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White Paper

Protecting Healthcare
Personnel Through
Emergency Communications
White Paper

Table of Content

Introduction 3
Recent Incidents 3

Effective Communication 4

Use Cases 5

Communication as a Part of
Emergency Preparedness 6

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White Paper

Introduction

Healthcare is a rapidly evolving industry. Each year brings According to the federal government, healthcare is the
significant new technological advances in the identification largest industry sector in the United States. And because
and treatment of disease, and medical staff are among everyone needs medical care at some point, individuals
the most dedicated employees anywhere in the world. of all kinds may be found receiving treatment – including
And while in other business sectors profits and products those with violent tendencies. When a violent incident
occupy the majority of working hours, the physical safety does occur, then, rapid response is critical. According to
of patients and staff in healthcare is always top of mind. the FBI, the typical active shooter incident lasts just 12
minutes. And with the average 100-bed hospital employing
Amidst the constant forward march of medicine, however, as many as 850 staff members, hundreds of them may be
is one unfortunate development in the healthcare industry: on duty when a violent incident occurs. Failure to quickly
increasing violence. According to the International Committee alert staff to the situation puts lives at risk.
of the Red Cross, more than 2,300 threats or acts of violence
were reported just between January and July of 2014, with This paper will examine recent incidents of violence in
the consensus that many more incidents go unreported. The healthcare settings, considering the role communication
Bureau of Labor Statistics reports that the rate of violence- played in the outcome. It will then present
related workdays missed for healthcare workers is nearly recommendations for implementing an effective crisis
4 times that of private industry. A single year, from 2009 to communication system.
2010, saw a 13 percent increase in acts of violence directed
at healthcare and social assistance workers.

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Effective Communication

A recent survey conducted by AtHoc revealed that information. Those who are in the immediate vicinity
the average business requires one hour to inform 80 of the violence can then provide regular updates
percent of its employees during an emergency. In a and receive additional instructions to quickly and
healthcare setting where there is the threat of violence peacefully resolve the situation.
or an active shooter, every minute of delay greatly • Multi-channel capability: Healthcare facilities
increases the risk of death and injury. A facility must typically utilize a series of communication and
have the communication tools in place in advance to warning systems, from landlines and radios to
maximize safety during such an emergency. In fact, the message boards, PA systems and electronic
Occupational Health and Safety Administration (OSHA) signage. Authorities need to be able to quickly
recommends that businesses use devices including distribute alerts to all these systems simultaneously,
alarms, radios, cell phones and other security devices as as well as personal cell phones carried by staff
part of an emergency response system. members. By addressing as many communication
channels as possible, employees receive
Healthcare organizations should carefully consider the
notifications more quickly and safety will improve.
state of their emergency notification system before
• Scalability: As hospitals and healthcare systems
they face incidents of violence. Not only is there the
grow over time, more employees need to be
risk of injury or death, but hospitals and clinics may find
supported by the emergency communications
themselves facing litigations, regulatory fines and other
system. It must be able to handle sudden spikes
consequences that impact the long-term viability of the
when an incident occurs while maintaining peak
business. In order for employees to rapidly send and
performance. Anticipating growth will prevent costly
receive emergency alerts, the organization should deploy
upgrades later.
a system with these capabilities:
• Off-site, mobile-friendly capabilities: For staff
• Authoritative, two-way communication:
members who work beyond the physical confines
Incidents of violence in hospitals and clinics could
of the office, such as those working providing
begin in the offices of management, but these
healthcare in private homes, protection should
incidents most commonly occur in areas where
include rapid alerting options such as a panic
patients are being treated. Any staff member –
button on a cell phone in case a patient becomes
nurse, doctor or administrator – should be able to
aggressive. Combined with abilities such as geo-
immediately notify management of the situation. A
tagging, this supports other measures designed
central authority can then rapidly distribute alerts
to establish personnel accountability including
to every employee with instructions that will keep
checking into and out of locations.
them safe and provide a single source of reliable

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Use Cases

Hospital Intruder Home Healthcare Threat


One night during her shift in the emergency room, a nurse A nurse providing home care for patients is making her
takes a patient to an examination area for assessment. As rounds one day, delivering medication. She reaches the
she takes the man’s vital signs, he produces a knife and last home, where she is invited in. Her patient has a
demands a medication that is a controlled substance. The history of mental illness and is acting strangely. Sensing
nurse agrees to take him to the secure room where the that something is wrong, she gets her cell phone out as
substance is kept. He threatens to harm her if he hears they speak, opening the company’s communication app.
anyone call security. She attempts to leave, but the patient bars the way.

One of the other nurses is at a workstation where she The nurse quickly hits the panic button on her phone
hears the situation. She uses the emergency notification without the patient’s knowledge and tries to keep him
system to send an alert to the hospital’s control center calm while she waits for assistance. He continues to
with information about where they are going. The control threaten her, and she locks herself in the bathroom until
center silently alerts security, which reaches the storage the police arrive, which were contacted by the hospital
room before the attacker. They wait and are able to after they received her alert. They take the patient into
disarm him as he enters the room. custody so he can be reevaluated for treatment.

Sources
http://www.who.int/hac/events/HCWviolence/en/
http://www.fbi.gov/about-us/cirg/active-shooter-and-mass-casualty-incidents/active-shooter-statistics
http://www.beckershospitalreview.com/lists/200-hospital-benchmarks-october-2012.html
http://wgntv.com/2014/11/18/dramatic-surveillance-video-released-in-suburban-hospital-shooting/
http://fox6now.com/2013/11/14/significant-police-presence-at-childrens-hospital/
http://www.medpagetoday.com/EmergencyMedicine/EmergencyMedicine/45535
http://www.latimes.com/local/lanow/la-me-ln-shooting-mlk-hospital-20150126-story.html
http://www.dailynews.com/general-news/20150127/nurse-wounded-in-los-angeles-mental-health-care-facility-shooting
http://www.safetyandhealthmagazine.com/articles/11172-workplace-violence-in-health-care-nurses
https://www.osha.gov/SLTC/healthcarefacilities/violence.html
https://www.osha.gov/Publications/OSHA3148/osha3148.html
http://www.cdc.gov/niosh/topics/violence/training_nurses.html
http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-18-2013/No1-Jan-2013/Workplace-Violence-Strategies-for-Advocacy.html

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Communication as a Part of Emergency Preparedness

Saving lives is the primary concern of our healthcare alone outside their facilities are particularly
system, so it is a natural extension of this duty that these vulnerable and should have access to emergency
organizations protect their staff and patients from the communication technology.
threat of violence. An effective emergency preparedness • Establish a daily work plan for field staff to keep a
plan involves a large number of factors that can be designated contact person informed about their
supported by a comprehensive communication system. whereabouts throughout the workday. Have the
OSHA’s recommendations include the following: contact person follow up if an employee does not
• Control access to facilities other than waiting report in as expected. A crisis communication
rooms, particularly drug storage or pharmacy system can provide reports of employees who do
areas. As physical security systems are connected not respond to alerts, simplifying the personnel
to networks, the capabilities of a networked accountability process.
emergency notification system are expanded.
More than a single aspect of emergency preparedness,
• Prepare contingency plans to treat clients who are
communication abilities in a crisis are an integral part
“acting out” or making verbal or physical attacks or
of nearly every aspect of ensuring safety. As healthcare
threats. Notification capabilities allow employees
facilities consider the best ways to promote safety,
to quickly alert administrators of a situation that
improving communication in a crisis can have a significant
escalates to endanger staff or patients.
impact on reaching that goal.
• Develop policies and procedures covering
home health care providers. Employees working

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