In recent weeks we have seen situations of discharged patients being “put out” into severe weather without proper clothing. Some of these incidents were captured and communicated widely via social media (you can view one such story here). With only scant information on the specifics, all we can do is to project how we would have our staff respond.

When reviewing these recent situations thoughts move to where breakdowns could have occurred. To start, one must understand that those responsible for dealing with this must first fully comprehend the organization’s position on how this is to be handled. That means understanding relevant policies, options and procedures.

As most of these situations require security involvement and intervention, it is crucial for all members of the security department as well as the clinical departments (especially the emergency department) to have a thorough understanding of the rules related to this issue. A thorough training component should be required for all involved. For security personnel to have a thorough understanding of the rules, the training should include such factors as: options available to obtain patient’s cooperation (setting behavioral expectations), ensuring patient safety (safe destination, appropriate clothing, reasonable transportation), and options and processes for use of force, including law enforcement involvement.

An additional element of consideration is a strong process for security staff to access internal department counsel from their leadership team at all times of the day. The reality is that many of these situations occur at times when few leaders in any department are present and opinions on how to deal with repeat patients, who can be troublesome, are to be handled. Many times, security staff have been directed to deal with these patients in a manner not consistent with organizational expectations. If this failsafe is not in place, and security staff are not fully empowered to access counsel at all times, situations like this are all but inevitable.

These posts will be used to discuss a current topic related to healthcare security. The opinions  expressed here are solely mine. The intent is not to find blame or to necessarily solve an identified problem. Rather it is intended to open dialogue and identify universal issues that may be shared by healthcare institutions and their security departments.