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1. International Association of Healthcare Security and Safety
 ASIS International Board Certified Physical Security Professional
Achieved PSP status on July 29th, 2011
 (IAHSS Basic Certification) CHSO Achieved August 30th 2012
 (IAHSS Advanced Certification) CAHSO Achieved September 19th
2012
 Valid for three years

2. What is IAHSS?
 The International Association for Healthcare Security and Safety, or
IAHSS for short, is the only organization solely dedicated to
professionals involved in managing and directing security and
safety programs in healthcare institutions. IAHSS is a
professional organization comprised of security, law enforcement
and safety professionals dedicated to the protection of healthcare
facilities worldwide. IAHSS strives to combine public safety officer
training with staff training, policies and technology to achieve the
most secure hospital environments possible. Additionally, the IAHSS
partners with government agencies and other organizations
representing risk managers, emergency managers, engineers,
architects, nurses, doctors and other healthcare stakeholders to
further patient security and safety.

3. Who is the IAHSS?
 The IAHSS has the basic purpose of promoting professionalism
in healthcare security and safety.
 The IAHSS was founded in 1968, as a non-profit organization
and has members throughout the United States and other
Countries.
 The IAHSS is a progressive Certification.
 I have satisfied the first of three levels. (Basic, Advanced and Supervisory)
August 30, 2012.
 I have satisfied the second of the three levels or advanced Sept. 19, 2012.

4. Who is the IAHSS?
 The IAHSS created a
guideline for Healthcare
Facilities to base Security
Designs off of.
 Parking and the External Campus
Environment
 Buildings and the Internal Environment
 Inpatient Facilities
 Emergency Departments
 Behavioral/Mental Health Areas
 Pharmacies
 Cashiers and Cash Collection Areas
 Infant and Pediatric Facilities
 Areas with PHI
 Utility, Mechanical and Infrastructure
Areas
 Biological, Chemical and Radiation
Areas
 Emergency Management

5. Opening Doors
 The IAHSS is recognized in
the Healthcare Arena

6. Speak Your Language
 Obtaining the CHSO and CAHSO
allows me insight into facility
requirements and how the system
may be utilized
 Short term
 Long term
 Reoccurring

7. IAHSS Created A Risk Assessment
Toolkit
 Our Customers Hospital may be a large inner city institution or a small
rural facility. Healthcare security professionals, regardless of hospital
size or location, should conduct an initial and annual assessment of
risk relative to their facility.
 Risk assessments can include identification of threats, vulnerabilities,
and based on both, an analysis of problem areas and the steps
required to reduce or mitigate loss. Determining the process and what
steps or controls are required to protect critical and sensitive assets
adequately, and in a cost effective manner, is the challenge they all
face. Determining how critical the asset is to the facility and the value
of that asset to an adversary is a basis for how likely it is for a loss to
occur and what the potential impact of that loss might be to the
institution.
 ESCO has a CD toolkit which includes an explanation of a risk
assessment, sample forms and sample policies.

8. Basic Training Manual for Healthcare
Security Officers – Fifth Edition
 The book is broken down into six sections.
 There are a total of thirty-eight chapters.
 Medical Records and HIPPA
 The Healthcare Organization  Support Units and Ancillary Services
 Security Services in the Healthcare Organization  Vulnerabilities and Risks in Healthcare
 Customer Relations: Public, Employee and Labor Relations Issues Settings
 Customer Service  Integration and Use of Physical
 Teamwork and Team Building Security and Access Control
 Patrol Procedures and Techniques  Equipment Use and Maintenance
 Security Interactions in Various Situations  Identity Theft
 Risk Reduction: Restraints, Self-protection and Defense  Overview of the Incident Command
System
 Professional Conduct and Self-development
 Basic Safety Protection of Officers
 Crisis Intervention
 Fire Prevention, Control and Response
 Interview and Interrogation
 Terrorism
 Report Preparation and Writing
 Bomb Threat Response Planning
 Report Value and Liability
 Emergency Management
 Judicial Process, Courtroom Procedures and Testimony
 Civil Disturbances
 Parking and Crowd Control
 Violence Issues: Domestic, Workplace
 Patient Care Units and Hostage Situations
 Business Office and Financial Services  Criminal and Civil Law
 Pharmacy: Physical Security, Narcotics and Dangerous Drugs  Statutes and Standards Affecting
 Emergency and Behavioral Units Security Actions
 Infant and Pediatric Units  Regulatory Agencies
 Public Safety Interaction and Liaison

9. Advanced Training Manual – Third
Edition
 There are a total of fourteen chapters.
 Security Awareness and Crime Prevention
 Enhanced Customer Service
 Premise Liability
 Methods of Patrol
 Investigative Techniques, Reports and Procedures
 Off-campus Security and Safety
 Workplace Violence
 Patient Risk Groups
 Interacting with Patients
 Special Security Considerations
 Security in Sensitive Areas
 Electronic Security Technologies
 Critical Incident Response
 Advancing Professionalism

10. Defining Healthcare Security
 A common error for healthcare organizations is to view security as
being closely aligned with the law enforcement function.
Security Law Enforcement
• Prevention of • Apprehension
Incidents Administrative Law Enforcement of Offenders
• Protecting an Remedies Remedies • Protecting
Organization Society
• Administrative To resolve a To resolve a • Legal Remedies
remedies situation in the best situation in • Statute defined
• Organization interests of the accordance with • Tax Supported
defined organization local, state and • Public Opinion
• Private and Tax federal laws
Funding
• ROI
 Moral responsibility, legal concerns, complying with accreditation/regulatory requirements,
contribute to quality patient care, maintaining the economic/business foundation of the
organization, and maintaining sound public, community and staff relations.
Hospital and Healthcare Security – Fifth Edition (Russell L. Colling Tony W. York Butterworth-Heinemann page 20

11. Influencing Organizations on
Healthcare Security
 TJC (The Joint Commission)
 NCMEC (National Center for Missing or Exploited Children)
 CMS (Center for Medicaid and Medicare Services)
 IAHSS - International Association of Healthcare Security and
Safety (I currently hold the CHSO and CAHSO Certifications)
 ASIS International (I am a Board Certified Physical Security
Professional with ASIS International)
 ENA (Emergency Nurses Association)
 NFPA (National Fire Protection Association) (I previously held install
and inspections licenses for Kentucky, Ohio and West Virginia)
 State Health Departments
 Federal, State and Local Legislation/Ordinances
Hospital and Healthcare Security – Fifth Edition (Russell L. Colling Tony W. York Butterworth-Heinemann page 35

12. Safety and Security Inspections
 There are two categories of inspections:
 Hazard Surveillance Rounds
 Security Surveys
 Both are critical in managing the Environment of Care Standards – and – are required by The Joint
Commission
 Hazard Surveillance rounds are a Joint Commission requirement,
findings from this inspection are reported to the safety committee of
the healthcare organization. Patient care buildings require
inspections twice a year as do satellite health centers.
 Fire hazards – corridor obstructions, blocked sprinkler heads, difficult to see signage
 Employee knowledge and understanding of the fire and emergency plans
 Hazardous Materials and MSDS sheets
 Medical gas shutoff policy
 Familiarity with the safe medical devices act and how to respond if equipment fails.
 Non-patient-care buildings and the exterior grounds require an
annual inspection
Advanced training manual for healthcare security personnel 3rd Edition – Chapter 1 page 1-4

13. Basic Healthcare Security
Risks/Vulnerabilities
 Assault Grounds  Imposter/Medical Imposter  Theft (From)
 Internal  Kickbacks/Fraud  Patient
 Staff
 External  Kidnapping/Abduction  Visitor
 Sexual  Stranger  Facility/Organization
 Bomb threat/Bombing  Domestic  Vandalism
 Burglary  Labor Actions
 Facilities  Slowdowns
 Vehicles  Strikes
 Dissident Group Actions  Loss of Critical Information
 Internal  Patient Elopement
 External  Robbery
 Drug Abuse/Loss  Internal
 Embezzlement  External
 Fire/Explosions  Stalking
 Hostage Taking  Terrorism
 Homicide  Against Facility
 Collateral Damage
 Identity Theft
Hospital and Healthcare Security – Fifth Edition (Russell L. Colling Tony W. York Butterworth-Heinemann page 53

14. Premise Liability
Security Department helps mitigate and reduce premise liability and the
expensive outlay of financial resources typically associated
 Property Owners have:
 Legal duty to maintain the property in a reasonably safe condition.
 Depending on the state, an invitee who is authorized to be at the site may have different rights than a
trespasser.
 Premise liability stems from a variety of conditions around the
property, including the physical condition; it may also include
activities taking place on the property.
 Negligence has four elements
 Legal duty
 Breach of duty
 Proximate cause
 Damages or injury
 For a tort claim to be successful, the individual would need to show by a preponderance of the evidence
that negligence by the owner resulted in all four elements.
Advanced training manual for healthcare security personnel 3rd Edition – Chapter 3 page s 3-1 and 3-2

15. Negligent Security – or – Totality of Circumstances?
“When acts of violence occur against patients, visitors, contractors, or off-duty
staff, the premise liability tort focuses on claims that the security was negligent.
As mentioned earlier, cases frequently center on the following”:
 Poor Lighting
 Ineffective access control
 Defective doors or locks
 Poor surveillance systems
 Low visibility
Premise liability claims related to security risks strive to demonstrate a breech
of duty in one of the following areas:
 Failure to perform a security assessment
 Failure to correct documented problems
 Failure to provide qualified security management and staff
 Lack of training
 Inadequate security staffing levels
 Inadequate patrol coverage
 Lack of basic equipment, such as lights or radios
Advanced training manual for healthcare security personnel 3rd Edition – Chapter 3 page s 3-6 and 3-7

16. Security-Sensitive Area
These areas are considered security-sensitive areas at healthcare facilities:
 Women’s Services
 Labor and Delivery
 Infant
 Toddler
 Emergency Department
 Pharmacy
 Cashier
 Utility generation
Each security-sensitive area must have the following procedures and controls:
 A detailed access control plan
 A specific, written security plan for the department or area
 A specific, written critical incident response plan for the department or area
 Initial training for all newly hired employees and annual refresher training for all
employees on the specifics of the security plan and the critical incident response
plan for this area.
Advanced training manual for healthcare security personnel 3rd Edition – Chapter 11 page 11-3

17. Examples of Security in a Security-Sensitive Area
Women’s services is one area for which many organizations have standards
and guidelines. NCMEC and Joint Commission state hospitals must at least
have the following security measures in place:
 Access control measures to account for every person gaining access
 A specific, written security plan to prevent infant abductions
 Another specific, written security plan for responding to an infant abduction if one
were to happen
 A training program that tells each new hire, including physicians, what the security
measures are, what the procedures are to prevent abductions, and what the
procedures are if abduction occurs
 Annual refresher training for each person working in this area regarding the
security measures and procedures to prevent and react to infant abductions
 A unique form of identification for each person authorized to handle infants; this
distinctive badge must be known by and be able to be recognized by the mother
and father (or significant other)
 Locks, alarms, and controls on all doors to and from the area
 Surveillance camera mounted at adult chest/head height at all entrances to the
area – taking and recording pictures of everyone who enters.
 This is not an all inclusive list, only a few…
Advanced training manual for healthcare security personnel 3rd Edition – Chapter 11 page 11-3

18. Examples of Security in a Security-Sensitive Area
Pharmacies must follow strict federal and state guidelines in addition to other
jurisdictional entities.
 All pharmacies must be protected with some type of controlled access
 This can be as simple as a mechanical key
 Electronic Access Controlled system (EAC) card plus pin (dual input identification)
 CCTV recording ingress/egress of person(s)
 All ingress/egress leading into or out of Schedule II locations
 All retail sales counters (including those considered over the counter (OTC)
Storage of Schedule II drugs requires a secured room or cabinet.
Often, Schedule II drugs are protected by a dual-key access, alarm systems and strict distribution logs.
 Compounding areas – are an additional zone of protection and may have card
access with a even more restricted access level
 Each checkout station will have a silent duress or panic button
 Pyxis and Omnicell type drug dispensers may be connected to the EAC or
another alarm system as well as under video surveillance
Basic training manual for healthcare security personnel 5th Edition – Chapter 18 pages 18-3 and 18-4

19. Examples of Security in a Security-Sensitive Area
Cashiers and Business Offices
 Each Cashier station will have a silent duress or panic button
 CCTV recording cash transactions
 Sound masking (HIPAA)
 Frequent – unscheduled Security Officer Patrols
 Physical barriers between Cashier and Customer
 Bullet resistant glass – and walls
 CCTV Recording Caution!
 Caution – Care should be taken when positioning cameras, so that computer screens, files/documents,
and other forms of media are not recorded that could contain HIPAA information.
Basic training manual for healthcare security personnel 5th Edition – Chapter 18 pages 18-3 and 18-4

20. Infants (under 6 Months) Abducted by Nonfamily
Members from US Healthcare Facilities from 1983 to
June 2009
Abducted
Mothers Room
Nursery
Pediatrics
On Premises
126 Abductions during this timeline – Indiana accounted
for 2 of the 126
Hospital and Healthcare Security – Fifth Edition (Russell L. Colling Tony W. York Butterworth-Heinemann page 509

21. 119 Abductions were thwarted
07 were successful
Outcome
Recovered
Still Missing
States with the most attempts:
California – 34
Texas – 33
Florida – 20
Illinois – 16
Maryland, New York and Ohio – 10
Georgia – 9
Pennsylvania – 8
Violence to Mothers – occurred 9 times
Hospital and Healthcare Security – Fifth Edition (Russell L. Colling Tony W. York Butterworth-Heinemann page 510

22. Timeline of Healthcare Security
1950 1960 1975 1990 2000 2009 2012 Future
Primary duty General law In-house Safety and September Convergence
was a fire
watch as a
function of
maintenance
and
engineering
enforcement
approach
evolved
security
departments
Security two
separate
entities, Risk
Management
starts being
developed
11, 2001 and
Katrina
change
function of
Security, Ris
k
of IT and the
modifications
to the
environment of
care
?
and Management
implemented continues
growth, TJC
combines
Security and
Safety
Hospital and Healthcare Security – Fifth Edition (Russell L. Colling Tony W. York Butterworth-Heinemann page 25

23. Can assist you with Design, Installation, Service,
Assessments and Inspections:
 Nurse Call
 Mass Notification
 Sound Reinforcement
 Fire Alarm Systems
 Physical Security
 Audio/Visuals
WWW.escocomm.com Toll Free 1-800-613-3726 Direct 317-298-2975