Stacie Jenkins, RN, MSN, CPSO
Vice President, Patient Safety and Risk
Healthcare organizations are subject to security threats due to the nature of our work – caring for patients with behavioral or substance abuse issues, keeping narcotic medications on-hand in our facilities, and dealing with dissatisfied family members who may be unhappy with a loved one’s diagnosis.
None of these threats disappeared when the COVID-19 pandemic began. Instead, the pandemic added new security issues impacting patient safety. LHA Trust Funds has identified the top five healthcare security issues impacting patient safety in 2021.
1. Medical Device Hacking and Availability
Since the pandemic began, cyberattacks on medical facilities and offices have risen significantly. Cybercriminals are using COVID-19 as an opportunity to take advantage of our vulnerable healthcare system as it tries to care for patients during uncertain times.
An automated inventory of medical devices within an organization is a great tool that can prevent imminent threats to security by easily locating devices needing remediation. An automated inventory can help organizations keep up with medical device utilization and include the information in risk assessments that determine which devices are given priority for security patches. Equipment flagged as a security concern can be identified and remediated more quickly, protecting vital patient information and preventing potential security breaches.
2. Theft at Many Levels
When the pandemic began, essential personal care and household cleaning items, such as toilet tissue, facial tissue, hand sanitizers and disinfecting cleaners, were almost impossible to locate in retail stores. These items were also difficult for healthcare organizations to obtain, presenting a threat to safe, quality patient care.
Recognizing the seriousness of the situation, many companies made healthcare a priority when distributing these essential products. In turn, healthcare organizations are now a target for the theft of these items.
PPE and Other Critical Equipment
While COVID-19 has challenged our healthcare system in numerous ways, a lack of PPE and other critical equipment such as ventilators and even beds has become a significant obstacle. LHA Trust Funds encourages all healthcare organizations to use the state of Louisiana’s ESF-8 portal for emergency communications, preparedness and response. Utilizing the ESF-8 portal is the quickest way to gain assistance in addressing any lack of resources at your facility.
The COVID-19 vaccine’s arrival has brought joy and relief to healthcare workers around the United States. The vaccine means lessening the risk of COVID-19 infection for essential workers and at-risk populations. Unfortunately, healthcare organizations that receive and administer the vaccine cannot let their guard down.
The COVID-19 vaccine may be the target of theft for a variety of reasons – resale on the streets or black market, reverse engineering opportunities, and by those who aim to sabotage the vaccine from rolling out because of their beliefs. Recommendations for tightening vaccine security to prevent theft include:
- Developing “from door to floor” secure processes to be implemented when transporting supplies to their intended destination in patient care areas
- Ensuring a security plan is in place to secure the vaccine from arrival at your organization through transport to the pharmacy.
- Developing multiple security controls to ensure the vaccine’s safety in the pharmacy such as physical barriers (in a specific room, behind locked doors), access controls (badge access into the room, keypad access), and inventory controls accounting for the whereabouts of each vaccine.
- Ensure security is in place when the vaccination is being administered at mass vaccination sites.
3. Access to Healthcare Organizations
Controlling access to a healthcare organization is very important to protect patients and staff members inside the building. Healthcare facilities and offices typically have many access points, and knowing who is inside can be a challenge if these points are not secured.
Restricting healthcare organization access to reduce the transmission of COVID-19 has created backlash because the new rules may prevent families from visiting ill or dying loved ones. As a result, some facilities have experienced visitors trying to gain unauthorized access to be with family members and creating violent outbursts toward facility staff members.
This type of security threat is driven by the aggressor’s emotions and creates dangerous situations that can lead to violence within the patient’s environment of care. Healthcare organizations need to ensure that plans are in place to handle:
- A surge of patients
- Family members of patients
- Communicating visitation policies to the community
- Evaluating access points and ensuring they are consistently locked
- Implementing surveillance using security cameras
An effective security force should also be well-trained in the identification and de-escalation of violence.
4. Extremism and Crimes of Opportunity
Healthcare organizations are critical to the infrastructure of any community, automatically making them targets of crime that can create an unsafe environment of care for patients. Community issues such as social unrest can result in a reduction of the workforce if employees are afraid to report for their shifts.
Healthcare organizations must also be alert to internal threats from employees who might be involved in extremism and may commit crimes while on duty. Staff members should pay attention to and report any suspicious behaviors of others, even if that means discussing a co-worker. Healthcare security expert Bryan Warren recommends educating staff members on behaviors of concern such as:
- Individuals surveilling medical facilities or asking odd questions about security features
- Patients or visitors verbalizing conspiracy theories and /or making threats against the facility
- Frequent, multiple ‘false’ alarms to test responsiveness
- Sabotage or holes in fences or security barriers or entry attempts on perimeter doors
- Vandalism of perimeter security equipment (lighting, cameras)
- Persons seeking entry who do not have proper identification or legitimate purpose
- Negligent or suspicious behavior of staff, especially those with access to critical areas (such as vaccine storage or other high-risk environments)
5. Alternate Care Sites
COVID-19 caused the creation of alternate care sites in many places as healthcare organizations attempted to treat non-COVID patients away from crowded facilities. Alternate care sites present a challenge since they are temporary locations and possibly temporary structures. The interim nature of these care sites makes it difficult to deliver the “same level of care” administered inside a healthcare organization’s usual walls.
Alternate care sites should be included in the organization’s emergency plan. Many security issues need to be considered to ensure the safety of patients at alternate care sites such as:
- Identifying and securing perimeters and access points
- Ensuring how patients will be transported to and from the organization if necessary
- Identifying and securing sensitive areas, such as where protected health information is stored, medication storage, critical equipment, PPE, etc.
- Setting up portable security technology such as cameras and portable alarms to alert staff members to unauthorized access
- Ensuring staff members are properly identified and provided access to patient care areas
The best practice for any emergency is to be as prepared as possible. These top five healthcare security issues can directly impact the safety of patients we care for, so learning from your organization’s previous experiences with them is essential to conducting emergency planning now and in the future.