Healthcare Design - December 2019 - 38

FOCUS

accessing unauthorized back-of-house areas. Visible security staff, visitor/
vendor badge systems, and even metal detectors should also be considered.
Once inside, compartmentalizing a facility will help limit the threat
of an active shooter by reducing the shooter's ability to move freely,
providing greater safety and escape opportunities for patients and staff.
This can be achieved through the use of physical barriers, access control, and rapidly closing cross-corridor doors that are integrated with
security system panic buttons. Designs should also include multiple areas of refuge to shelter in place with no visibility from corridors. If possible, these shelter-in-place locations should be securable, windowless
rooms with concrete walls. Add-on barricade options to prevent forced
entry have been utilized in many school systems and should be considered in a hospital's review with local code officials.
D E S I G N S T R AT E G I E S

While risk reduction is a multifaceted issue, attentive design is the first line
of defense against potential hospital security threats. The following strategies may be implemented by hospitals to create a safer healing environment through design:
1. Holistic design. It's important to integrate the owner's security team
with the project team at the onset of master planning and programming to help ensure vision and needs are captured. A holistic approach
to security design should consider the physical, electronic, and operational elements that integrate technologies with physical barriers,
structural resiliency, strategic lighting, and incident command centers
to address today's hospital security risks.
2. Risk assessment. Evaluate the facility's existing issues by conducting a risk assessment to test system resiliency. This should be done
with a comprehensive technical and operational team composed of
architects, engineers, security personnel, clinicians, and IT staff. Using
mock scenarios (domestic violence, abductions, active shooter, theft,
cyber-attack, etc.), this team should evaluate facility security weaknesses, particularly the impact that threats may have on high-risk areas such as the pharmacy, emergency department, labor and delivery,
loading docks, and the building perimeter. Once risk has been assessed,
the team will make recommendations and develop corrective action
plans to address potential security breaches and areas of concern. It's
recommended that hospital administrators collaborate with local law
enforcement during design to create security command center and
overall emergency response plans.

DECEMBER 2019

2/5

In 2017, TLC Engineering Solutions
helped secure existing
points of entry for the
Phoenix campus of
Mayo Clinic Hospital.
The team installed
8-foot-tall steel panels
infilled with a steel
woven mesh to enclose
the space, increasing
visibility while softening the enclosure. New
masonry was also added to the existing wall
structure to increase
the overall height to
6 feet. Additionally,
small openings in the
existing masonry walls
were infilled with a
glass/bronze/steel
sculpture to prevent
individuals from using the openings as
footholds.

3. Security technologies. Project teams
should consider current and developing
technologies that can help reduce risks. For
example, virtual fencing uses security cameras and video analytics to define a "fenced
area" and send an alert to security to investigate when an unauthorized individual has
breached a zone. Additional technologies,
from visitor management systems to access
control to emergency notification and duress
systems, are designed to allow security personnel to minimize risks and respond swiftly
to potential threats.
4. Education and training. The International
Association of Healthcare Security & Safety
and the Occupational Safety and Health Administration offer hospital safety guidelines
that should be considered for implementation into facility operations and building design. Ongoing security education, protocols,
and technology user training are extremely
important. Regular training drills should
be utilized to keep hospital staff prepared to
implement emergency-response plans with
technologies implemented.
NEXT STEPS

If hospitals are to be conduits of healing, the
safety of patients and hospital employees is
essential. Administrators looking for ways to
address today's increasing security threats
should start with a holistic risk assessment using a comprehensive team that can integrate
the operational, technical, and physical building elements needed. Armed with these results,
administrators can begin to make the security
adjustments needed in existing facilities, master plans, and new projects to ensure that the
hospital can accomplish its mission of health. 
Ted Hood is senior project manager at TLC Engineering Solutions (Brentwood, Tenn.). He can be
reached at T E D . H O O D @ T L C - E N G . C O M . David
Stewart is a principal and healthcare studio leader
at Orcutt/Winslow (Nashville, Tenn.). He can be
reached at S T E W A R T. D @ O W P. C O M .

SPOTLIGHT ON

HCD EXPO

HCDMAGAZINE.COM

The authors spoke on
this topic at the 2019
HCD Expo & Conference
held in New Orleans in
November. Watch for more
coverage of the event at
HCDmagazine.com and
learn more about the 2020
show at HCDexpo.com.

A.F. PAYNE PHOTOGRAPHIC

http://www.HCDmagazine.com http://www.HCDmagazine.com http://www.HCDexpo.com http://www.HCDMAGAZINE.COM http://www.HCDMAGAZINE.COM

Healthcare Design - December 2019

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