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ED Accreditation Update
ED and security team up, create plan
Several years ago the security plans for the ED at Miami Valley Hospital in Dayton, OH, were significantly revamped. The process required strong teamwork between ED leadership and hospital security.
"Several years ago we gathered together in response to staff concerns about the continuing amount of disruption in the ED," recalls Bonnie Coalt, RN, the nursing director of the ED. A team of about 20 people was put together, including mental health assessment, registration, campus police, nurses, and physicians, Coalt says.
"We held brainstorming sessions to identify what people thought were good ideas, and came up with almost 40," she says. "We probably implemented 20 in one shape or another."
All the recommendations were put in one document and then priced out, says Coalt. "The team picked the top 10 we wanted to take forward with immediately: triage area improvements, lockdown process, metal detectors, the ability to 'wand' patients who come by ambulance, panic buttons, and incident debriefing," she says.
Perhaps the most important change involved a revamping of the triage area, Coalt says. "We developed a construction plan and redid the area," she says. "We created four private triage rooms, each with an exit door so the triage nurse has a way to escape, and each room has a panic button," she says. Now there are only a limited number of "in" and "out" ED doors, Coalt says, because "we had way too many ways to get into the ED."
Processes also were changed. Now, presenting patients see a greeter and a campus policeman before they even reach a nurse.
Lt. LaMark Davis, operations manager security officer, says that in addition to having a steady dialogue with the ED on the new plan, "we communicate on an as-need basis. And whenever an incident occurs in the ED, we get together and debrief on how things could have been handled differently. We communicate well together."
Communication is enhanced by the placement of security personnel, adds Barbara Johnson, vice president of operations. "The campus police command center is located in the heart of the ED, which we think is very important," Johnson says. "And, on the recommendation of our security consultants who provide a new assessment yearly we set up a second one because we were missing redundancy." In other words, if there was an event and there was only one command center and it was disabled in some way, the facility would lose command over the situation. That second center is in a building right across from the main facility, she says.
There are now formalized internal safety and external safety committees, she adds. "We interface not only with campus police, but with town police officers," Johnson says. "We've partnered with the local police department to help with perimeter security, and they sit in on meetings with us."