NOT so long ago, an eminently qualified young security and safety professional told me that he once responded to an advertisement to fill a vacancy for a senior security position at the  Georgetown Public Hospital Corporation, only to discover that those responsible for conducting the interview were fixated inadvertently or otherwise, on having a former police officer fill the position. This he surmised from the line of questioning which ensued, suffice it to say that he was not hired. A recent advertisement posted by a private hospital for the recruitment of security personnel, demonstrated a lack of knowledge of the importance of industry-specific safety and security procedures. By flippantly accepting military or police training as the standard criteria for employment in its security department, hospitals expose their patient population, and the visiting public who have occasion to be present within their legal confines, to numerous safety hazards.

Hospitals are the focal points of education for health professionals and clinical research necessary for the advancement of medicine. Thus, the hospital is one of the most complex of all administrative organizations. Therefore, it requires a thorough knowledge not only of the hospital set-up but also of its purpose, history, classification and the peculiar conditions which prevails in hospitals, of all types both large and small, in order to effectively manage the risks inherent in hospital safety and security operations.

Definition of hospital
An evolved definition of the hospital is as follows:
“A modern hospital is an institution which possesses adequate accommodation and well qualified and experienced personnel to provide service of curative, restorative and preventive character of the highest quality possible to all people regardless of race, colour, creed or economic status; which conducts educational and training programmes for the personnel particularly required for efficacious medical care and hospital service; which conducts research assisting the advancement of medical service and hospital services and which conducts programmes in health education.”

Hospitals provide medical care to the sick and needy. They are not in the business of manufacturing consumer goods, but for rendering critical services and are far more dependent than other organizations upon their employees’ morale and commitment. Employees in such institutions, including the security staff, who function as a buffer zone between the hospital staff and the citizenry, are constantly facing the public. Institutions which provide medical care are generally criticised more for the attitudes of their personnel than for the quality of the care they provide, which is often a source of security concern.

While a hospital has many organizational and operational elements in common with hotels, industrial organizations and educational institutions, it is a unique institution as it often includes all the activities present in each of the afore- mentioned groups. However, the difference between administrative work in hospitals and in other organizations, except for prisons, can be attributed to the existence of the following conditions peculiar to hospitals:

1. The consumers of the services provided in a hospital ( the patients) are physically or mentally ill and are rendered services within the four walls of the hospital. As compared with most other institutions of business, government and education, this is an unusual situation again except only for prisons and presents quite different problems and management challenges.

2. The customers of the hospital (the patients) have individual needs and requires highly personalized and customized services.

3.  In addition to the more common intuitional services and functions such as hospital hospitality, general housekeeping, laundry, maintenance, purchasing, personnel, credit and dept collection and public relations. The hospital also provides a wide range of scientific and technical services such as nursing, diet therapy, anaesthesiology, pharmacy, radiology, clinical laboratory, physiotherapy and medical social work. It is important to note that many of these services are provided continuously, round the clock, every day of the year.

4. All these services involve many individuals-the ill customer himself, his emotionally tense relatives and friends, physicians, technologists, clerical staff and manual labourers. All these individuals who are working, suffering, eating, and sleeping within a comparatively small space are constrained to do so in an unusual atmosphere, which is highly charged with emotion and tension. only a very capable administrator assisted by competent heads of departments can adequately appreciate and effectively deal with the human relations problems arising from these constraints.

5. Nurses and certain other personnel must accept direction from both the matron and the physicians under whom they work closely every day. The human relations problems inherent in such situations of dual authority are much more frequent, delicate, varied and complex than in organizations where this situation does not exist. For these reasons,it is often said that the hospital is a “total institution” with an ethos and peculiar institutional philosophy of its own, as is the case with the prison system or disciplined forces.

6. Handicapped by relatively low wages, rigid discipline and some apprehension of exposure to disease, hospital personnel are expected to maintain a very high level of efficiency and confidentiality, as their functioning affects the wellbeing and lives of  patients. Many doctors and nurses work long hours which ultimately affects their mannerisms, judgment and tact under stressful circumstances, thus resulting in  public relations crises, and a  constant source of concern  for the security staff.

7. Another way in which the responsibilities and activities of the hospital administrator differ from his/her counterpart in other fields is in the amount and variety of training programmes that the hospital has to provide; this is especially the case with hospitals like the GPHC. Since the hospital must confirm to strict quality control regimes, its staff must be trained to national and international standards. This training lasts anywhere from six months to seven years in the first instance, even semi-skilled and semi-technical staff members have their own curriculum.

Special areas of concern to hospital safety and security staff

While hospitals are very expensive institutions to run they are by nature relatively porous installations, because security procedures in hospitals should not impinge on the quality and effectiveness of patient-care services. They are also complex operations and their security is typically more involved; which in turn presents more challenges than other types of facilities. Developing, implementing, and managing a hospital security programme that provides the required levels of control and protection, while maintaining or improving the desired levels of accessibility, service and patient satisfaction is often a challenge.

Safety management is a very important aspect of planning in every form of infrastructure, and includes aspects of not only fire safety, but also security measures to militate against a whole range of unsafe encounters such as theft, pilferage, extortion, abduction, riot, natural calamities, sabotage, murder and acts of terrorism. The hospital, as an infrastructure, has many heat – dissipating equipment, combustible gases/fuel, chemicals, and a lot of electrical wiring etc. Therefore, adequate measures need to be considered, designed, and practised to ensure safety to all.
There are ten special areas of concern to hospital security, namely: 1.Facility, 2. Personnel, 3.Patients, 4. Medical equipment, 5.drugs and controlled substances, 6. Supplies 7. Utilities, 8. Patients’ property 9. Visitors and  10.Visitors’ properties. In addition, special attention should be given to these areas in order of their priority and depending upon the size and location of the hospital being secured. Naturally, small rural hospitals are not complex places and do not require the same level of protective resources as larger hospitals located in urban settings.

Large urban hospitals, especially those run by the government, have some additional security concerns which ought to be given attention in order of their priority, these are as follows: 1. Parking lots, 2. Triage 3. Emergency department, 4.Psychiatric wards, 5.Forensic patents, 6.Newborn and Paediatric facilities, 7.Staff quarters, 8. Information infrastructure 9. Pharmacy and 10. Supply stores.

Other areas which will need the attention of the hospital security manager are, animal control, waste management, information security and the prevention and  control  of violence within the hospital settings.