risk management in healthcare

A recently released report from the FBI has found an increase in the number of active shooter incidents in the U.S. since 2000. Many hospitals and schools conduct active shooter training. However, 40 percent of active shooting incidents happen in a business location, suggesting that other businesses should also establish an active shooter plan and provide training. Below are a few elements that we believe are essential in active shooter preparedness and response.
1. Risk Assessment
Assessing risks of an active shooter can predict the likelihood of an incident as well as help to establish evacuation routes and other procedures.

2. Access Control
Identifying potential threats before they enter the building could decrease the likelihood of a shooting incident.
3. Surveillance
If there is an active shooter in the building, seconds matter and early detection is essential. If a possible threat is identified on the premises remote surveillance may allow security personnel to locate and respond more quickly.
4. Mass Notification/Communication
Notifying personnel in the building may help in the safe evacuation or lockdown of a facility. This should also include communication within security teams, local law enforcement, and other emergency services.
5. Trained Personnel
Security should have active shooter training, however, they are not the only entity that should be trained. Administrators, personnel, and other frequent visitors (i.e. students) should be trained on what to do in the incident of an active shooter.
6. Delegated Authority Figures
Even though you may have gone through training, in an unpredictable and intense situation like an active shooter there is likely to be chaos. A delegated line of authority or leaders can help contain chaos in many emergency situations.

The above are just a few useful elements in active shooter response. However, it is important to consult security industry specialists to assist in risk assessment, plan creation, and routine training.

Photo by U.S. Naval War College




Last month, OSHA launched an online resource to help prevent injuries and violence to workers in the healthcare industry. The launch sheds light on the safety risks facing healthcare workers.

Working in a hospital can be surprisingly dangerous: over 150 healthcare workers out of every 10,000 experience an incident of violence in the workplace, three times the total of other private industries like manufacturing or construction.

Patients, visitors, and healthcare personnel may be facing high-stress situations. However, risks of injury and violence in healthcare settings can be decreased when healthcare systems commit to safety and security.

OSHA recommends implementing a safety and health management system to create a safer workplace for staff and an overall better healthcare experience for patients and visitors. The following are      6 key elements necessary to create safety and health management systems.

1. Management Leadership
Managers, administrators, and others in leadership should communicate their commitment to sustaining a safe healthcare environment through establishing goals and procedures, providing resources and support, and setting a good example for workers.
2. Employee Participation
Employees should be actively engaged in creating safety and health management systems, reporting any hazards that they notice to administration and security personnel.
3. Hazard Identification and Assessment
One of the best ways to prevent these hazards is by proactive risk assessments. Assessments must be completed on a continuous basis to identify possible risks and update safety plans and procedures. We would recommend partnering with certified and experienced security industry specialists in conducting assessments.
4. Hazard Prevention and Control
These are the measurable plans, procedures, and protocols established to maintain a safe healthcare environment.
5. Education and Training
Having a trained, knowledgeable workforce will help to prevent accidents. Training should be holistic and cover a number of possible scenarios. A few examples of procedures that workers should be trained on are:

  • Crisis Prevention
  • Hazardous Waste Management and Disposal
  • Environmental Emergency Procedures

6. System Evaluation and Improvement
The system should be measured and monitored and necessary measures should be taken to improve its effectiveness.

These elements are useful in creating a culture of safety and high-quality patient care. Worker safety is a serious issue, but with strong leadership, planning, and a trained security and healthcare staff these incidents can be minimized.

Photo by MilitaryHealth

Healthcare Security Trends and Predictions for 2014

January 14 , 2014 | | In: Healthcare

Security plans should be updated and the personnel that implement them should be continuously trained to address rising, industry-specific trends. Many are predicting that in 2014 the healthcare industry will go through a number of changes as a result of recent U.S. healthcare reform. Below is a compilation of some of the top predicted healthcare trends for 2014 and ways your security staff can stay prepared.

Heightened Focus on Compliance
With healthcare reform underway in the new year, there is more pressure for healthcare institutions and their affiliate businesses to be compliant with legal and industry-wide standards. Being compliant with legal standards has always been pertinent for quality-conscious healthcare systems, and with the September 2013 enforcement of the HIPAA omnibus rule and audit programs increasing in frequency, the pressure to meet compliance is even stronger.

How to Prepare:
Patient privacy protection is a priority for healthcare institutions and security staff. Physical security plays a unique part in the protection of patients and their information. All healthcare security officers should be trained on an ongoing basis to meet HIPAA and other industry-recognized standards.

Patient Increase
A report from CNN in December 2013 reported that 365,000 previously uninsured Americans have now signed up for healthcare insurance under the Affordable Care Act. Although that number is unlikely to reach the projected 7 million by 2014, experts predict that it will continue to grow despite the program’s initial shortcomings. Some healthcare facilities could see an influx of patients as the new year rolls in, and pressure will be on healthcare security as well as healthcare personnel to manage the increased patient load.

How to Prepare:
Managing security concerns often associated with overcrowding should be incorporated into each facilities’ security plan and training. For optimal security efficiency, security staff and healthcare personnel should be trained on various policies covering:

  • Emergency preparedness
  • Crisis prevention
  • Active shooter violence
  • Aggressive behavior management

Although, there may be an increase in the number of people throughout a facility, it can be well managed with:

  • Access control
  • Perimeter patrol
  • Video surveillance
  • Visitor identification and management

Healthcare Service Model Shift
As industry competitiveness increases and consumers become more spending conscious, organizations like the Healthcare Professionals Network and PwC’s Health Research Institute are predicting that a growing number of healthcare systems will be forced to shift to a more consumer-focused business model. This shift could affect multiple aspects of healthcare facility operations, including the physical security program.

How to Prepare:
Physical security officers balance ease of access and comfort with ideal levels of security necessary for enhanced patient care and safety. Risk assessments in healthcare facilities will help to prepare security for any potential risks while keeping in mind the patient and healthcare personnel comfort. A security force trained in security technologies, customer service, and safety protocol is key to an evolving healthcare business model.

 Photo by: 401(K)2013

Once the Affordable Care Act  makes insurance mandatory, people will be taking advantage of their newly obtained insurance benefits. One prediction made by KSTP is that the shortage of primary care doctors and clinics accepting new patients could force individuals to seek medical services from already busy hospital emergency departments (ED).

In 2012, hospital emergency departments were a vital source of care for over 48 million uninsured Americans.  Often emergency departments experience overcrowding and prolonged waiting periods that can hinder the delivery of high-quality medical care and compromise patient, visitor, and ED staff safety. A possible influx of patients in the future has some hospitals and their security staff preparing and improving existing security measures to keep up with the changing U.S. healthcare industry.

At Criterion Healthcare Security we have developed ED – Secure™ to specifically address emergency department safety needs.  ED-Secure is a comprehensive toolkit that incorporates industry best practices in healthcare security in a program methodology that is easy to implement and maintain.  Some of those best practices are to:

1. Complete risk assessments with security industry specialists, recognizing potential threats and adhering to national patient safety goals and standards.

2. Control and track who is in the facility, identifying any potentially dangerous visitors.

3. Develop a security approach that addresses violent behavior including separation and de-escalation of combative patients and visitors using Crisis Prevention Intervention techniques.

4. Train all ED personnel on security procedures and techniques to identify, prevent, and mitigate violence.

5. Have emergency or ‘panic’ buttons properly installed in locations for ED nurses, physicians, and other personnel to call for hospital security.

Photo by KOMUnews

Risk Assessment in Healthcare

November 21 , 2013 | | In: Healthcare Security

Overall patient satisfaction with their healthcare delivery experience is a significant measure of the perceived quality of care of a health care practice. One common facility related factor that correlates well with improved perceptions of care is the general openness and accessibility of the facility. However, health care providers also have a primary responsibility to ensure that the care that they provide to the public is done in a safe manner and setting. Delivering the highest quality of medical care in the safest and most comfortable environment should be the foundation of any healthcare practice mission statement.

Risk assessment is one of the first steps a healthcare system can take to improve the security and safety of their facilities, patients, visitors, and staff.  Risk assessment answers two questions:

1. What is the probability an event will occur?
2. What is the magnitude of the loss should it occur?

Risk assessments are used for many industries and are critical in the healthcare industry.  Events that present a threat in most healthcare facilities could include:

1. Human threats like combative patients or other workplace violence
2. Natural threats like earthquakes or flooding
3. Environmental threats like chemical leakage or pollution

Risk Assessment Process

The risk assessment process may be completed within several weeks or months depending on the specific facility and industry. The figure below visually represents the 5 step Risk Assessment Process:

1. Identify Threats – Involves a thorough investigation of the healthcare facilities and security procedures.

2. Assess Vulnerabilities – Vulnerabilities are weaknesses in a healthcare system’s protection plan that have the potential to harm assets.

3. Establish Security Measures and Controls– The current security measures are evaluated for effectiveness.

4. Prepare Corrective Action Plan – Any adjustments will be included and implemented.

5. Monitor & Review – Since risk assessment and management is an ongoing process, security  should be continuously monitored and reviewed to measure effectiveness.