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Tip of the Week: Securing your hospital and creating a welcoming atmosphere are difficult tasks to balance, especially in light of recent surveyor imposters.

Accreditation Connection, June 20, 2005

Preplanning and recognizing risks can curtail the need for designing a fortress instead of a hospital. When conducting a hazard vulnerability analysis for building security, Russell Manning, a safety manager for the U.S. Army Health Facility Planning Agency in Falls Church, VA, suggests the following three tips:

1. Know who your neighbors are

Take a grassroots approach by contacting your local police department and the Federal Emergency Management Association to find out what they view as threats to your organization, Manning suggests.

When it comes to human aggressors, community leaders and the hospital should try to predict what methods such people will use to create disturbances. It's cheaper to prevent problems than to design a building that can withstand them.

"If you can stop the tactic, you've solved the problem," Manning says. Remember, this isn't just about terrorism. The same ideas apply to more mundane occurrences, such as unauthorized visitors trying to enter the emergency department (ED).

2. Figure out what your assets are and how to defend them

Dollar values-as well as what constitutes "acceptable damage"-are particularly hard questions for a hospital to handle, Manning says. Yet, it is an important debate. Logic dictates that any building owner should place greater assets closer to the center of the structure to protect them.

This may not work for hospitals, however. For example, you'd want the ED to survive a bombing, but in practical terms, that area needs to be near an entrance, not in the core of the building.

Reasonable steps you could take include replacing standard glass panes near the ED. When such glass shatters, "it's like a whole bunch of knives flying at people," Manning says. Solutions include a combination of laminated glass to reduce shattering and reinforced frames to stop the pane from flying out.

3. Plan for entry-point screening areas

Some urban EDs routinely check for weapons, but other hospitals currently do not take these steps. But, what if the government raises its terror alert to the "severe" status? Many hospitals might then deem it necessary to screen all visitors.

"Screening equipment takes up room and slows down patient entry," Manning says. Having a preplanned lineup area and process could help alleviate a jam.

If possible, limit deliveries to exterior checkpoints, Manning says. Also, analyze how you screen these packages, and whether the carriers conduct any of their own prescreening that might assist you.

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