Walking the Hospital Security Tightrope

By Katy Mena-Berkley
Monday, May 1, 2017

A well-trained team of armed security personnel may improve safety in healthcare facilities, experts say. However, this approach carries risks, and analysts emphasize the need for a multipronged approach to security.

The scene was horrific. Authorities say that at about 2 a.m. on July 17, 2016, a man who had entered a Titusville, Florida, healthcare facility virtually unnoticed shot and killed a 92-year-old patient and her 36-year-old caretaker.

Police declared it a random attack, and an attorney for the suspect in the double murder said the man is severely mentally ill, Becker’s Hospital Review reported.

Although unarmed guards were hailed as heroes for tackling the man after the shooting, this and other violent incidents have led to renewed questions about arming guards and taking other measures to make hospitals safer.

“Armed guards do offer a higher level of deterrence and authority,” says Jordan Ferrantelli, MBA, CSC, Senior Security Consultant with Jensen Hughes, a Baltimore-based company that provides fire protection and life safety engineering and consulting. “However, there is a significant amount of liability to the hospital with armed guards because if a weapon is discharged and hurts innocent bystanders, the hospital will assume the liability.”

The potential security benefit is more substantial, Ferrantelli says, if armed guards serve as first responders, similar to the role police would perform.

“If they are tactically trained and will respond to an active shooter in a hospital, then there is a faster level of response to subdue the assailant,” he says, adding that that is not the prescribed role of security professionals in all settings.

Competing Priorities

For hospitals that do arm guards, striking a balance between maintaining safety and putting patients at ease can be a delicate task, observers say.

“If [security is] armed at the front door, they need to have a pleasant uniform and not a tactical uniform,” says Tony Sparks, founder of Phantom Services, a security services company based in Hollywood, Florida. “They need to look like ... your guardian angel and not a guy with a gun.”

According to Sparks, that requires specialized training for officers who were trained in non-healthcare settings.

“You can’t take an off-duty police officer that works in a hospital at night and click in his brain how to react inside a hospital versus how to react in a dark alley to a guy approaching him to bring violence,” he says. “You can’t change that reaction, that instinct … . It takes time to change his culture and the method he brings inside the hospital.”

When Illness and Security Collide

Critics of arming guards or of doing so without adequate training point to instances when unarmed individuals acting without malicious intent were injured. Such was the case when a bipolar patient, Alan Pean, voluntarily sought care in August 2015 at St. Joseph Medical Center in Houston.

According to The New York Times, Pean arrived at the facility in a state of distress and was later subdued by security — two moonlighting police officers — who had been summoned by a nurse when Pean became increasingly agitated. Ultimately, Pean was shocked with a Taser and shot.

Although Pean survived, the Times reported similar incidents — some fatal — in Ohio, Utah and Virginia around the same time. And it noted findings from a 2014 survey showing that slightly more than half of medical centers nationwide have security personnel who carry handguns. That represented a more than 100 percent increase from three years earlier. The same article pointed out that most violent crime at hospitals is directed at employees rather than patients.

Taking Action

In response to the 2016 double homicide at Parrish Medical Center, the hospital increased security at its main entrance and in the emergency department waiting area, Florida Today reports. Visitors entering at night also face additional restrictions. The hospital did not comment on the possibility of arming its guards.

“For many years, we all labored under the assumption that health care was immune to travesty and horrific incidents — that somehow those seeking to do harm would not enter into a place dedicated to healing. Unfortunately, this assumption was wrong, and we are seeing that no location is immune to terrible acts when someone is committed to inflicting injury.”
— Stuart Mitchell, Executive Vice President and Chief Operations Officer, Health First

Another healthcare system in the area, Health First, responded to the attack by stationing armed guards at entrances to its facilities, installing metal detectors, and implementing a system to determine whether a visitor is a felon or is on a watch list.

Additionally, Health First conducts random bag checks, utilizes a 24/7 campus surveillance monitoring center, and ensures that the entire security team is certified in crisis prevention intervention and trained to deal with situations in which an individual uses or threatens to use a weapon, or takes hostages.

“There are no guarantees that these enhancements will avoid a tragic event, but they allow us the opportunity to be prepared,” says Stuart Mitchell, Executive Vice President and Chief Operations Officer with Health First. “Since the implementation of these enhanced security procedures, we have confiscated many items that are in violation of our policies for safety and security.”

A Broad Discussion

There is no single answer to the question of whether to arm hospital security, Ferrantelli cautions. He says making the right decision begins with soliciting wide-ranging input.

“Every hospital is unique and needs to be addressed uniquely,” Ferrantelli says. “Arming guard staff is a debate that should occur with hospital leadership, local police, legal and other relevant stakeholders to determine the appropriate choice.”