The escape prompted Laurel Regionals parent, Dimensions Healthcare System, which also includes 375-bed Prince Georges Hospital Center in Cheverly, Md., to decline nonemergency medical transfers from the state police and the Maryland Department of Public Safety and Correctional Services. The corrections agency blamed what happened on the officers failure to follow protocol: two guards on each prisoner at all times, one of them armed and a second unarmed, an approach designed to prevent exactly what happened. In Pokes case, the guard with the gun had been left guarding Poke alone while the partner took a break. Both were fired.
Baratta, of GE Security, says that hospitals require a carefully planned and zoned approach to security, welcoming the public into an outer layer but erecting layers of defense toward the core of the hospital, a concept thats generally recognized but inconsistently executed and can be helped or hurt by a facilitys construction. Forensic patients, he suggests, are best served in areas built for behavioral health patients, outfitted with secure doors and designed to keep equipment out of reach.
Hospitals are acutely aware of the need to secure their newborn infants, and labor and delivery units are second only to emergency departments in the number of hospitals that reported to the IAHSS that they protect them with electronic access and video surveillance. There have been 123 infant abductions from hospitals since 1983, and the numbers have dwindled as hospitals have become hardened targets, with no more than five in a single year since 1999, according to the National Center for Missing & Exploited Children.
A narrow time lapse and other breakdowns allowed a woman to walk out of 226-bed Central Florida Regional Hospital, Sanford, on a March afternoon carrying an abducted baby boy in a large shoulder bag, according to a report generated by the Florida Agency for Health Care Administration. Jennifer Latham, 39, was arrested about an hour later and has been charged with kidnapping. The child was returned unharmed to the mother. She had relinquished him to Latham, dressed as a nurse, who lied that the baby needed an eye exam, witnesses told investigators.
The HCA-owned hospital hired an outside consultant to help bolster its system for controlling access and responding to a breach, and state surveyors revisited the facility in May and determined the problems had been corrected. The surveyors concluded from their initial observations and interviews that several things went wrong in order for the alleged kidnapper to get as far as she did.
The precise timing was impossible to nail down, the surveyors concluded, because the clocks on the maternity wards alarm system, the security cameras and the one used by the operator were not synchronized. The view from the main lobby camera, however, showed that the woman left the hospital 49 seconds before the first responder arrived there.
The interviews and camera footage, according to the report, indicate that Latham signed in at the front desk and slipped into the postpartum unit through a keypad-controlled door behind a maintenance worker. Once inside, she changed into a nursing outfit, and then changed back into street clothes before walking out the same door with the baby. It could not be determined how she was able to get through the door, which should have been locked with magnetic force by the radio-signal tag on the infant apparently stowed in her bag, which did trigger the alarm. A nurse responded about 30 seconds later and checked the mothers room and soon after asked a staff member to issue a hospitalwide Code Pink.
Chief Nursing Officer Angela Lambert, not wanting to give anything away to would-be intruders, declined to describe in detail the changes that were made in response to the incident. She offers, though, that the hospital now generates photo identification for every visitor to the childbirth area, and staff identification procedures have been enhanced.
Anything that happens like this is always a challenge, and it requires a continued focus and being even more vigilant, Lambert says. We had a lot in place, and we now have some redundancy to our existing system.
What allowed the Florida abduction has long vexed hospitals and the people whose job it is to protect the people who work and receive care in them, says Tony York, president of the IAHSS and senior vice president of Hospital Shared Services, a Denver-based company that offers support services, including security, to providers in several states.
Access control to the healthcare environment is one of the greatest risks facing our industry today, York says. Neither he nor the IAHSS recommends turning hospitals into armed fortresses or packing them full of expensive surveillance gear without a well-thought plan as to whats supposed to be accomplished.
In many cases, York says, controlling who comes and goes is best accomplished under the guise of customer service, along the lines of Wal-Mart greeters, making sure everyone who enters the hospital is personally acknowledged and guided to a destination. After-hours visitors should be required to show government-issued identification and given visitors passes.
In new construction, meanwhile, hospitals have opportunities to design pathways, lighting and landscape architecture that eliminate hiding spots and help staff realize when people have gone somewhere they shouldnt. Labor and delivery units can also be placed on upper floors, making it take longer for would-be kidnappers to get out, York says. A growing number of hospitals are choosing to work with a single vendor to provide integrated electronic access, surveillance and environmental controls, he adds.
The results of the IAHSS survey indicate wide discrepancies in the ways hospitals approach security and what they spend on it, but York says he doesnt believe that means the government or the Joint Commission needs to take a more aggressive role. I dont think theres a lack of regulation, York says. The Joint Commission standards and the conditions for participation in federal health programs, which include providing a safe environment, set what York calls floor standards for what hospitals need to do. In the trade groups survey, 49% of the respondents said they had received zero Joint Commission deficiencies on their most recent report, while 13% received five or more.
The Joint Commissions Gervais affirmed what the survey results suggest, that hospitals by and large do quite well living up to the security demands for accreditation. Its a requirement weve had for many, many years, and hospitals have always taken it seriously.