1. H
B Y A N N L O N G M O R E - E T H E R I D G E
Duress Buttons Keep Panic at Bay
Giving panic buttons to employees in high-risk areas of a Denver hospital
leads to faster response and a greater sense of security.
Case Study
HOSPITALS ARE MEANT to stand as
sanctuaries where healing can occur in a
peaceful environment. Unfortunately, that
is often not the case. “Violence in health-
care is very real. It’s all numbers on paper,
but if you’re a nurse or security officer
dealing with it, it becomes a serious con-
cern,” says Eric Smith, CPP, security direc-
tor for Exempla Healthcare at Exempla
Saint Joseph Hospital in Denver.
Smith oversees security in three hospi-
tals, the Sisters of Charity corporate of-
fice, and a boarding school for troubled
youth. The flagship facility, Saint Joseph,
is in the heart of Denver on a 14-acre
campus. It includes 565 beds, 30 operat-
ing theaters, and a large emergency room
(ER). Saint Joseph sees an excess of 18,500
patient admissions annually, as well as
more than 169,000 outpatient visits,
nearly 52,000 ER visits, and close to 4,000
births. Staff includes approximately
4,850 employees and physicians and 400
volunteers.
On the extreme end, “We’ve had a
number of incidents—some pretty seri-
ous assaults. We’ve had [patients] commit
suicide, and we’re in a high-crime area,”
he states. “It’s almost a steady thing, too—
some kind of violent act where security…
or nurses are getting assaulted. And for-
tunately, it’s not usually a very serious
thing, but still, no one wants to go to work
and worry about getting a black eye.”
Staff had approached security in the
past, inquiring about a panic-button sys-
tem to speedily notify security of an inci-
dent taking place. “The big challenge was
to get the capital to do it,” explains Smith.
“A lot of systems require hardwiring the
buttons to a desk in a central location—
that ends up with the need for cables run
to a network closet tied to a phone line
that runs to a dispatch center.”
In the case of Saint Joseph, such a sys-
tem would necessitate “running cables
through patient care areas and entail put-
ting up containment to keep the installa-
tion from affecting the patients, and it be-
comes a challenge and costly to do,” he says.
But the requests for duress buttons con-
tinued “on a regular basis,” and, in late
2012, Smith says he heard of a potentially
suitable system through one of his contacts
in the International Association for Health-
care Security and Safety (IAHSS). The then-
president of the IAHSS’s Colorado Chapter
was Eric Banghart, senior business develop-
ment manager for Inovonics Wireless
Corporation of Louisville, Colorado, a
provider of enterprise life-safety and spe-
cialized commercial wireless systems.
Banghart told Smith about the Radius
Enterprise Mobile Duress (EMD) system,
which offers a type of button that is not
tied to a particular spot, but can be carried
by staffers. It is a wireless system that
functions by the use of repeaters. “I liked
this system because it runs on a wave-
length that [would not] interfere with any-
thing else in the hospital,” Smith explains.
The Radius EMD system also promised
near-instant communication. Other duress
systems that Smith had investigated “had
a two-minute lag until security received
the message…. A nurse left to deal with a
combative patient for two minutes—blam-
ing the duress button is not going to fly.
It’s still going to be seen as security’s fault.”
Inovonics’ Banghart explains the phi-
losophy behind the Radius EMD system.
“Panic buttons need to be mobile. They also
must be able to locate where the user is in
the facility with some level of accuracy.
The system should reside on an appropri-
ate network that is security hardened and
designed around security, mission-critical,
and life-safety applications. They should
cover a large number of users in a scalable
fashion—one department, or several, or
an entire building or campus.”
WIRELESS PANIC BUTTONS help security officers
respond quickly to violent incidents at Exempla
Saint Joseph Hospital.
24 FEBRUARY 2014 PHOTO COURTESY OF SAINT JOSEPH HOSPITAL

2. Case Study
Radius EMD’s wireless repeaters “create
a mesh network wherever you want,” says
Banghart. “The repeaters require local
power, but have batteries that last up to 24
hours if there is an outage. A network coor-
dinator connects the server at the front
end, so it manages the mesh network, cap-
turing button activation signals.” The sig-
nals are fed by the network coordinator to
a server, “where the brains of the system
reside. This is not a system where you
watch a screen and monitor what’s going
on; it’s about mobile buttons being acti-
vated, the network picking this up, the
signal being located, and then sending that
alert message directly to a mobile respon-
der in a variety of formats—over two-way
radio to a security responder, or over phone
lines, cell phones, pagers, e-mail, or public
address systems. Or the signals could go to
a dispatch center, as it does at Saint Joseph.”
Smith did not have enough funds to
cover the entire hospital at one time, so he
selected the top three problem areas. The
behavioral health unit “had a high level
of combative patient incidents, and the
director of the ICU was concerned about
security because of some of the family dy-
namics in the waiting area.” The ER, with
its difficult patients and possibilities of
spillover and domestic violence, was also se-
lected. “The only other department I would
have liked to include was labor and deliv-
ery because we get a lot of—frankly—Jerry
Springer-type stuff that goes on,” he states.
The scalable system allows an unlim-
ited number of duress buttons, but Smith
decided to limit the number to 45. “On-
duty personnel get them when they start
their shift; they wear them throughout
their shifts, and then they turn them over
to their relief,” he says. Smith selected a
two-button model that signals after both
buttons are pressed for one second. Staff
from the three units were given samples of
the types of buttons available before Smith
made the purchase. The staff decided that
a belt-clip version was easiest to use.
The installation began last July, was
completed by August, and staff had the but-
tons by early September. Twelve repeaters
were installed to cover the chosen units.
The repeaters catch and send the duress sig-
nal to the security dispatch center, which
then sends a group notification to all secu-
rity officers on duty. During incidents, “it
takes about 20 seconds from the time the
button is pushed to security hearing the
call…. I am very pleased with that,” Smith
says, adding that the installation was
trouble-free.
When the buttons were given to the
staff, security conducted training. After-
wards, Smith recalls, “There were a few
questions during the first week and a few
nurses who felt they hadn’t had the right
training…. I think they weren’t convinced
that all they had to do to get help was hit
the button. So, we repeated training a cou-
ple of times.” One of the features that secu-
rity pointed out to staff was an LED on the
button that illuminates to show that the
duress signal has been received by security.
At the time of this interview, Saint Joseph
staff had been using the Radius EMD sys-
tem for about two-and-a-half months. “It’s
a very flexible system and the feedback
from the nurses has been tremendous,”
says Smith.
A button is also carried by the security
officer posted in the ER. “We’ve had prob-
lems with our radios there. That’s one of
our dead spots and also where we have
high-risk patients,” according to Smith.
Shortly after the system went into use, a
suicidal patient tried to strangle himself
while in the ER. The security officer
“couldn’t get help on the radio, so she
used the button and immediately security
dispatch got the message and help was
there within about 30 seconds,” he states.
Smith says that Exempla is building a
new Saint Joseph hospital that will be
open by the end of 2014. “I would like to
get the EMD system in the new hospital
in the high-risk units, and also add it to
labor and delivery and a few other units.
It’s a lot easier to get in there during the
building phase,” he notes. ■
(For more information: Inovonics Wireless
Corporation, phone: 303/939-9336; Web:
www.inovonics.con; e-mail: sales@inovon-
ics.com.)
For product information, #13 at http://securitymgmt.hotims.com
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