Rise in Healthcare Facility Workplace Violence Urges Examination of Duress Solutions and Response Procedure

Rise in Healthcare Facility Workplace Violence Urges Examination of Duress Solutions and Response Procedure

From Facilitycare.com


Two men entered an East Coast hospital separately with the intent of seeing the same woman who was a patient. An argument ensued as the two men made their way in, and the situation quickly escalated into a physical altercation involving weapons. Hospital staff immediately activated their panic button system to notify security. The altercation moved throughout the facility, and as it moved, other panic buttons along the way were activated, alerting security to the situation location in real time. Eventually the men were apprehended by law enforcement and the situation was resolved with only minor injuries to the two men.

This situation is not an uncommon scene in hospitals today. Violence not only between patients but also against staff is a rising concern across the country. According to a recently released survey by the International Association for Healthcare Security and Safety Foundation (IAHSS), the number of violent crimes within hospitals in the U.S. increased 40 percent between 2012 and 2014 with an incident rate of 2.8 per 100 beds. The majority of assaults in healthcare facilities were against employees by patients or clients. With the increasing rate of violent crimes at healthcare facilities, it is vital that healthcare staff are provided with tools to alert first responders and protect themselves.

While panic buttons have been in use for decades within the healthcare industry, many systems are antiquated, incomplete or not properly functioning, or do not trigger the needed response. When it comes to a panic button system within a hospital setting, it is imperative to think of it as the lifeline for facilities staff. The panic button may be the only option to request assistance during an emergency situation, so it must work flawlessly.

Evaluating Healthcare Facility Safety Systems

An inventory of equipment is the initial step in evaluating your current system. This may seem like a basic first step, but oftentimes systems that have been in place for long periods of time go through changes. Not all changes are relayed to security management, which can create gaps in the coverage. A centralized inventory of all locations as well as any equipment changes (deletions, additions, relocations) should be managed on an ongoing basis.

All lifesaving equipment undergoes regular testing to ensure proper working order. Panic buttons are no different — they should be regularly tested to ensure performance of the equipment is up to par.

As the inventory is taken, gaps in coverage will likely surface. Older systems may only have a few locations where equipment is installed in a facility — typically centered on admittance, or entrances to the facility. Given today’s increase in violent healthcare facility situations, it is imperative that coverage be expanded deeper into the facility to provide a more substantial scope of coverage. Incidents can occur in any location where there are patient-staff interactions, nurse’s stations, behavioral health units, cashiers and HR/administration offices.

Considerations for System Investments

Once the evaluation phase is complete, outcomes may include a healthy system that is functioning as needed outages in the current system need to be addressed/upgraded. A third possibility is that the current system is antiquated and no longer meets the safety standards of the facility. Panic button systems for healthcare facilities vary based on size of facility and requirements for protection. Most panic button systems are classified as wired, wireless or network-based. Each has advantages and disadvantages, again based on requirements and the existing IT of each healthcare facility.

Wired panic buttons have been used in hospitals and healthcare facilities for decades. These systems tend to be a basic button or switch that when triggered will activate an alert at a control panel. The advantage of these systems is they are relatively easy to use and manage, are readily available, and fit into various types of facility budgets. Wired button systems don’t allow for mobile buttons that can be carried by staff. Wired systems also typically require ongoing human monitoring of a control panel, which opens up the possibility of missing an alarm. Additionally, wired systems tend to be more difficult to expand and more costly.

Wireless panic buttons are a newer technology and can range from Wi-Fi-based buttons, which can use an established facility network, to 900 MHz buttons that function on their own wireless network. The primary advantage of wireless systems is that they not only cover the fixed locations, but they can also provide coverage for staff who are mobile/frequently moving throughout the hospital or healthcare facility. Additionally, many wireless duress systems provide multiple communication methods for relaying alarms.

Some wireless systems have limitations on the ability to expand using repeaters; in other words, these systems may have a limited range and may have issues with covering large healthcare campuses. Another issue is that some Wi-Fi-based systems can struggle in high wireless traffic environments, resulting in issues for alarm transmissions. Fighting a perception within an organization regarding reliability may also be a concern. While most systems are as reliable as wired systems, the perception that they aren’t can still be hard to shake.

The final type of panic system is a network-based system. These are typically server-based systems that use a client residing on the user’s computer that, when activated, will trigger an alarm at a monitoring computer. These systems leverage current facility network infrastructures to provide a large coverage area under a single system. These systems can provide other capabilities, such as access control, mass notification, etc. Network-based systems can be costly. Many of them require a dedicated server, which can be a substantial investment upfront and is often costly to maintain, thus making it unrealistic for some facilities. Additionally, the network-based system requires a user to be tethered to a workstation in order to trigger the system. As some apps become available for tablets and phones to make them a mobile solution, The Joint Commission requirements on locking of devices still make it a time-intensive task to activate an alarm.

It All Comes Down to Response

In our example of the two men visiting the same woman in the hospital resulting in a physical altercation, proper planning and placement of buttons, along with proper training, quickly brought a dangerous situation to an end by eliciting the proper response. In this case, on-site security was able to receive immediate updates about the location of the incident over their radios and eventually resolve the incident.

Systems that rely on dispatch centers and monitoring stations add extra layers to initiating a response, which can cost precious time. Ideally, a multipronged approach should be used in which information is delivered directly to first responders through radio or phone, and additional information is sent out via email, text message or PA announcement to staff.

If your current panic button system sufficiently meets your needs at this time, it should be re-evaluated on a regular basis to ensure optimal performance. Be sure to check your system, test your buttons and regularly train staff on usage policies. Should you ever find yourself in need of a replacement, whether it’s now or in the future, sufficient coverage and response times are criteria that should be at the forefront of your considerations.

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