meeting today’s healthcare security challenges with integrated technologies · 2017-11-17 ·...

Meeting Today’s HealthcareSecurity Challenges withIntegrated Technologies

Steve Nibbelink, CHPAOctober, 2013

Schneider Electric -- AHCA FHEA Conference.......Meeting Today’s Healthcare Security Challenges with Integrated Technologies 2

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


Healthcare & Security –The Hospital Basics


Healthcare & Security –The Hospital

The Hospital’s Responsibility and MissionThe # 1 responsibility and mission of thehealthcare 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


Healthcare & Security –Impact Organizations in Healthcare Security


Impact Organizations in Healthcare & Security


Impact Organizations in Healthcare Security


Healthcare & Security –Security Applications in the Healthcare Setting


Security vs SustainabilitySecurity is an important element in the design of a building, unfortunately

in many cases, it is not part of the planning, design and construction

SecurityIncreased Lighting – to deter crime to create a safe environment (physically & psychologically)

SustainabilityDecreased 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 Messageof Technology . . . . .

Technology should not providethe message of a less secureor safe environment

. . . . . it should be the ForceMultiplier to support and help


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


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


Security in Hospitals – Needs / Safeguards

SignageSign-In Logs

Marking / LabelingAggressive Incident Investigation

Policy of ProsecutionConditions of Employment

Enforced Disciplinary SystemGreeting / Staff Acknowledgement

Way Finding & GuidanceLandscape Design / Architecture

Community Outreach

Psychological

Access ControlVideo Surveillance

Visitor ManagementFire SafetyIntrusion

Infant & Patient ProtectionIdentification Badges

BarriersGlazing

Communication DevicesPanic – Fixed & Personal

Physical

Encryption and theProtection of Patient Data

Securing Network SystemsID Security and

Password ManagementAsset Management / RTLS

Logical

Lighting

Fundamental

Security……Relationships, Communication and Collaboration


Healthcare & Security –Standards, Regulations & Integration


Joint Commission – Most Cited Issues…Hospital (overall)

The following Environment of Care (EC) and Life Safety (LS) standards appearedamong the 10 most-often cited standards overall during Joint Commission hospitalsurveys in the first half of 2011. They are listed in order of frequency.

LS.02.01.20 The hospital maintains the integrity of the means of egress.LS.02.01.10 Building and fire protection features are designed and maintained to

minimize the effects of fire, smoke and heat.LS.02.01.30 The hospital provides and maintains building features to protect

individuals from the hazards of fire and smoke.EC.02.03.05 The hospital maintains fire safety equipment and building features.LS.02.01.35 The hospital provides and maintains systems for extinguishing fires.


Joint Commission – LS.02.01.20

LS.02.01.20The [organization] maintains the integrity of the means of egress.

Questions & Challenges…..

Unattended items (other than crash carts and isolation supply cartsfor patients on contact precautions) left in the corridor for more thanthirty (30) minutes will be subject to a citation from a surveyor


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 identifiedsafety 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 eventof a security incident?

+ Does the hospital report and investigate security incidents involvingpatients, staff or others within its facilities?

+ Does the hospital orient external law enforcement and security personnelon now to interact with patients, hospital procedures and communications?


Integration for Patient & Staff SafetyIf 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


Healthcare & Security –A Security Leader’s Perspective, Globally


Crime, Workplace Violence, Security & RiskOccupational 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 offerparticular allure by way of availability of drugs and/or money.

Bryan Warren, CHPA, CPO-IDirector, Corporate SecurityCarolinas HealthCare System, Charlotte, NC, USA

The increasing risk to healthcare is the move to provide care in thecommunity (where we have our healthcare workers providing careoutside 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, CPPExecutive Director, Integrated Protective ServicesFraser Health, Vancouver, BC, Canada


The Risk to Healthcare Facilities

The primary concerns for healthcare facility risks are:- Lack of clear requirements against suppliers and business partners thatprovide vital products and services that support the “core activities”.- Faulty collaboration between the facility management and the hospitalorganization that leads to expensive and non optimal security solutions.

Oskar NordahlBusiness Continuity ManagerThe Karolinska University Hospital, Stockholm, Sweden

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 inthe process (before it gets out of control), we can then avoid the codeblack situations (and keep any disturbance at a code grey level).

Chris RasmussenSecurity ManagerSt. Andrew’s War Memorial Hospital, Brisbane, Australia


The Risk to Healthcare FacilitiesThe 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 CollingAuthor, ConsultantFounding Member of IAHSS


Healthcare & Security –The Healthcare Security Director’s World


Healthcare & Security –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


Selection & Recruitment


Policy & Procedure


Training & Education


Technology – The Force Multiplier

The Reality and Messageof Technology . . . . .

Technology should not providethe message of a less secureor safe environment

. . . . . it should be the ForceMultiplier to support and help

We used to look at security technology as different widgets, andthen went under a paradigm shift. Now we think about strategyfirst, then technology, which concentrates and simplifies thesearch for technology solutions.

Mike Howard, Chief Security Officer, Microsoft


Meeting Today’s HealthcareSecurity Challenges withIntegrated Technologies

Thank You.

meeting today’s healthcare security challenges with integrated technologies · 2017-11-17 ·...

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