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If hospitals want to improve safety, start by talking to the employees


Many health systems aren’t engaging in a simple but useful step. Paul Sarnese, a security consultant, talked with Chief Healthcare Executive about protecting workers and patients.

Seattle - Hospitals and healthcare organizations have encountered more violent incidents recently, and they are facing growing pressure to protect their employees.

A Tennessee hand surgeon was fatally shot in his orthopedic clinic earlier this month. Other hospitals have seen fatal shootings. Even aside from gun violence, physicians and nurses say they’ve suffered more physical abuse in recent years.

Some health systems are working to better protect their workers and patients, but Paul Sarnese, a security consultant, says some organizations are failing to take one essential step.

Hospitals need to talk to their employees about improving safety, and some aren’t doing that, Sarnese says.

“One of the big things that I believe is missing is really getting the voice of the customers,” he says. “It's really talking to employees. Organizations can spend hundreds of thousands of dollars in security investments, and the employees will still not feel safe. So you really have to engage the employees, the physicians, the residents, everybody that's coming in and really kind of gauge their perception of security.”

“I think a lot of organizations miss that opportunity,” he adds.

Sarnese led a session on violence in healthcare organizations at the American Hospital Association Leadership Summit earlier this week. Before the conference, he sat down with Chief Healthcare Executive® to discuss ways to improve hospital safety. (See part of our conversation in this video. The story continues below.)

The former president of the International Association for Healthcare Security and Safety, Sarnese says talking with employees will help leaders see gaps that may not be apparent. It’s also vital because some healthcare leaders may be a bit removed from having delivered patient care. At a minimum, leaders will show their employees that they care about their safety, he adds.

Executives should ask their workers if they feel safe entering a room, or if the facility is designed in a way to reduce the risk of attacks.

“Nobody knows their job better than the employee,” Sarnese says. “Nobody knows the unsafe circumstances that may present themselves better than an employee. So you have to ask: What can we do to make you feel safe or what can we do to keep you safe?”

Read more: Hospital leaders urged to join fight against gun violence

More hospitals are looking at systems to identify weapons, including metal detectors and cameras, says Sarnese, who previously led security at Virtua Health in New Jersey.

Some systems are also increasingly turning to K-9 units to assist with security, which Sarnese says can be a good move.

“I’m a big fan of canines,” he says. “They certainly have a great deterrent value, but they're also very therapeutic.”

Hospitals should be looking at the physical environment of their organizations, including ease of access for patients. Executives need to look at whether employees feel safe getting to parking facilities.

“Look at things like access control, and surveillance, and emergency communication, all of those things that really create a comprehensive, multi-layered security program,” he says.

As more health systems are increasingly providing care outside the hospital, Sarnese says it’s important to pay attention to the security of outpatient facilities and clinics.

More hospitals are also taking a look at their security staffing, Sarnese says.

While staffing shortages of nurses and other critical healthcare workers have drawn attention, he says some hospitals have struggled to fill openings for security positions.

“One of the things I encourage all of my clients and others is to do a market analysis as to what are you paying your security officers,” Sarnese says. “Because if Taco Bell and Walmart are paying the same that you're paying your security officers, you’re going to have a really hard time.

“Being a healthcare security officer is a hard job,”  he adds. “So you know, you kind of get what you pay for … So yes, we are struggling in the industry as a whole in recruiting right now.”

Some healthcare workers have said they don’t feel like hospital executives have done enough to ensure that those who assault employees are prosecuted. Sarnese said hospital leaders should talk to their local prosecutors to stress the importance of filing charges against those who attack workers.

“It sends a heck of a message to the rest of the community that it's not tolerated,” Sarnese says.

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