Introduction

The hospital is an integral part of a social and medical organization the function of which is to provide for the population complete health care, both curative and preventive and whose outpatient services reach out to the family and its home environment, the hospital is also a centre for the training of health workers and for bio-social research. The hospital is a subsystem of a larger social system. The hospital subsystem again consists of various subsystems, like clinical services diagnostic services, therapeutic services support and utility services. The present-day hospital not the same as it used to be during early ages. The present-day hospital is not only a centre for medical care but also takes care of the various aspects of hospitality management. A star hospital of today provides high tech medical care and beyond that the star facilities of a star hotel. The hospital is very labour-intensive organization that mobilizes the skills of widely divergent group of professionals, semi- professionals and non-professionals to provide highly personalized services to individual patients.

The hospital has got direct access to any body and virtually any time of the day. The shopping malls may have security checks for all the entrants, but it is rarely seen in hospitals. Following are the two brief stories not about India but about the developed countries, which try to emphasize the need of security and safety arrangements in our hospitals. This will also emphasize that the hospitals are very soft targets. At one hand we are trying to develop medical tourism and encouraging foreign nationals to come for treatment and tourism and the other hand there might be perceived threat also. Then how to strike a balance? How to organize the security system? How to make the security system effective? How to modernised the security services of our hospitals? These are really causes of concert in times to come.

1. The New York Police Department’s chief spokesman, Paul Browne, said the department’s Operation Nexus sent a warning to city hospitals after foreign nationals, falsely claiming to be hospital inspectors, asked to survey hospitals inventory. He said the incidents, though they did not represent a specific or credible threat raised the concern that the fake inspectors were trying to gain access to radioactive materials, which are stored in hospitals and could be used to build a dirty bomb Operation Nexus, which promotes security at businesses and organizations, sent letter to hospitals April 28, cautioning hospital security officials to look out for individuals attempting to conduct “surveys at unusual times of day, asking irregular inquiries about surveillance, and prowling the vicinity of storage rooms containing radioactive materials or radioactive medical waste. The letter also warned hospital officials to watch for suspicious individuals in the vicinity of vents or gas, water and telecommunications feeds into the Medical facilities such as hospitals have people. Chemicals, pharmaceuticals, and radiological materials, making such locations attractive – targets, the letter, obtained by The New York Sun, said. It urged security officials to report any events so police can track patterns that emerge in the city.
2. LUBBOCK, Texas: A television reporter trying to – gauge security at two hospitals in Amarillo has been arrested on suspicion of attempted aggravated kidnapping, authorities said Wednesday The arrest came a few weeks after a New Mexico woman was accused of going to a Lubbock hospital dressed in hospital scrubs and kidnapping a days-old girl hidden in her purse.
3. Hospitals, and other healthcare facilities such as nursing homes, psychiatric hospitals, clinics, assisted living and retirement communities, etc. are, by nature, relatively porous. They are also complex operations and their security is typically more involved and challenging than other types of facilities. Developing, implementing and managing a health care security program that provides the needed levels of control and protection while maintaining or improving the desired levels of accessibility, service and patient satisfaction is a challenge. Critical assets to consider in the hospital security planning may include:

 

Critical Assets of the Hospital

The critical assets of the hospital as well as the critical areas, need special emphasis while planning for the hospital security organization. The critical assets of the hospital as well as the critical areas, need special emphasis while planning for the hospital security organization.

Critical assets to be considered in the hospital security planning are:

1. The buildings and furnishing (ag against vandalism)
2. Vehicle’s parking lots and structure Cash
3. Car storage
4. Nuclear medicine
5. Equipment’s, Labs, instruments and reagent
6. Loading docks
7. Children and infants
8. Staff, patients, visitors and families
9. Elderly Patients and residents
10. Supplies including linens, scrubs and food
11. Private information of confidential nature
12. Pharmacies and pharmaceuticals
13. Equipment’s
14. Patient, visitor and staff property
15. Tenants and their people and property.

 

Role of the Hospital Security Services

Before making a security plan for the hospital it would be a prerequisite to understand the role of the security services in the hospital. This will also help in the job design and job specifications of the hospital security services.

 

Role of Hospital Security Services

1. Provide security services to all the staff of the hospital Provide security to all the patients including the visitors of the hospital.
2. Protection of the hospital property.
3. Prevention of hazards by modern techniques.
4. Training of the security personnel to combat threats.
5. Analysis of security threats.
6. Preparation of strategy for security plan.
7. Organization, monitoring and evaluation of the security plans Conduction of survey for security threats.
8. Surveillance programme
9. Reception of visitors

 

Staff Security Awareness Program

Health Care Workplace Violence Prevention and Response Processes and Training. Development of Hospital Security or Workplace Violence Policies, Plans and Procedures, including Security Management Plans. Enhancement or Development of Hospital Security Officer/Police Programs, whether contract, proprietary, sworn officers or hybrid, including Training Programs; creation of Post Orders; Contracts, Scopes of Work, Job Descriptions, or Specs, etc. Note that security staff is typically the costliest, and sometimes problematic, aspect of the security program. There is much that can be done to better assure a more cost effective and consistently professional and customer service focused security force.

1. Reviews, Benchmarking, Development and Enhancement of Hospital Security or Police Departments.
2. Incorporating Security and Workplace Violence Response into existing Emergency, Crisis and Disaster Plans and Training.
3. Serving as a hospital and health care expert witness in related litigations.
4. Development of Self-Assessment and ongoing Hospital Security Audit Methodologies, or
5. The providing of ongoing security support on a retainer basis (The Virtual Security Manager).

 

Need for Security Technology

The age-old method of crime detection, prevention and control is effective and there is no substitute for it, but at the same time the crime has also become very technical due to advances in technology. Unless the security organization also keeps up dated about the technology, the crimes may go un-noticed or difficult to detect and control. The hospitals are high tech, the equipment’s are high tech, the criminals have also become high tech then, there is no option except to develop high tech system for crime detection, prevention and control.

 

Development of Security Technology Plan

The methodology of development of a security plan for the hospital will consist of the following steps:

Hospital security is a unique challenge. Consider the variety of people who make up the typical hospital environment – patients, staff, vendors, physicians, visitors and even their enemies. Consider the place many different rooms and spaces, high-value equipment, accessibility to drugs, many entrances and ease-of-movement around the building and premises. It all adds up to a need for different approaches to security. Hospital managers base their security decisions on law, costs, and fear of litigation, and to protect their facility’s reputation. But the critical assets of a hospital-its people, property, information and reputation must be protected with good security. The main threats in a hospital environment; as insider/ threats against patients or staff, and crimes of opportunity

1. Conduct a survey of the hospital premises to find out the possible reasons of security threats and lapses in the security system. To analyse security needs, begin by listing the departments, reviewing the business culture of the hospital, determining the threat levels in each department, interviewing a in department heads about threats and crime, and planning possible countermeasures for each department.
2. Development of a master plan and reviewing it against a “reality check on the basis for the plan and the tools that will be needed. Don’t forget, that we have options in security – high-tech, low tech, even no-tech.
3. Among the no-tech options, policies and procedures can be developed to enhance Training and supervision keep those policy. And procedures at the forefront. Programs help. Promote security awareness in the staff.
4. High-tech choices

a. Alarm systems

b. Access control systems

c. Photo identification

d. CCTV

e. Two-way voice communications

f. Weapons screening systems.

New tools such as:

a. Patient locators video pursuit software

b. Delayed egress hardware

c. Active asset control systems

d. Enterprise-wide systems Digital video and pager alarms can enhance security even more

5. Professional should look at the threats likely in specific areas:

a. The emergency/trauma department (gang fights, vendettas, domestic conflicts, child custody conflicts, VIP patients)

b. Infant care area (infant abduction, need for CCTV and infant security).

c. Pharmacy/drug storage area (alarm and access control systems) iv. Prisoner care area (receiving, elevator lock-off, surveillance, command centre).

d. Operating rooms (access control, delayed egress hardware, CCTV)

e. Labs (access control, duress alarms, CCTV)

f. Nuclear medicine areas (access control, CCTV)

g. Geriatric care area (patient locators CCTV)

h. Psychiatric care area (lock-down capability, access control, staff duress, solitary room).

i. Morgue (decedent services area, access control, alarm system, CCTV), and

j. PBX area (late-night security, rest room security, door release, duress alarm)

 

Don’t forget such places as;

1. The parking lot (lighting access control. CCTV in stairwells, duress alarm at fee collection booth).
2. Food service area (duress alarm), gift shop (burglar alarm, duress alarm) and shipping/receiving areas (CCTV. Patrol)
3. Study the threat potential of biohazard waste storage and disposal (CCTV, access control).
4. New products such as alarm pagers, infant abduction detection systems, patient wandering systems, CCTV video pursuit systems, people trackers and asset protection systems can each enhance hospital security.
5. Indeed, hospital security is unique, but with good planning, protection of its assets can enhanced.

The manual workers are very costly and at the same time the human element of management is always associated with it. The video monitoring system is cost effective in comparison to, the manual monitoring with the help of security guards. Though the initial cost of video monitoring system is much higher in comparison to the recruitment of the manual workers but the long-term benefits are definitely more with the advanced technology: To cope up with the increasing threats of different types to the soft organization like hospital, we must develop a technologically advanced system for security of the hospitals, One of such technology is video domain technology which has been successfully installed in some hospitals. This technology has got a centralized control system located at the administrative centre and installing a system in all the hospital areas. The control centre can monitor after hour-entry at the hospital areas or centre via remote video.

 

Management of Security Organization

How the security organization is to be managed? It is million-dollar question. At one hand there is an increasing trend of going for contractual system. It leads to another problem, whether the security is to be fully privatised of some supervision and control at the top level is to be retained and maintained as an internal organization of the hospital.

1. Selection of security agency on contractual system: short listing and selection of the agency should be done by a Departmental Promotion Committee (DPC) Following steps are to be followed for selection of the security agency:

a. Short listing of agency.

b. Establishing bid specifications

c. Submission of bids

d. Evaluation of bids

e. Final selection of agency.

2. Verification: All security staff including ex-army men and ex para military personnel should be verified by the hospital administration through civil authorities for their antecedent and police records. All personal details like finger prints, personal identification details, photographs and securities, etc. must be maintained.
3. Discipline: Discipline of high order is required in the security organization; it should be on the pattern of the defence forces. Prompt action should be initiated on the following types of incidences:

a. Absence without permission

b. Alcohol abuse/drug abuse

c. Failure to report incidences/false reporting duty

d. Sleeping while on

e. In subordination

f. Corrupt practices like bribery.

4. Training of security staff: The security staff must be trained about their field, technology and about organization: Following types of training is essential:

a. Induction training

b. On the job training

c. Refresher courses

d. Training on technology updates

e. Training on surveillance system of crime

f. Security awareness programs

g. Administrative training of officers.

 

Law and Security

The security staff may be public, private or mix of these two, have to perform all such duties where enforcement of law and order is required, since this is a very sensitive issue as it invites controversies many a times from human rights commission, women rights, judiciary and executive. Under such circumstances the enforcing authorities have to work within their limits. This is more relevant in case of the security agencies which are totally private. It is very essential to mention certain important provision under the law of the land.

These are:

1. Right of private defence: Nothing is an offence, which is done in the exercise of private defence, under IPC section 96 and 97.
2. Theft: A theft is always committed in relation to the movable property, under section 378 of IPC.
3. Pilferage: It is removal of small items due to temptation of daily needs like pencils, pens, food etc.
4. Robbery: Under section 390 Robbery is an aggravated form of theft. There is imminent force or violence is present.
5. Dacoity: When five or more persons jointly commit a robbery it mounts to dacoity under section 391 of IPC.
6. Mischief: Whoever causes or intends to cause or knows that he is likely to cause loss or damage to the security of the property, commits an offence of mischief under section 425 of IPC.
7. Criminal trespass: Whoever enters into the property of another with an intention to commit an offence; or to intimidate, to insult or to annoy the owner. Of that property, commits the offence of criminal trespass.

The security officials do not enjoy the authority to arrest and detain; this authority is vested with civil authorities. All major incidents of theft, accidents, and other offences must be reported to the police in the form of First Information Report.