Hospital and EMS Security Administrators: Violent Assault Response?

[N. A. Corbier]

This is for hospital security administrators and those charged with protecting ERs, or advise EMS companies on how to protect their staff.

Something an Paramedic/Police Officer turned me onto is the insane amount of violent attack against EMS and ER workers [b]internationally[/b[. Most believe that this is something that "goes with the job," and simply file a workman's comp and are done with it.

There are several factors in which a violent attack on your staff may constitute a liability scenerio:

- The Employee is injured or killed
- The Employee uses excessive force to defend themselves
- The Patient is attacked, and a vicarious liability suit arises from the EMS or ER having care, custody, and control of the patient.

I'm told by thie person, a man named Kip Teitsort, that hospital administrators and EMS admin will acknoledge the issue, when they actually get to talk with the man on a one on one level. Kip runs a program called DT4EMS. I would consider him a "vendor with a cause," like some services vendors are, because this man believes that violent encounters happen, and there isn't an adequate level of training.

So, my question to our hospital and EMS security people is: How do you manage the posibility of violent assault? Would you be comfortable with training your medical staff (not security or police) in basic self defense? And, if it is deemed an occupational hazard by OSHA, how would you handle the threat to EMS and ER workers from violent attack, to stay compliant with OSHA occupational hazard mandates?

[jmaccauley]

I can't believe I waited to actually present my DT class for medical personnel. I have a DT course designed for staff and employees of medical facilities that I was hoping to present as a continuing education credit course. My research indicated that those workers were the fastest growing group to report assaults on the job. The liability of the employers is incredible and like the airlines, rely on patients and others to assist if needed. I'm interested in hearing from hospital and medical facility security personnel on this issue also.

[N. A. Corbier]

One of the people you addressed this post to is "EMS security people." I've been in EMS for 4 years now and have yet to meet an "EMS security person." Is this common in other areas of the country? How are EMS workers to be protected by security? It's almost impossible.

I do like the idea of EMS workers learning DT tactics, however. Unfortunately, what you'll find is a lot of these people are barely in good enough shape to do their jobs, let alone defend themselves or others against violent attacks.

I have met administrators who are responsible for the protection of employees in their agency, who are termed a "Security Officer," or "Safety Officer."

You have been in EMS in the NY area for 4 years. Your mileage will vary depending on size, agency, and status (Volly or Paid).

As far as "good enough shape," you don't need to be strong or even "in shape" to use body mechanics and joint locks against someone.

Compared to the alternative - death and/or suit for hitting some guy with a LifePak or O2 bottle, I'd take the training.

How about you tell us what your agency believes you should do during violent attack? Or have they addressed that?

[mallpopo]

id just feed them food from the cafeteria

[N. A. Corbier]

id just feed them food from the cafeteria

I like the local hospital cafeteria food. Strangely enough, the stuff they feed visitors and employees is not only edible, but good.

This thread also made Security Week in Review, to which I thank the editors of SecurityInfoWatch. While I have my personal beliefs on which vendor to contact, I believe that hospital security directors, and EMS safety officers should be looking at this liability vector to increase employee safety and lower potential liability.

[Bill Warnock]

N.A. you are on the mark! The following is submitted:
*DUTY OF CARE:

In negligence law, duty is the basis of liability:

Without a duty to conform to a particular standard, there is no legal cause for negligence.

Businesses are not insurers of employees or customer?s safety, but have an obligation to provide Reasonable Care for their safety and security.

Definition of Reasonable Care is not clear-cut; the facts, circumstances and jurisdiction of each case will be determining factors.

Factors in determining liability for inadequate security:

If the location and character of business provides reasonable expectation of criminal activity, the definition of foreseeability may be broadened and property owners may be held liable.

Owner has a duty to take reasonable measures to prevent crime. What is general corporate plan for protection?

Crime must be reasonably foreseeable.

Personal injury or property damage must occur.

Failure to provide reasonable care was the cause in fact of the crime being committed.

Status of claimant (business employee, invitee, or trespasser).

Foreseeability is an imprecise term that is determined by the court system. Factors that help determine foreseeability are:

Prior incidence of similar crime on premises.

Prior incidence of all crime on premises.

Crime in surrounding community.

Once an inadequate security lawsuit is filed, the plaintiff?s discovery is most likely to include:

Staffing levels.

History of prior crime or incidents.

Security patrols and documentation.

Security lighting.

Security equipment (CCTV, alarm and locking systems).

Security training and documentation.

Professional certification and affiliations.

Security policy and procedures.

Adequacy of background checks.

Duty to warn.

Emergency procedures and knowledge.

Security practices and procedures in surrounding community.

*Taken from the handout entitled ?Duty of Care? prepared by Mr. Chad Callaghan, CPP, Division Director of Loss Prevention, Marriott® Corporation, with permission. ©Marriott® Corporation.

Enjoy the day,
Bill

[Crinsol]

N.A.

You bring up great points, things my company has brought up with several of our healthcare clients. The results are not very satisfactory. As a electronic security integrator, we can make recommendations to our clients on what steps should be taken but don't provide that direct service.

Here is what we are running into and suggestions to overcome are appreciated:

1) Healthcare is overwhelmed with meeting the simplest of HIPPA compliance.
2) Most of facilities lack the proper infrastructure to support integrated security.
3) IT depts are very territorial and often work against security depts.
4) Security depts do not have the internal clout to advocate serious policy changes.
5) Security depts are more concerned with the actions of security personnel than attacks on hospital employees.

[Mr. Security]

N. A. Corbier,

Your concerns are exactly why I refused to accept a post in the ER. The security company stated in their handbook that physical force could only be used to protect individuals who were in immediate danger of being harmed or worse. However, the company instructed us 'off-the-record' to restrain patients when asked to do so by the client. Since the security company is unwilling to document this in the post orders, the s/o would likely be defending themself in court if the force used is judged excessive by the patient or another concerned party.

Also, the hospital where the account is located only has one s/o on duty. Imagine being asked to restrain a patient by yourself who is often under the influence of drugs, alcohol, or both. NO THANKS

[N. A. Corbier]

N.A.

You bring up great points, things my company has brought up with several of our healthcare clients. The results are not very satisfactory. As a electronic security integrator, we can make recommendations to our clients on what steps should be taken but don't provide that direct service.

Here is what we are running into and suggestions to overcome are appreciated:

Lets see if I have anything reasonably intelligent to add to this. Sometimes I do, sometimes I don't, and for those times, there are other forum members. Which is why I love industry forums.

1) Healthcare is overwhelmed with meeting the simplest of HIPPA compliance.

They're looking for the Return on Investment, and resisting practices that don't provide high ROI. Having known people in the healthcare field, its very territorial, with everything from primadonna doctors to hospital administrators who have to juggle personnel drama with the myriad of government regulations. HIPPA exists because healthcare failed to protect patient confidentiality, so the government stepped in. Same for SarbOx in the Financial sector.

2) Most of facilities lack the proper infrastructure to support integrated security.

There is a wonderful series on the main site, www.securityinfowatch.com, that addresses retrofitting and building out for integrated security in the hospital. I made my girlfriend, who just graduated a CNA school and was clinical lab interning at a local hospital, read both parts. She found them addressing things that didn't exist. For her internship, she was issued a paper ID card with a logo and her name, that's it.

3) IT depts are very territorial and often work against security depts.

Indeed they are. Disrupting, interfering, or God forbid, inconviencing a geek is a good way to get your email deleted. RFID tags, etc, are tools to deal with the common fact that the average person hates password authentication, indeed, any authentication. People change passwords back to their known, etc, because they don't want to deal with "someone else's problem." The only way you can get through to IT is basically pretend they're running the show, while compiling a list of every deficiency they have, every lax practice, and then show it to senior management with a list of questions such as, "How does the IT department justifiy these issues?" If your lucky, you'll have a former l33t hacker who knows about information warfare and security, then they'll help.

4) Security depts do not have the internal clout to advocate serious policy changes.

In alot of Fortune 500 companies, the security department operates out of Facilities Management, Safety, or Maintenance. They are not supposed to advocate serious policy changes, they're supposed to hire the guard company who stands at the front door, take out the trash, and fix the post that that old customer hit on the way out.

The only way past that is to empower your client POC with detailed knowledge broken down into digestable morsels. Both the contractor and client POC for security have to prove a negative: Security is needed and works. Basically, unless you can sell policy, you have to wait till someone exploits the current policy to the point there's a loss, then have documentation that others were warned. You'll be seen as a visionary then.

5) Security depts are more concerned with the actions of security personnel than attacks on hospital employees.

Liability, pure and simple. The security department (client) fears the reprocussions of hiring untrained guards to do the job, but they know that they don't have the budget, training, and resources to do it in-house.

They have Corporate Counsel screaming in their ear, "You can NOT let these people touch anyone, they're not police officers with immunity to liability." Little does Corporate Counsel know that most states provide immunity to liability for actions of the property owner, and that the courts are not in a forgiving mood for inaction and failure to maintain standard of care.

They have the guard company, who also has their insurance and counsel screaming, "Your not a police department, you cannot touch anyone," who then instructs the guards through written post orders: Observe and Report Only. The client responds, "Can't they do something, though?" So, now we have an implied or assumed duty, which courts have found are just as enforcable as contractual duties.

Most companies think in terms of liablity avoidance. If they tell their employees to become physically engaged with people, they'll get worker's comp claims. If they tell them to run and hide, then they're safe from those claims, barring the occasional claim due to the guard not running fast enough.

The only way to mitigate the issue of assmued duties is to instruct security officers, from the lowest employee to the highest supervisor, to immediately refuse (politely), contact their supervisor, document the request, and then have management contact the client to redetermine the client's needs. If the client wants a hands-on security approach, then that can be arranged. But, it may require a higher price due to additional training, armorment, and recruiting. If, in fact, they don't want a hands-on approach, then the client needs to inform the client's employees that the guard's purpose is deterrance and observation, NOT protection. The average person believes three things:

1. Security guards are there to protect them.
2. Security guards have less power than private citizens.
3. Security guards are low wage menial labor, if they're wearing a uniform, who cannot be counted on to do anything more than run away.

I've actually had clients instruct the armed security officers, against their training and company policy, that "the police said all you can do is call them, your company is wrong, you can't remove people from the property or handcuff anyone." When the officers asked the client to communicate this to the company management, he informed them that it was THEIR job. When this was brought up to his property management company, he stated he never said that, till the wireless mike dash-cam tape was brought in.

[Mr. Security]

The only way to mitigate the issue of assmued duties is to instruct security officers, from the lowest employee to the highest supervisor, to immediately refuse (politely), contact their supervisor, document the request, and then have management contact the client to redetermine the client's needs.

Absolutely right...AMEN