There’s nothing I like more than questions from the studio audience, so this week I thought I’d field a question on one of those risks that never seems to go away completely, as much because there are not very many specific requirements. So, let’s consider abduction drills.
The current situation at this particular organization involves what I think is a pretty good cross-section of activities: campus-wide drills, suspicious person(s) on the unit drills, mother/baby-specific drills, as well as random quizzing of staff throughout the organization on their role(s) in the infant abduction policy (they have to answer 10 questions about the policy), and a monthly operational test of the infant security alarm system. Again, I think that’s a very good start to things. But it does sort of beg the question as to what requirements exist? Well, dear reader, I beg you, please read on.
Strictly speaking, The Joint Commission (TJC) does not have a great deal that could be characterized as requirements in this regard. EC.02.01.01 EP #9 requires hospitals to have written procedures that can be acted upon in the event the hospital experiences any security incident, including abductions of infants of pediatric patients. That’s pretty much all there is in the standards. I’m presuming that you have a written procedure for responding to an infant and/or pediatric abduction incident, so we’re off to a good start.
As for abduction drills, TJC does not require them at all, with the caveat that the number of drills to be conducted, if any, would be based on the organizational risk assessment. The types of things you would want to consider when thinking about drills would be:
- Do you provide care and/or services to these “at risk” patient populations?
- Which environments are used by these “at risk” patient populations (you would need to include outpatient-type settings as well as inpatient settings)?
- How many shifts those areas are open?
- Are there particular scenarios, etc. that might represent a greater risk of abduction? E.g., custody issues between parents, between the state and the parents, etc.
You’d want to consider the physical layout of the space, including what security technologies are available, and you would definitely want to consider past drill performance by staff. If you have fairly flexible visitation hours, then you might need to consider off-shift drills a little more closely. Another thing to consider would be how response protocols might differ based on activation of the fire alarm system. The perimeter door magnets on your secure unit(s) may deactivate when the fire alarm systems is activated, so that might be a good scenario to try.
I think the best approach is to work with the clinical leaders and frontline staff in these areas to help develop scenarios that are realistic and properly “stress” the folks involved (much as would be the case with any emergency response exercise—if you don’t push “hard” enough, it’s tough to be assured that you’ve identified any potential vulnerabilities).
The program outlined at this organization includes exercises/drills that involve the entire organization, but also include suspicious persons on patient care units (abductions aren’t necessarily the only risk we would have to manage from a security standpoint), as well as exercises focusing on individual units. It wasn’t mentioned which units were exercising on an individual basis, but I’m assuming mother/baby and pediatrics, which is cool, but don’t forget those other settings like clinics and the ED, maybe even surgery if they are doing pediatric cases.