Danger in the Emergency Room
Like every large healthcare facility, a Level 1 Trauma Center in Virginia was facing potentially explosive situations—and not once in a while, but just about every day. Individuals referred for mental health treatment arrived daily through the doors of the hospital’s emergency department, putting patients, families, and staff into close contact with individuals who posed an established threat to themselves or others.
The hospital was struggling with these patients, who were sometimes aggressive and often had items on their persons that could cause harm.
explained a senior executive at U.S. Security Associates with 30-plus years of expertise in the special challenges of healthcare security.
The hospital needed to find an effective way to remove contraband from patients identified as at-risk to ensure the safety of all involved in the treatment process and promote successful patient care outcomes. Contraband came in many forms, from syringes of drugs like fentanyl and other illegal substances to guns, knives, razors, scissors, and other items that could be used as weapons.
The challenge—and the stakes—couldn’t have been higher. The hospital needed a way to enhance safety by identifying and removing dangerous items from potentially dangerous and unstable individuals—and do it in a manner that didn’t spark the exact violence that the hospital was trying to prevent. It needed to apply security policy but seamlessly fit enforcement with the hospital’s patient-centric focus and mission of care.
Finding the Right Partner
Ultimately, it was decided that only the right people, with the right training, could solve the problem. It was a job for security, certainly, but more important was the need to integrate qualified, trained security personnel into the hospital’s care team.
U.S. Security Associates (USA) put together a plan to meet the hospital’s needs. It included technology—handheld wands to scan at-risk patients for weapons and prohibited items—but it was built around people. USA Officers, handpicked for the intricacies of the assignment, were extensively trained to deftly manage even the most unstable patients and most dangerous situations.
Our patient became suddenly violent against staff and the response by the Security Officers was proactive and kept staff and the patient safe. You all deserve to be recognized for the wonderful help that you guys gave us in controlling this patient.
— Emergency Medical Technician
Level 1 Trauma Center, Virginia
The results have been dramatic. From the outset, Officers began removing a staggering number of potentially deadly items from at-risk patients—threats that had previously gone undetected. In a single month, for example, USA Officers received 182 behavioral health calls and conducted 79 positive searches for contraband items. In all, USA Officers removed 579 contraband items from behavioral health patients in 2017.
More important, however, was the ability of USA to conduct the vital security searches, and usher at-risk patients through the care environment, while mitigating the risk of violence. Since the program’s rollout, year-over-year incidents of violence have declined by a staggering 45 percent.
Those tangible results, coupled with the enhanced feeling of safety that has resulted from integrating security experts into the hospital’s care team, have prompted the hospital to double its use of USA Officers. Officers pay for themselves by reducing the risk of violence, as violent incidents lead to significant costs for workers’ compensation losses, overtime, absenteeism, temporary staffing, training costs, higher turnover, additional infrastructure for employee safety, and deterioration of productivity and morale.
For example, nationally, in-facility violence costs hospitals $234.2 million for staff turnover, $42.3 million in compensation for lost wages made to employees injured on the job, and $90.7 million in disability and absenteeism costs, according to an American Hospital Association report by Milliman Research in 2017. A single nurse that leaves out of fear or because of an act of violence costs a hospital $58,400. To replace a general practitioner costs $245,128. And those figures don’t account for potential lost revenue while positions remain open.
One note from an emergency medical technician describes how importantly the hospital views Officers’ ability to de-escalate potentially deadly situations: “I just wanted to call your attention to a great security response from [USA] Officers during a VERY intense patient assist,” he wrote. “Our patient became suddenly violent against staff and the response by the Security Officers was proactive and kept staff and the patient safe. Even after an Officer got spat on by the patient, everyone kept their cool while going hands-on and getting the patient restrained.”
Managing security in a hospital environment is a uniquely difficult challenge fraught with pitfalls—a point evidenced by even the most casual review of healthcare news and driven home by citations issued to hospitals by regulatory agencies. “It’s 180 degrees different than protecting a mall or a warehouse, it requires highly educated and technical personnel,” explained a senior healthcare consultant for USA.
It also requires an ability to interact and communicate effectively with a wide range of individuals, from healthcare clinicians on the care team to an individual in the midst of a mental health crisis. Care for individuals in need of mental health services has been decentralized, which has put the nation’s hospitals and emergency rooms on the front lines of managing these individuals.
To impart Security Officers the confidence and skill to manage highly charged events in accordance with hospital policy, USA places screened and certified Officers through healthcare education that consists of 13 training modules. They also learn through an extensive series of role-playing exercises, ones that not only provide them practice for their particular assignments, but also require them to see events from the point of view of others. Officers assume the roles of clinicians, patients, and other staff during scenario exercises to gain a deep understanding of how situations can appear to different stakeholders. They learn the difference between clinical aggression and criminal aggression, are taught what it is like to be a victim of each mental health diagnosis, and—using a variety of training techniques—discover how requests by security Officers may seem to a patient who is under the influence of drugs or hearing voices.
Effective program management has also been important to the program’s success, including close monitoring of the volume of assistance calls in order to calibrate Officer staffing. USA’s on-going refresher training recognizes that, just like technology, the human element of security—which relates to decision-making, common sense, and awareness—must be continually upgraded. Finally, the training of security staff isn’t limited to security issues. Training recognizes that to be an effective part of the care team, Officers should be well versed in the facility’s culture, history, mission, and norms—and not just job tasks.
U.S. Security Associates (USA) is the market-leading, wholly-owned American, full-service safety and security solutions provider. With over 160 locally-responsive offices, international locations and over 50,000 dedicated professionals, they offer the most complete array of physical security, remote surveillance, and global consulting and investigations to ensure better outcomes for thousands of clients and a range of industries. Innovative applications of leading-edge, proprietary technology enable USA to rank annually among the world’s best training companies, sustain the highest standards of quality, and underscore world-class customer service with unparalleled accountability. USA’s rise as one of the largest innovative security solutions leaders is a natural byproduct of these differentiators which enables the company to provide the most Safe. Secure. Friendly.® environments for people, assets, and brands. For more information, contact us here.