Hospital Security –This time you get to play “Doctor”

Approach any hospital security project with the understanding that you will be a participant in saving lives.


Surveying a site in need of a security upgrade can be a challenge. You are never quite sure what to expect. One rule holds true: the older and bigger the facility, the more likely you are to discover older lock solutions which don't meet today's security needs.

Case in point: A large metropolitan hospital. Hospitals strive to achieve JCAHO certification. JCAHO stands for the Joint Commission on Accreditation of Healthcare Organizations. It's the medical community's seal of approval and elevates a facility to a higher level within the medical reimbursement universe. In other words, it is critical to a hospital's survival.

While JCAHO covers a myriad of areas, we'll concentrate on safety and security as it relates to swinging doors.

Traditionally hospitals have been considered open environments. As a boy, I remember visiting relatives by sneaking in through the back stairwells or emergency exits, back in the day when hospitals severely restricted visitors and children under 12 were almost never let in.

It's quite different today. Aside from traditional access control needs, like audit trails, hospitals have extremely expensive equipment to protect these days. Patient record confidentiality is a much newer requirement and the HPPA laws passed by Congress impose strict regulations and penalties for failure to safeguard information. Protecting pharmaceuticals and narcotics adds another dimension. Stairwells and parking garages now require a different level of attention with a greater emphasis on restricting usage.

Will the facility manager call the locksmith first to tackle these issues? Probably not. The systems integrator will most likely include the electrified door hardware as part of their complete package, which might include CCTV, card readers, DVRs and other wired elements. Most integrators will call an outside locksmith as a sub-contractor to help them meet their requirements.

When called, how should you approach the project? Approach it with a serious conviction and understanding that you will be a participant in saving lives.

When discussing the importance of properly installed and maintained door hardware and locks, I recall the story of the young pregnant doctor at Bellevue hospital in New York City almost 20years ago. We were shocked as a community when we learned of her death at the hands of a homeless man while she was working in a laboratory.

If she were working in a lab today, the odds are the door would be self-closing and an access control system would control entry to the room. In the case of the unfortunate young doctor, the door to her lab was wide open and the person approached her without resorting to any extraordinary actions. I always wondered what the homeless person was doing walking the halls of the hospital unnoticed. Turns out he was not walking the halls; The murderer had taken up residence in an unused equipment room. It was deep enough for him to set-up a bed. The homeless person also suffered from mental illness and lashed out at the doctor during one of his episodes. When arrested, he was walking around the hospital in a lab coat with a stethoscope around his neck.

When speaking with the police, you learn that opportunity is an important component of any crime. The open hospital environment and the unsecured equipment room were clearly major contributing factors in this unfortunate incident. We've made great strides in the past 20 years and advances in locking technology are the types of things we must bring to the attention of those who ask us to perform surveys.

Conducting a security site survey of a hospital

Your first visit to a new doctor will include the doctor asking you questions so a history can be developed. The doctor first identifies your history and existing conditions before possibly suggesting a course of action. Conducting a site survey gives you the chance to play doctor, but you'll need to follow the same protocol.

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