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Security checkpoint: Will metal detectors really make a big difference in your hospital's ED?

Healthcare Security and Emergency Management, April 1, 2004

A serious act of violence shouldn't be the determining factor in whether your hospital needs metal detectors.

Almost 17 years ago, John Galbraith, CHPA, CFE, CHSP, de cided it was time for his hospital to install metal detectors because of a risk assessment, the hospital's location, and local crime statistics.

"It wasn't a reaction to a particular incident, but we started to realize that maybe this would get us ahead of the curve," says Galbraith, director of public safety, transportation, and parking at Tarrant County Hospital in Fort Worth, TX.

"In many cases, people think this is only about confiscation of weapons, but it's about prevention. A metal detector's purpose is a proactive approach," he says.

In 2003, the hospital confiscated 312 weapons per month through metal-detector use. "The majority are pocket knives, but we've had meat cleavers, ice picks, and just about anything you can imagine," Galbraith says.

Evaluate your facility

How do you know whether metal detectors are right for your hospital? It will take an in-depth evaluation to figure this out.

Consider these four issues when deciding whether your hospital should use metal detectors:

  • Think about your hospital and its surroundings, and assess crime in your area. In 2003, Jim Clark, security director for William Beaumont Hospital in Royal Oak, MI, decided to put metal detectors at the main entrance to its emergency department (ED). Beaumont is a level-one hospital, so it handles many life-threatening traumas, Clark says.

    "[The ED] can be a highly emotional environment. People come in off the street, in many cases, un prepared for a hospital visit under all kinds of conditions," he says. ED patients could be dealing with substance abuse, emotional and mental illness, or just may feel angry with their situation. "We chose for those reasons to ensure that they do not have anything that can be used as a weapon in the ED for the safety of staff, patients, and visitors," Clark says.

  • If you think only urban hospitals need metal detectors, think again. "A lot of violence in healthcare facilities in the past has been in suburban environments, so hospitals in those environments should not think it is only an urban problem," Clark says.

  • Complete a risk assessment to see whether a potential for violence exists, Galbraith recommends. "Whether you install metal detectors has much to do with the foundation you lay when you look at crime statistics and the near-misses you may have had at the hospital."

  • Enlist the support of hospital staff and administration. Ultimately, this will be something staff and administration need to feel comfortable with in order to move forward.


  • Consider the costs and other details

    Although metal detectors in hospitals may be controversial, Russ Colling, CHPA, CPP, says it isn't the actual detector that raises concern but the feasibility and practicality of using them .

    Colling, a security consultant for Colling and Kramer in Salida, CO, says there are a number of issues to consider, including the following:

  • Staffing: Do you have enough staff to operate the metal detectors? Detectors generally require two employees to operate them-one to monitor people walking through, and the other to search people and property. Some hospitals simply can not afford the cost of additional security officers. "When it's all sorted out, most hospitals can't afford them," Colling says. "The equipment isn't the expensive item-it's the operation. It isn't about whether it works, but the cost driven for the gain."

  • The layout and design of your hospital: The more entrances to the ED area, the more metal detectors and security officers you'll need.

  • Policies and procedures: The addition of metal detectors will require a detailed security-operations plan and policy.

  • Training and education: .Using metal detectors will require you to provide staff with training and education on how to use them.

  • Weapon confiscation plan: You must have a plan of what to do with weapons if you decide to confiscate them. Some hospitals choose not to hold weapons at all and send patrons away. Henry Ford Hospital in Detroit, however, confiscates an average of 800 weapons every month, says Nick Radu, CHPA, director of security/police. "If you get 800 items a month and only 60% are legal-what do you do with the other 40%?" Radu says. "Develop a way to account for the weapons and a method for claiming them."

  • A plan for other items you uncover: Create a plan of how to react to other items, such as narcotics, that may come through the metal detector. On a weekly basis, Radu's staff confiscate narcotics from hospital visitors simply by asking people to empty their pockets before walking through the metal detector. "You don't want accusations that security took someone's dope," Radu says, so he recommends that security have a specific policy and protocol to handle these situations.

  • Local law enforcement: .Metal detectors will require you to develop a working relationship with local law enforcement, if you haven't already done so. "If you find something, you must call the local police, because you can't take a prohibited weapon," Galbraith says. "Metal detectors are an adjunct to a complete security-management plan," he adds. "They're part of a management program but certainly aren't the end-all."



  • The pros and cons of hospital metal detectors

    The following is a look at some of the com mon pros and cons associated with hospital metal detectors.

    Pro: Metal detectors add a feeling of safety and security for staff, patients, and visitors.

    Since the September 11 attacks, some people may feel that the addition of metal detectors means heightened security .

    "Employees may buy into it because it shows that someone cares about where they are and that they're safe at work," says John Galbraith, CHPA, CFE, CHSP, director of public safety, transportation, and parking at Tarrant County Hospital in Fort Worth, TX.

    Con: Some people hold the perception that metal detectors make a hospital unsafe and unfriendly.

    Galbraith is frequently asked about this issue by fellow security directors, though he's never received feedback from patients, visitors, staff, or customers stating that the hospital seems unsafe.

    Pro: The operation of metal detectors will likely work as deterrent.

    "Very little actual violence occurs in the hospital because of a weapon," says Russ Colling, CHPA, CPP, security consultant for Colling and Kramer in Salida, CO .

    "If you take 100 random incidents of violence, you would be lucky to find that a weapon is involved."

    With that said, however, it doesn't mean that weapons couldn't pose a threat. The goal is to keep people from coming into the facility with weapons, which metal detectors should accomplish, Colling says.

    Con: Their operation calls for additional staff and cost.

    There's a price involved in using metal detectors: They require monitoring by two security officers at a time .

    To man one metal-detector station for one year would require five security officers, which Colling estimates could cost a hospital about $200,000 per year .

    "The five officers for one year includes vacation, sick time, and days off," he says.

    Pro: Metal detectors require little upkeep and maintenance.

    Metal detectors only cost about $3,500-$5,000, Galbraith says. Over the course of 17 years, Galbraith has replaced his metal detectors three times.

    Con: Metal detectors may require more staff training.

    Security officers who handle the metal-detector area must be fair and impartial, Galbraith advises .

    "This requires a lot of tact and a nonconfrontational attitude," he says .

    Look into training for your security officers, particularly in communication and deescalation techniques.



    What if the price isn't right?

    If your hospital can't afford to invest in metal detectors, consider other options.

    "Look at all safeguards and come up with your own recipe," says Russ Colling, CHPA, CPP, security consultant for Colling and Kramer in Salida, CO. Colling says the following are a few points to remember:

  • -An alert staff is the best and most economical violence prevention

  • -Train staff and security officers in deescalation techniques

  • -Consider alarm safe buttons that alert the nurse station or security

  • -Station a security officer in the emergency- department area or have security patrol the area regularly

  • -Reduce the number of entry points in the emergency area by locking certain doors