Security Smackdown - Safety versus Dollars

Necessary evil. Cost center. Wasteful expense. This is often how businesses describe security. Security professionals have been working hard to show the return on investment and value that security adds to a business. Forward thinking business leaders do see past some of the old ideas and realize that security is a critical business function, one that supports and helps a business meet goals and objectives, not just an expense.

However, just as security professionals are striving to join their organization's colleagues as a vital business function, there is another setback, this time in the healthcare security arena.

Hospitals have been struggling to stem the tide of violence against their staff members. Anyone working in emergency rooms or dealing with psych patients has been at a much higher risk of being a victim of violence than people in most other industries. Hospitals have been responding through staff training, improved security response, monitoring at-risk patients, using duress alarms and so on as means to protect their staffs as well as patients.

Many hospitals have even used metal detectors. However, the LA Times recently reported that metal detectors were going to be removed from several hospitals and emergency rooms, not because it was a safer environment, but rather due to money! Under the new Affordable Care Act (ObamaCare), hospital reimbursement is now impacted by patient surveys and scores. The worry was that some of the measures that enhance security might have a negative impact on the scores and result in less reimbursement. The changes could cost hospitals millions of dollars each year.

In a perfect world, visitors and patients would understand the necessity of security measures, even metal detectors, in urban emergency departments. In reality, they might not grasp the level of violence faced by healthcare workers and almost certainly do not realize the number of combative and dangerous patients encountered daily and the types of weapons often carried by them. Some hospitals have reported that since adding metal detectors, hundreds of weapons have been taken from patients or visitors, including lipstick cases disguising blades, homemade daggers and firearms.

In this showdown between security and profits; facts, risks and crime data will be no match for dollars. The situation makes you wonder what the next steps will be. Some people think even seeing a security officer may be unwelcoming and send the wrong message to patients. How many other hospitals will abandon other crime prevention measures in order to secure more federal reimbursement? Healthcare leaders, and in particular security professionals, need to be on high alert and ready to show the value of various security measures and enhancements. Anything from cameras, to visitor management or visitor check-in, even locked doors causing inconvenience, could be a target if it is seen as contributing to a negative patient score.

In round one of ObamaCare's security versus dollars smackdown, dollars least in LA at those locations removing metal detectors. In the long run, who will be the ultimate winners and losers? Doctors and nurses worried about working in unsafe environments will leave for other hospitals and if the best ones move on, the ultimate losers will be the very patients the hospital wants to appeal to.

Note: This post is not about the value of metal detectors. Rather it is about the risk to any security measure due to government healthcare reimbursements based on patient scores in lieu of objective risk assessments.
Eric Smith, CPP is the leading authority on organizational self-defense. He has extensive experience in law enforcement as well as security management. Eric is available for staff education and security awareness training as well as business coaching to help organizations provide safe workplaces. To learn more email


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  1. Eric

    If security programs are implemented after the need for them was demonstrated in a risk assessment then it's pretty hard to remove the protections unless the threat has abated or better solution is enacted.

    If hardware was installed without a clear problem in mind or the statistics to back it up then it's difficult to know when you're justified in removing it.

    Of course an enterprise cannot buy what it cannot afford but changes to its security and safety posture needs to be part of an effectively integrated risk management structure.

    Be well.


    1. In the case in LA, the metal detectors were put in place because of a shooting in the Emergency Department several years ago, according to the article. Unfortunately, security measures are often decided upon as a knee jerk reaction to an event and later undone without any real understanding of the risks - usually when the organizational memory fades...