Hospitals face intrusion of violent world into facilities

Both surburban, urban cope with security risks


Howard County General Hospital is a typical suburban facility, its administrators proud to be known for the cozy maternity suites, the cancer support programs and sophisticated technology.

But they're not so happy about the kind of publicity the hospital has faced in recent weeks: a midnight brawl in the emergency room that ended in three arrests and three injuries; a suspect awaiting drug charges who slipped out and remains at large.

While rare, such incidents have unnerved patients and staff and highlighted the fact that once-sleepy suburban hospitals - like neighboring shopping malls and schools - now have to cope with complex crime and security issues.

"Today, every hospital is at the same risk of exposure to drug and alcohol abuse, domestic violence and psychiatric patients," said Roger Sheets, president of the Maryland chapter of the International Association for Healthcare Security and Safety. "All of it shows up in your emergency room, and your security officer at the front door has to have a better level of training than being told to say, `Good morning. How are you?'"

For their part, suburban hospital officials say they offer an appropriate level of security given the risks they typically encounter - the occasional unruly patient, emergency room ruckus or specialized needs, such as those posed by psychiatric units.

"The hospital employs security guards, not police officers," said Mary Patton, a spokeswoman for Howard County General Hospital, who declined a request for an interview with the hospital's security director.

Hospital security experts say concerns have escalated at virtually every institution - urban and suburban - in the wake of Sept. 11 and worries about such issues as bioterrorism. Some states, such as New Jersey, have considered sending in "red teams" of undercover agents and contractors to test hospital security.

"Right now, the federal government is trying to determine how lax hospitals are, and I can tell them ahead of time that they're not anywhere near where they need to be from a security standpoint," said Jeff Aldridge, former director of safety at the University of North Carolina Medical Center at Chapel Hill and now a consultant on health care security. "Hospitals want to be an open, warm atmosphere where people can come bond with a patient, but you can't do that anymore."

More cameras

Security measures include sophisticated camera systems allowing staff to monitor hallways and emergency rooms; intensive training for guards, who may be armed in some cases, and equipment that can lock down all of a facility's doors.

But there remains a gulf between the level of security offered at smaller, suburban hospitals and at urban complexes such as the 500-bed Sinai Hospital of Baltimore, the state's third-largest, which handles 10,000 visitors a day.

Sheets, who directs security for Sinai and the three other LifeBridge Health facilities in the Baltimore area, said the 80 security officers at Sinai carry batons and some of them carry guns. Most of the facility can be locked down electronically.

At 187-bed Howard County General, by contrast, security officers do not carry weapons of any kind and only security supervisors carry pepper spray. Howard County can lock some of its doors electronically, but a spokeswoman would not say which ones. At 260-bed Anne Arundel Medical Center, emergency room doors must be locked manually.

"After 9/11, and even more so after Hurricane Katrina, all of us are looking at this issue," Sheets said. "After Hurricane Katrina, one facility went 10 days without help from the outside world. They had to face bands of roving gangsters. They now know how valuable a proficient security force is. Could that happen in Baltimore? Absolutely."

Howard hospital officials are painfully aware of how a security issue can erupt even in a relatively peaceful suburban community.

On a Saturday night in June, for example, an angry crowd of 20 to 30 tried to shove past guards in the emergency room - even trying to climb over the reception desk - in an effort to see a friend who had been fatally shot. Three were arrested, and the hospital had to divert incoming patients elsewhere for a short time.

Last Sunday, a patient who had been brought in after nearly drowning while fleeing police slipped out of an inpatient floor where police had left him to be treated for severe injuries. Authorities had been waiting for him to recover so they could charge him with cocaine possession. He remained at large yesterday.

The pressure is on

Hospital and police authorities insist that they acted properly in both cases. Hospital spokeswoman Patton said the police would have to explain why no one was guarding the drug suspect.

"If a police officer had been stationed with him, we would have given that officer an orientation, told them how to contact our security, if they needed help, and checked in with the officer on an hourly basis," Patton said.

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