For most Americans, the local community hospital serves as a backdrop for contrasting milestone events in their lives. It is the place where children are born, and the place where loved ones are often lost. It is the place we long to reach when in the midst of a medical crisis but dread to enter when the purpose is to diagnosis a potentially life-threatening disease. It is perhaps these dramatic contrasts which in the end, leave most people with a neutral passion with regards to the local hospital. But top security experts and even regulators are growing increasingly concerned that violence in the hospital setting is escalating and may spike even further as passions and perceptions are shaped by the ongoing national health care debate.
According to the federal Occupational Safety & Health Administration (OSHA) more assaults occur in the health care and social services industries than in any other. Reliable statistical data is difficult to obtain because physical violence in the hospital setting is generally manifested in one of three forms – and sometimes protected from disclosure by privacy laws.
Patient Violence (PV)
Since the beginnings of medical science, healers have been subjected to the threat of physical violence from the very patient they are trying to help. Persons with mental or neurological disorders have long been appreciated as having a propensity for violence when first brought into the clinical setting of a hospital. In more modern times the risk posed by powerful drugs like cocaine and pcp have added to this threat.
Jeff Aldridge of Security Assessment International noted in 2010 that the increasing trend in hospital violence could be the result of, “more people are on alcohol and drugs and a lot more people with health issues can’t afford medical care.”
Aldridge also noted that the aging American population is resulting in more patients with dementia and behavioral problems.
Non-Patient Episodic Response Violence (NPERV)
Hospital Emergency rooms have long dealt with violence triggered between families and friends following a medical emergency. This form of violence frequently accompanies scenarios such as fights breaking out in the waiting room while the injured combatants are being treated. Another familiar circumstance occurs when the conflict erupts between the loved ones of automobile accident victims where one party is deemed to have been at fault for inflicting injury or death on a second party.
Aldridge also noted that violence in the hospital setting is more prevalent because society as a whole is more violent.
Recent years have seen cash-strapped Emergency Departments forced to spend more money on items like armed security guards, metal detectors, video surveillance and advanced access control entry systems in response to this violence.
Institutionally Specific Violence (ISV)
The third category, Institutionally Specific Violence, and its increasing occurrence in the past three years is the area that raises the most concern among security experts. ISV incidents can occur between any of the three general groups to be found in a hospital: caregiver, patient and visitor as well as a fourth group –intruders. But unlike the foreseeable typical examples of Patient Violence and Non-Patient Episodic Response Violence, ISV events are almost impossible to anticipate and difficult to prevent.
Some recent examples of ISV include:
· A wife who brought a gun into a cardiac intensive care unit and shot her husband to death.
· An unconscious drunk being wheeled into treatment on a stretcher suddenly produces a gun and shots several hospital staff.
· A retired school teacher distraught over the recent death of his mother comes into a hospital and opens fire killing three people.
· A hospital employee comes to work with a gun and proceeds to kill two fellow employees before committing suicide.
· A man, who officials say was neither a patient, employee or visitor, is shot to death by police outside the emergency room of a major hospital following a violent confrontation.
Last year, in response to the rising tide of violence in hospitals the Joint Commission on Accreditation of Hospitals, (now known as simply ‘The Joint Commission’) took the dramatic step of issuing a ‘Sentinel Event Alert’ on the issue.
A Sentinel Event is broadly defined as something that can happen in the hospital setting resulting in injury or death to the patient. The term has traditionally been applied to events such as medication errors, acquired infections and general patient safety. Alert 45 did not include violence against hospital staff but rather focused specifically on, “assault, rape or homicide of patients and visitors perpetrated by staff, visitors, other patients, and intruders to the institution.”
The JCAH Alert offered guidelines for hospitals on balancing between security and access to the facility while remaining open and accessible for patients and visitors.
Among the wide range of possible violent scenarios which could occur in a hospital is the threat of a possible terrorist attack. Concerns over the likelihood of one or two heavily armed terrorists attacking a vulnerable facility such as a hospital have increased in the wake of the deaths of Osama Bin Laden and other high level Al Qaeda operatives. On Friday (June 3, 2011) Al Qaeda Spokesman American Adam Gagahn, also known as “Jihad Joe” issued a nationwide call for Islamic radicals living in the west to purchase guns at American gun shows and immediately go out and kill Americans. Gagahn called the easy availability of assault rifles a, “golden opportunity and a blessing” and implored followers to, “rush” to capitalize on this opportunity. He ended the brief statement with a frightening challenge to followers in the words, “so what are you waiting for?”
All these factors form a witch’s brew of potential conflict ingredients just waiting for a catalyst which may come in the form of the passionate and highly polarized debate over health care reform legislation.
The American public, which is just beginning to come to terms with accepting the intrusive security associated with aviation travel may soon discover that getting into a hospital as either a patient or visitor may be as demanding as boarding a commercial airliner.
No comments:
Post a Comment