“It’s craziness but this stuff is really happening,” said Gary Collins, senior director, healthcare at Virtual Energy Solutions, after showing news accounts and video clips of staff assaults at healthcare facilities to attendees at the 2021 Healthcare Design Expo & Conference. In fact, nearly 75 percent of the almost 25,000 assaults and other workplace violence reported annually in the U.S occur in a healthcare setting.

During the session “Security Directors: What PDC Teams Need To Hear About Designing Your Next Facility,” Collins; Frank Finley II of Force Project; and Gordon Snow, chief security officer at Cleveland Clinic Foundation, shared their expertise and offered design strategies to improve security at healthcare facilities, whether on a renovation on new construction project.

Hospitals face constant security challenges not only from the constant flow of people in and out of a facility but also related to disgruntled employees, recent outrage over mask mandates, and political unrest, according to the speakers. To begin strengthening security strategies, the speakers said owners and project teams must first understand the operational flow of a facility, as well as the future business expectations, while also looking at the physical building itself.

“We try to look at everything outside and inside,” Snow said. At Cleveland Clinic, the organization developed security standards, and conducts a one-year occupancy review to assess what’s working, what needs to be changed, and what staff like and dislike.

Finley said it’s important to use data-based decision making to create a roadmap for designing in layers of security that mitigate threats as well as protect critical assets, such as equipment and supplies. Using a security risk assessment, which collects relevant crime and threat information, a facility or project team can begin to prioritize the top 10 to 20 targets on campus, representing the elements that are the biggest potential for loss, and then look at the vulnerability of each.

These proactive steps can help a facility identify risk areas and begin addressing them through design. For example, the potential for vehicle ramming would affect how entrances are designed, including their location and the use of barrier system. “Crime prevention through environmental design is critical,” Snow said.

The speaker outlined some of the common threats and vulnerabilities at a healthcare facility, including assaults, vandalism, weapons, and loss of critical utilities due to natural disaster or reliability, and some risk mitigation measures to consider. Starting on the outside, Finley says facilities should provide an outer layer of protection, such as a gate, landscaping, or barrier system, as well as utilize license plate readers or face recognition cameras to help intercept a person before they get on campus or into a building. Segregating parking lots for staff and patients as well as separating the public from private clinical space is also critical to protect staff from assaults or unwanted interactions.

To get desired security features included in the design of a facility, the speakers suggested developing a cost order of magnitude to serve as a financial roadmap of risk mitigation measures implementation. Additionally, Collins added that it’s important to embed security early in all phases of planning, design, and construction. “We try to lay out as much fiber and line early on,” Gordon added.