A guide to Security Systems for Healthcare Sector
A healthcare facility or hospital is generally open 24 X 7 and is open to the public. Providing a welcoming and safe environment for patients, staff and visitors while protecting millions of Indian rupee in technology and expensive equipment is a challenge, patient records and confidentiality that needs constant protection, parking and door access control needs and medicines that need to be kept safe. Use of Closed Circuit Television Camera System is comprehensive security solution and is a crime prevention tactic for many hospitals. However, if a camera is not properly positioned or is not functioning correctly, this proactive security measure is wasted.
1. Access Control:
Access control provides the ability to control, monitor and restrict the movement of people, assets or vehicles, in, out and around a health care building. Example, a single entrance door, to a large integrated security network. There is also huge potential in terms of integrating HR and other systems, such as Time and Attendance, Visitor Management, Automatic Number Plate Recognition (ANPR), Fire, Intruder and CCTV, which can cut costs and streamline administration costs.
Health care are not only made up of members of staff who will be there on a daily basis, but also patients and a large volume of visitors passing through the premises. Furthermore, an abundance of confidential documents such as patients' notes will be stored on the premises of the hospital or residential care home as well as a range of medication. Consequently, electronic access control systems are increasingly being used to enhance safety and security in hospitals and nursing homes to enable access only to the people with the necessary authority.
A. The physical barrier – to physically restrict access to a building or location via such methods as:
• Doors; secured by either a magnetic or strike lock and can be revolving or sliding.
• Turnstiles and speedgates; designed to limit access to one person for one card presented.
• Car park barriers to limit vehicular access to only those that have authority.
B. The identification device – there are a number of different technologies used to identify users of an access control system, including the following:
• A proximity card and reader using Radio Frequency Identification (RFID) – cards can either work at a short read range or a long read range.
• A smart card and reader / PIN Pads
• Biometric (for example, fingerprint and iris scanning etc).
B. The door controller and software – The door controller and software are at the heart of the system and are used to decide who can gain access through which access point at what time of day. These can vary dependent on the size of the system and how many readers or sites you are trying to control from one point. Some of the options include:
• A stand-alone door controller linked to a single door with no software.
• A number of door controllers all linked together to a single PC to control one site.
• A number of sites all interlinked together over a wide network area.
Main benefits:
Visitor monitoring - In an environment with a fleeting number of patients and visitors, the use of PC and computer networks should be considered. These systems can print photographic ID and allow access to be restricted to certain areas within the hospital or residential care home. Moving to a software solution for visitor management is an easy and inexpensive solution and can provide a number of added benefits.
Automatic Number Plate Recognition (ANPR) - For hospitals and residential care homes where a large volume of staff, patients and visitors will be driving in and parking on-site, ANPR is a feasible option. To monitor the entrance of vehicles on-site, CCTV-style cameras and computer software can be used to identify number plates of vehicles. Some systems can also store photographs of the driver and vehicle for subsequent analysis. This sophisticated software allows critical information to be passed to the police to assist in the pursuit, identification and capture of offenders.
Key considerations:
The outcome of a thorough risk assessment for your hospital or residential care home will determine the level of security you require and in turn influence your choice of access control system. Access Control systems should cover the following areas:
• Parking areas – Proper parking management arrangement is required for visitor, guest care.
• Accounts Room – Includes locker room, cash counter and emergency department doors.
• Server Room – Include main server / network room alongwith floor wise Switch room. Work with your legal advisors to ensure the Reader / Locks is properly controlled.
• Pharmacy areas – In addition to Access door control, this is an area that needs special security control because of the medications being stored here.
• Other areas – This could include anywhere special or expensive equipment is housed, ICU, Utility Room per floors, HR room, Procurement working area or other areas that are deemed important or vulnerable.
The placement and number of Access doors and their scopes of uses / access rights should be properly documented and continually evaluated and updated by the security team during quaterly facility assessments.
Legislation:
The Disability Discrimination Act was amended in 2005 and has significant impact not only in terms of the design of new systems, but also means that many systems may need to be upgraded to ensure compliance. This is of particular importance also for the healthcare sector as staff, patients and visitors will all need to have adequate and user-friendly access to the building.
2. Video Surveillance Systems
System consisting of camera equipment, storage, monitoring and associated equipment for transmission and controlling purposes, sometime called Video Surveillance System (VSS). Urgent care centers, healthcare facilities or hospitals and residential care homes are perfect locations for video surveillance. Hospital CCTV and surveillance cameras allow you to effectively monitor large areas with minimal manpower while helping to increase security and control costs. Patients and employees can feel safer and security breaches can be held in held in check. Surveillance can help to provide visual evidence in case of incidents, help to increase productivity and to prevent false claims. With newer HD surveillance cameras can be monitored from several locations at once so all security personnel can access a live feed at all times.
Main benefits:
Safety & Security – Security cameras installed throughout a hospital or residential care home prevent crime, medical insurance claims, break-ins, and allow security operators to monitor the property for patients in trouble or unauthorized visitors in restricted areas.
Dishonest claims – False claims can be a big problem for hospitals or residential care home. Visitors and patients will sometimes falsely claim to have been injured while on hospital property, having detailed visual footage from the hospitals security cameras can help to disprove such claims. This helps to save the hospital from paying out large unwarranted insurance claims.
Digital HD Storage – Digital storage from security cameras has many advantages for Hospitals or residential care home. Cameras systems enable the hospital to store digital recorded footage onto digital video recorders with large capacity hard-drives. This footage can then be easily accessed by authorized users. Since the video footage is digital, searching for a specific time or date is instant and this allows for more improved searching capabilities. Recommended to store video feed 90days.
Visual Evidence – When investigators need help solving an incident or crime, surveillance cameras will provide them with the visual evidence the need. Best of all your surveillance system can backup incidents directly to a USB drive, email or network drive so they may continue the investigation from there police station.
Employee disputes – When you have clear, detailed proof on video employee disputes can easily be resolved. Incidents in question can solve disputes quickly when using surveillance cameras.
24hr Real-time Monitoring – Hospital or residential care home cameras can be monitored or viewed from various different platforms such as Video wall, PC, Mac, iPhone and Android.
Video Monitoring – With iPad and Tablet supported digital video recorders hospital or residential care home employees can easily monitor specific areas from anywhere on the local network. Employees can even monitor their stations and hallways from another building of floor.
Proper placement of a CCTV system should be based on the risks identified through security assessments and insights gained from prior security challenges. Your security team can assist with recommendations for placement and should be in charge of monitoring the system and ensuring it is operating correctly.
Key considerations:
• Public entrances and exits – Includes exterior views of all vehicular entrances (main entrance) and exits to the hospital or residential care home, and all interior and exterior views of doors, delivery points and loading docks. Camera should be Minimum vandal proof with Megapixel resolution.
• Parking areas – Includes garages and gated parking lots. This can also include garage stairwells and dimly lit areas if your cameras have backlighting & megapixel resolution.
• Waiting areas – Includes outpatient and emergency department visitor areas. Camera should be Minimum vandal proof with Megapixel resolution.
• Emergency Department – Cameras in this area can be very useful as many violent events occur here. Be mindful of viewing and recording, and if you are using mega pixel vandal proof cameras for observing patient watches, review of the CMS Conditions of Participation requirements.
• Nurses’/administration stations – Vandal proof mega pixel cameras can ensure everyone’s safety at all stations. Work with your legal advisors to ensure the cameras, and most importantly, the recording is properly controlled.
• Pharmacy areas – In addition to CCTV monitoring, this is an area that needs special security surveillance because of the medications being stored here.
• Other areas – This could include anywhere like, Maternity Wards, lift lobby, money is stored, special or expensive equipment is housed, public access points other than main entrances, ambulance bays or other areas that are deemed important or vulnerable. Camera should be Minimum vandal proof with Megapixel resolution.
All equipment installed should be suitable to withstand the prevailing environmental conditions according to the environmental classes in BS EN 62676-1-1. This includes protection against dust, particles, water and any special environmental conditions that may prevail on the site (e.g. corrosive or explosive atmospheres). Ensure cameras are in areas where the view is not obstructed and the cameras cannot be tampered with.
Patient privacy is important and should be considered when installing security cameras. Do not install cameras in those areas considered private or in those areas where their privacy may be captured on video.
Warning signs, as required by the Code of Practice of the Information Commissioner are displayed at all access routes to areas covered by the Hospital CCTV.
Healthcare Camera Configuration
There are certain factors that should be considered when deciding to install video surveillance cameras in a hospital or healthcare facility:
• Do you currently have security systems in place?
• Are you short staffed or have minimal security personnel?
• Are there multiple buildings at the hospital?
• Do you have an adjacent parking lot or structure?
• Have you experienced past criminal activity on the property?
• Have you had issues with break-ins?
• Have you had employee or visitor disputes that would have needed visual investigation?
• Has there been any insurance claims made against the hospital in the past?
• What areas are most critical and require video surveillance?
Healthcare Camera Setup Advice
• Install security cameras so they may monitor and record all exit and entries of the hospital building its imperative to capture detailed video of those leaving and entering the premises.
• Hallways should monitored and recorded as well. All activity from employees, visitors and patients can be visually monitored by guards and staff.
• Cameras should be installed at all fire escapes and in elevators.
• Parking garages and lots should also be monitored. This includes all loading areas.
• Restricted areas should have cameras installed to maintain that only authorized users are granted access.
• Both the exterior and interior of the hospital should have cameras installed.
Legislation:
The following legislation has been taken in to account:
• The Data Protection Act 1998
• The CCTV Code of Practice produced by the Information Commissioner
• The Human Rights Act 1998
• The Regulation of Investigatory Powers Act 2000
• All associated information, documents, and recordings obtained by CCTV are held and used in accordance with the Data Protection Act and the ICO’s Code of Practice 2008.
3. System integration
There are a number of advantages to be gained in both the security and commercial aspects of designing and adopting an integrated system.
Access control systems:
By integrating access control with other systems many advantages may be realised. For example:
• Fire Alarm mustering – know where your employees are at a given time.
• Know which doors / areas employees are entering, or trying to enter.
• Link CCTV images with access control events.
• Link Time & Attendance monitoring using the same badge / token software.
• Link Visitor Monitoring with Access Control & CCTV using badge / token software.
• Integration with intruder & hold up alarm systems.
Visitor Management Systems (VMS)
For many hospital or residential care home a manual paper-based, VMS providing visual identity of visitors. However, computerised systems linked to Access Control and Time & Attendance systems are the natural bedfellows for integrated security systems.
CCTV Systems
By integrating CCTV and other systems many advantages may be realised. For example:
• Live camera views can be integrated with the access control software, equally access control or other data can be integrated with the CCTV system.
• Access control and other security detection systems can initiate pre and post-event video recording, linking the video recording with the event information. This makes searching for events on the Network Video Recorder (NVR) or Digital Video Recorder (DVR) more effective as only the event needs to be searched, for example ‘door forced – stores door’ or ‘zone 3 – perimeter breached.’
• Track individuals and record their access details against the recording to track suspect users or stolen card users.
Intruder Alarms Systems
By integrating intruder with other systems, many advantages may be realised. For example:
• Set / unset the intruder system using an access reader. No need to use the intruder keypad.
• No entry delay time if main door forced. The entry timer is bypassed thus providing an instant alarm.
• Disabling of access readers when the intruder system is in the armed state, to prevent false alarms due to unauthorized entry into an armed area.
• Using an occupancy count from another system, the intruder & hold up alarm system can be notified that there may be persons present in the building when the system is being set.
Fire Systems
By integrating fire with other systems, many advantages may be realised. For example:
• In the event of a fire, all emergency exit doors on the fire escape route need to be automatically released from an electrical point of view, but physical quick release locks may be in place to maintain security and still allow people to escape. It is common practice to install a relay in series with the electric locking mechanism controlled by the fire panel. An alternative is to feed a fire input into the access control system, which then automatically releases the appropriate electric locking mechanisms. The proposed link between the access control system and the fire system should be evaluated as part of the fire risk assessment.
• CCTV cameras may also be linked to software to detect smoke or fire and provide a good early warning of fire.
Building Management Systems (BMS)
Building management systems are responsible for monitoring and controlling the environment of a hospital building, for example lighting, heating and ventilation (HVAC). In the current climate of energy saving, why leave lights on when an area is unoccupied? By integrating access control systems with BMS systems, the lighting can be automatically controlled by recording when people access an area. The system can also be configured to control the heating by reducing the room temperature when no one is present rather than leaving it on all day and off at night. The use of mobile device apps to remotely control building systems is becoming more popular.
Lift control
By integrating lift control with the access control system, access to certain floors in a hospital building may be restricted, particularly outside normal working hours or in multi-tenanted buildings. Also, modern lifts, can take a data feed from the access control system and advise the user which lift car they should go to. This is known as “elevator despatch”, this improves efficiency of the lift system and reduces energy usage.
External perimeter detection
One of the fundamental objectives of a security system is to provide protection at the outermost perimeter of a Healthcare property. A perimeter intruder detection system can be used, linked with CCTV or access control to provide early warnings and increased security through verification in the event of a breach. For example, external doors could be automatically locked if the perimeter system detects an abnormal event. This is most important for psychiatric hospital.
Car park management
By integrating Access & CCTV with CPM systems, many advantages may be realised. For example:
• Visually through CCTV.
• Audibly through an intercom system.
• By using CCTV automatic number plate recognition (ANPR) systems vehicles could be tracked and logged in and out of hospitals.
• Access Control tokens.
Guard tour
By using a guard tour package that integrates with the Access door readers can be used to define and monitor a tour by a specific guard, providing a real time indication if the guard does not reach a set point in time (or even if he arrives too early) – equally integration with the CCTV system can provide visual verification of the guard’s location and wellbeing. Many time & attendance systems incorporate guard tour functions as part of their software package.
Auditing
Another most important segment is security Auditing. Camera SEE everything, MISS nothing. SEE is unless you SEE, how will you know what you MISSED? This 'SEEING' what the Cameras 'SAW', is AUDITING. Unless healthcare facility / team Audit CCTV feeds as a Standard Operating Procedure, how will they achieve the benefits of HD video? Cameras can bring Video Feeds from anywhere; from basement of a healthcare building to top roof; BUT, what one NEEDS to do, is to 'SEE". Auditing of the CCTV system is a critical part of the maintenance and review process to ensure that the outcomes it provides meets the constantly changing requirements of an organisation or user. The audit process not only takes into account the reasons why was initially installed but also present outcomes that the close circuit television images are to deliver.
This Artical publish on Safe secure Magazine - Sep 2017
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