---the multi-faceted issue of providing protective services in the emergency setting (an issue that keeps growing each year despite constant attention by healthcare security professionals) ---the current focus on the increasing use of access control, video / cctv, exterior door locking, staff training / education and the design challenges for the people / vehicle pathways, both internally and externally to the hospital Russ Colling Author, Consultant Founding Member of IAHSS The Healthcare Security Director s World 26 Fundamentals of the Security Department _ The fundamentals of the healthcare security department are: _ Selection & Recruitment _ Policy & Procedure _ Training & Education _ Technology the Force Multiplier The name of the hospital, the organizational structure, the language and local culture may all be different, but these four concepts are the fundamentals in the healthcare security department 27

Selection & Recruitment 28 Policy & Procedure 29 Training & Education 30

31 Technology The Force Multiplier The Reality and Message of Technology..... Technology should not provide the message of a less secure or safe environment..... it should be the Force Multiplier to support and help We used to look at security technology as different widgets, and then went under a paradigm shift. Now we think about strategy first, then technology, which concentrates and simplifies the search for technology solutions. Mike Howard, Chief Security Officer, Microsoft Meeting Today s Healthcare Security Challenges with Integrated Technologies Thank You. 32