Hospital loading docks rival ERs for security concerns

RALEIGH, N.C.—Loading docks are one of the most vulnerable security areas at hospitals, posing a threat to facilities large and small, says Lisa Pryse, president of the International Association for Healthcare Security and Safety.

“Loading dock areas are volatile areas and, unfortunately, very often overlooked,” Pryse said.

Emergency rooms have long been a focus of hospital security, understandably. But receiving and delivery areas need surveillance cameras at the very least, Pryse said, adding that hospitals that don't already have video surveillance there are beginning to realize that need.

In a couple of instances active shooters have entered hospitals through unsecured loading dock doors, she said. Also, loading docks are often the pick-up sites for hazardous materials, such as chemicals and used hypodermic needles.

Vehicular access control to and from loading docks is important, she said, but it's complicated because of the convenience issue.

“We've got to get this trash out of here, the food in here, the medicine and equipment in here, and we only have so many bodies,” Pryse said. Like so many aspects of physical security, it's a balancing act.

Cameras and “a vendor management system” are crucial, she said. While many hospitals focus on visitor management systems, management of vendors is equally important, she said. Vendors arriving at loading docks often are allowed in hospital areas where some staff members are not allowed, such as when they deliver needed medical equipment directly to a patient's room.

“These areas are sterile, we have to know if [vendors] have had inoculations, that they have an appointment and that we know where they are,” Pryse said.

Waterbury Hospital in Connecticut secures its loading docks and receiving areas, said Kenneth Rasmussen, manager of security services.

It has security cameras in place in those areas, although he would like to see more cameras installed to monitor delivery people once they get inside the facility. After hours, Waterbury's fenced-in delivery area is locked so those making deliveries must use an intercom to gain entry. His rule is that the delivery doors can be unlocked only if security staff are present.

Cameras help with the orderly flow of deliveries and pickups from loading docks. “We don't want to make it Fort Knox, but we do need an orderly procession,” Pryse said. Maybe a hospital lets five trucks enter at a time, then alerts when others can move in, she said.

Cameras also act as a deterrent to would-be criminals who consider the “back door” loading-dock area as an easy entry to the hospital.

In Waterbury, those vendors that come in to remove sharps and hazardous waste materials are credentialed, Rasmussen said, but general delivery personnel and trash collectors are not.

All deliveries there are inspected by the receiving department. “If they were to find something suspicious, like [a box that is] wet on the outside or has wires protruding from it, and even if there's no purchase order for it,” receiving staff will alert his security department, he said.

Physical security at hospitals has come far in the past 20 years, but there's still much work to be done, Pryse said. “It has become a field of its own, but it's hard to keep up with the prolific society.”

Advanced cameras, biometrics and behavioral recognition technology all are areas to be investigated to secure patients and staff, but it all boils down to the simple fact that entire organization must be involved, from the c-suite on down, she said.

“The entire organization must be a partner with that patient: 'Let's talk about how we want this patient to be safe.' Even if you have $1 million to spend on technology, the security and safety of that patient is most important,” she said.