Lori Morrow, Senior Vice President Enterprise Healthcare, Allied Universal describes why security and hospital leaders need to work together to mitigate workplace violence and improve healthcare security.

Healthcare security

It is no secret that increased workplace violence is one of the top challenges impacting the healthcare industry today and security professionals are typically on the front lines responding to these situations.

The C-suite and security leaders continually strive to find the answer to the question everyone is asking: “How do we reduce the violence our employees are experiencing so they can go home safely at the end of their day?”

While there is no magic formula that eliminates violence, there are several key factors that can help to mitigate it.

The first is an acknowledgment of what is contributing to the increased violence.

Violence in healthcare has been around for decades, but it is no coincidence that the instances and levels of violence have dramatically increased over the last few years as illustrated by recent industry surveys:

• According to a survey by Preceptyx from April 2022, 92% of healthcare workers experienced workplace violence directly or was witness to an event
• The International Association for Healthcare Safety and Security (IAHSS) Foundation’s 2022 Crime Survey found that hospital violent crimes increased by 47% compared to 2020

While the pandemic caused a resounding crisis around the world, no industry felt the impact more than healthcare.

Most are aware of the physical and emotional strain put on clinicians and the staffing shortages caused by healthcare workers leaving the industry in droves, as well as the supply chain issues and cost increases, but many do not realize the long-term effect of those impacts.

Hospitals are experiencing one of the worst financial periods in history, with the majority sustaining significant losses.

While some are starting to see their first glimpse of recovery, healthcare leaders have had the arduous task of identifying how to cut costs without negatively impacting patient care. 

Contracted and travel nurse pay to fill staffing shortages, increased compensation to retain and recruit critical staff and hiring and retention bonus incentives have resulted in the need to reduce the cost of contracted or non-revenue producing services, which impacts healthcare security in several ways.

To manage violent situations effectively, training clinicians and healthcare security officers should work in conjunction, which will result in a cohesive unit that responds in tandem and in partnership.

When training is not consistent, response could be delayed, disjointed, rash or even excessive and may result in an undesired outcome.

Unfortunately, since the pandemic, hospitals have been forced to curtail hands-on de-escalation training for staff, resulting in undertrained clinicians who rely more heavily on security to take the helm in disruptive incidents.

Next-level crisis management training is the single most important tool we can provide to our workforce, giving them the skillset needed to feel prepared and confident in their response to any situation. 

While clinicians and healthcare security should receive the same core de-escalation training, investing in enhanced training that complements and expands on those elements should be considered.

Creating an elevated healthcare security professional who is specifically trained to manage violent and combative patients and situations is critical.

While de-escalation tactics for healthcare security professionals are crucial, non-escalation measures should be the key strategy to avoid situations altogether.

Importance of a non-escalation strategy

Empathy and respect are key elements of non-escalation. When we understand and empathize with what a person may be going through, compassion itself goes a long way in calming situations before they become a problem.

Often individuals just want to be heard and feel that someone understands them and is on their side.

All of us feel the pinch day-to-day of excessive inflation and other societal pressures. Consumers are angry and frustrated and patients may now be facing hefty medical bills on top of financial struggles.

Others are scared and may have received a diagnosis they do not know how to deal with or may not even fully understand what is happening to them or a loved one.

Meanwhile, others may have trauma in their past that is triggered when they are in an uncomfortable situation where they feel they have no control.

Training healthcare security professionals to identify potential underlying indicators and respond with compassion and informed care is a critical step in avoiding escalation.

This can be accomplished through enhanced education about mental health.

Key tactics to avoid harm

When physical intervention cannot be avoided, there are several tactics healthcare security officers need to employ to ensure a successful outcome for everyone.

These include situational awareness, proxemics, placement, holds and blocking in a manner that prevents harm to the patient and themselves.

Not all crisis management programs are created equal in teaching these skills. Healthcare is probably the only industry where security professionals go to work every day knowing they will face aggression and violence at some level.

It is our responsibility to ensure they are properly prepared for it. Healthcare security leaders must look beyond the standard off-the-shelf programs and implement training specific to the clinical setting, scenarios and unique patient dynamics encountered daily.

Staffing for success

The workforce situation, while beginning to improve, is still dire, especially for healthcare and security workers.

Staffing shortages, frequent turnover, financial cutbacks and fatigue are compounding injuries to those engaged in violent patient interactions.

Depending on the facility, this could mean that clinicians or security professionals are responding alone to incidents or have minimal assistance.

One measure a facility can use to combat this is the implementation of a Behavioral Emergency Response Team (BERT).

BERTs include various department members who can quickly respond to incidents and are trained in methods to address behavioral emergencies so that medical care is not impeded.

Some health systems have been successful with these programs but sustaining them has been a challenge as turnover and staffing shortages lead to a loss of trained team members.

A concentrated effort should be made to breathe new life into this initiative where it has fallen off and advocate for implementation at other sites, based on studies that show they can be highly effective in mitigating injuries and providing a better patient experience.

Staffing challenges

The shortage of security staffing has become an epidemic within itself. As the risk healthcare security professionals face is the highest it has ever been – from the increased threat of violence and active shooter events – a sizable percentage have determined that the wage does not match the ask.

Markets have become increasingly more competitive in pay due to industries outside of healthcare recognizing the need to increase pay to attract today’s more discerning and less tolerant workforce.

It is not surprising that many are electing to work in less stressful and demanding industries, such as warehouse, distribution, retail and food service.

To address this, leaders must work with the C-suite to change the perception and culture around security and look at tackling the overall problem holistically.

The days of viewing security as something necessary but not a valued piece of the organization must end.

While budget constraints are always a dilemma, security must be viewed as an integral department of the healthcare setting which plays a key role in impacting employee and patient satisfaction.

Elevating healthcare security programs

When talking to staff or leaders of a hospital, most will say that they need more security, but budgets will not support it.

Certainly, in some instances, more is necessary, however, it could be more effective to elevate the program instead of expanding it. It is possible to achieve more with less, if security professionals are highly compensated and skilled, resulting in a higher functioning team with more experience and increased aptitude.

When these healthcare security professionals are further developed through specific enhanced training, the result can be highly effective with the potential to reduce incidents and provide staff, patients and visitors a higher confidence in security.

There is an abundance of challenges facing healthcare security, but it is time that healthcare and security leaders rally together to create a solution and stop accepting violence as the norm.

The partnership between security and hospital leaders has never been more important and we must work together to solve these challenges with a unified goal.

Through an elevated program and integrated security solutions driven by advanced technology, a partnership focused on a comprehensive solution can forge a road toward a future of next-level healthcare security and a reduction in violence for all healthcare facilities.  

This article was originally published in the September edition of Security Journal Americas. To read your FREE digital edition, click here.