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Incorporating duress signaling into a facility’s security plan

By Rom Eizenberg / Special to Healthcare Facilities Today
May 13, 2019

Building occupants can find themselves under duress in an instant, especially in a hospital or hospitality environment where there is heightened risk of workplace violence. For example, a hospital patient might unexpectedly attack a doctor in an examining room or a nurse might be jumped going to the hospital parking lot after a night shift. A patient’s angry family member might confront a doctor about the care protocol or frustration over a lack of response to the treatment.

Each of these examples can create threatening situations that generate concern and could pose a risk to the safety of hospital personnel. Mitigating these risks requires a thorough understanding of the requirements for an effective response system, the latest of which use Bluetooth Low Energy (BLE) beacons for real-time location-based tracking and issue easy-to-activate duress signals that facilitate immediate notifications to the correct contacts. These systems also facilitate central management of duress alerts and response processes, both in the cloud and through the facility’s healthcare IoT stack.

A growing threat

Hospitals and other healthcare organizations have a responsibility to protect not only patients but also clinical staff. Increased concern about the dangers that doctors, nurses and other caregivers face on a regular basis is fueling healthcare industry dialogue about what is needed to ensure that staff get the support from hospital security teams and law enforcement when they need it – and at exactly the location where they need it. 

About 25 percent of nurses experienced workplace violence each year. While the healthcare sector makes up just 9 percent of the overall U.S. workforce, it experiences nearly as many violent injuries as all other industries combined. Between 2005 and 2014, the rate of healthcare workplace violence increased by 110 percent in private-sector hospitals, according to a U.S. Bureau of Labor Statistics report. 

According to a 2015 study published in the Journal of Emergency Nursing, 76 percent of nurses at a private hospital system in Virginia said they had experienced physical or verbal abuse from patients in the previous year. Hospitals can utilize BLE beacon technology in an end-to-end IoT platform to reduce these violence rates and protect their caregivers, especially if such incidents escalate into a violent incident. There are several important things that organizations need to know about using these systems to trigger a duress alert.

Five things to know about triggering a duress alert

To trigger a duress signal that catapults security forces or police officers to the rescue, healthcare leaders must understand the five key things about an effective response system to address real-time duress during a high-risk situation 

Easy-to-activate duress signals are needed. Hospitals need an easy and fast way for a staff member to send out a distress signal from any spot inside a facility or even in the parking lot.  The ability to send such a signal must be pervasive, reliable and simple to integrate into existing systems and tools. Indeed, simplicity is highly important. The person under duress must be able to signal the need for help with a minimal amount of friction and allow for instantaneous calls to action when the need arises. Although BLE beacons can provide this functionality by themselves at locations throughout the facility, it can be more effective to integrate the beacons into popular access control cards already in use. In this way, staff members or clinicians can just press the back fo their badge to instantaneously trigger a duress alert that identifies them and their location, whether inside the hospital, the parking garage or other areas that have been configured for duress alerting capabilities.

Real-time location-based tracking. Location is everything when a matter of seconds means life, injury or death, which is why a duress signal must pinpoint for security personnel the person’s location. Whether the doctor or nurse is being attacked in a patient’s room, the parking lot, an isolated hallway or elsewhere on the healthcare campus, security personnel must be able to quickly locate the person with precision and reliability. Ideally, the system’s beacons should simultaneously support iBeacon (Apple), Eddystone (Google) and sBeacon (BluVision) protocols and pointpoint the location of the user down to 6 feet (2 meters).

Notifications must be sent immediately to the correct contacts for immediate response. A signal can be sent out, but if it doesn’t go to the proper authorities, it’s useless. Hospital security personnel and first responders must be able to coordinate a quick response in an organized manner during a duress alert. If the victim can take action within the alert’s reach, help can be on the way thanks to a silent alarm radiating from a beacon.

Hospital leaders must manage duress alerts and response processes through a healthcare IoT stack.  It’s possible to tie a duress alert response mechanism together with other hospital systems on a common platform, making a duress response capability more easily manageable. The IoT (Internet of Things), specifically, has created new possibilities for hospitals to provide more intelligence, including location-based services. Hospitals no longer need to operate with disparate systems for different applications, so putting duress alert capability on a common platform, powered by low cost, low-energy Bluetooth, can efficiently provide for this added level of security for the hospital staff. Today’s location services platforms streamline and enable multiple applications in a unified healthcare system so that real-time duress detection and alerts can be easily plugged into the healthcare IoT infrastructure. Beacons are centrally managed in the cloud to transfer new messages, send firmware updates and conduct battery status checks remotely.

Hospital security policies and procedures must evolve to accommodate new “distress call” technologies. The proper level of security policies and procedures should be put into place to ensure the appropriate level of response to the stressful or life-threatening situation in the care setting or on campus. These protection technologies for employee safety are likely to be more widely adopted when the proper policies are put in place in a meaningful way.

In general, hospitals and other facilities are becoming more connected. Nothing is isolated. Greater visibility through location-based services is needed to protect doctors and hospital staff. In high-risk situations, never has this been more urgent than it is today. Ultimately, these technologies must provide peace of mind to doctors and nurses, so they can focus on the care they provide to patients.

Rom Eizenberg is the vice president of the Bluvision segment of the identification technologies business within HID Global.

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