Hospitals must work not only to keep their communities well, but to keep them safe.
Christine Schuster, RN, MBA, is president & CEO of Emerson Health in Concord, Massachusetts
The recent tragic mass casualties at the Independence Day parade in Highland Park, Illinois the Robb Elementary School in Uvalde, Texas, and at the Saint Francis Health System in Tulsa, Oklahoma are a stark reminder that these events can happen anywhere.
Hospitals must always be prepared to ensure the safety of patients, visitors, staff, and their broader communities.
Emerson Hospital, located 20 miles west of downtown Boston in an idyllic, suburban setting, once might have been considered exempt from the security considerations of, say, a larger urban teaching hospital. We have known for some time that security is just as important for our community hospital, and we have made a major effort to plan for every contingency. That planning extends beyond the campus, as we must ensure the safety of the many hospital-owned clinics, physician offices, and service sites, which cover an expansive geography.
Beyond the immense physical, technological, and training investments we make in the security of our campus and affiliated properties, we have a major focus on ensuring that our patients are safe even once they leave the hospital setting. We train staff to be alert for signs of potential abuse, and, just as important, how to support a patient who may live in fear of their spouse or a family member.
The focus on safety has accelerated in this new millennium. The events of 9/11 brought surge planning and emergency preparedness into sharp focus. More recently, COVID-19 forced a complete re-examination of our efforts to keep our community safe. I have learned much during this time period, including the following six key lessons that can benefit other hospitals.
1. Coordination with local authorities is critical.
We work closely with our local police and fire departments, and that includes information sharing and regular visits to build their familiarity with our campus. We bring them up to speed on any public safety concerns and we solicit their input whenever we update procedures. Because we are located just over a mile from a state prison, we have the same tight coordination with state police, as any prisoner escape must be met with a lockdown of our campus.
2. Drill, drill, and drill again.
Drills are essential for smooth handling of crises. We regularly conduct tabletop exercises, drills, and full-scale exercises to test our emergency response. Just as important as the drill is the debrief that occurs afterward. This is when we fully learn how we did and what could have been done better. Drills always present the opportunity to improve upon our response.
3. Prevent workplace violence.
We realize that our hospital, like any, is subject to internal and external threats. Far too often in our nation, disgruntled employees become the source of violence. We have instituted trainings so that supervisors and managers can recognize when an employee poses a threat to co-workers and the community, and to de-escalate the situation and get additional support.
4. Maximize local resources.
For nearly 10 years we have worked with our local domestic violence services network to ensure that patients we serve can get the resources and support they need when they live in fear. This agency trains our caregivers on supporting abuse victims and helping these individuals to get to safety. We know all too well that not only do about one third of women experience physical or sexual abuse in their lifetimes, according to the World Health Organization, but that abusers can become homicidal. Preventing the senseless abuse of women keeps our entire community safer.
5. Leverage technology.
Just as threats to hospitals and other institutions have intensified, the technology to respond to those threats has vastly improved. Highly sophisticated tracking and monitoring systems enable our public safety team to track movement across our campus. Computer programs can recognize changes in speech patterns and tones to flag when a crisis may be unfolding and so that help can be summoned without a gesture that is obvious to anyone else. Hospitals must continuously upgrade their campus safety technology.
6. Make data-driven decisions.
Data is central to our efforts to maintain a safe campus. We analyze the data to determine the changes we must make to our campus. We look at how fast patients and staff get on and off campus, where they park, and how they circulate to devise the best methods for ensuring safety. We measure how attentive staff are and how quickly they respond to different types of stimuli. We constantly tweak our operating protocols in response to data.
The Tulsa hospital shooting and the other tragic events are painfully sad reminders that our world is inherently dangerous. Hospitals must step up and be the leader for safety in their communities.
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Christine Schuster, RN, MBA, is president & CEO of Emerson Health in Concord, Massachusetts