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Hospital preparedness, security paramount during the Baltimore riots


On April 25th, a palpable tension filled the city of Baltimore. After several days of peaceful protests over the death of Freddie Gray at the hands of Baltimore police, a group of protestors turned violent, pelting officers with rocks and damaging at least five police cruisers.

Hospital preparedness, security paramount during the Baltimore riots

As protestors reacted to the death of Freddie Gray, hospitals throughout the city initiated plans to protect their campuses

On April 25th, a palpable tension filled the city of Baltimore. After several days of peaceful protests over the death of Freddie Gray at the hands of Baltimore police, a group of protestors turned violent, pelting officers with rocks and damaging at least five police cruisers.

Two days later, the violence had escalated into a full blown riot, as people around the country turned on their televisions to see a local CVS consumed in flames, looters rummaging through stores, and police firing pepper balls into crowds of protesters.

Elsewhere throughout the city, Baltimore hospitals were preparing for any potential overflow onto their campuses. With four major hospitals within the Baltimore city limits (Johns Hopkins Hospital, Mercy Medical Center, Bon Secours Baltimore Health System, and the University of Maryland Medical Center), each facility faced potential security risks if the riots spiraled out of control.

Ultimately, there were no reports of looting or violence on the hospital campuses, according to Caroline Ramsey-Hamilton, CHS-III, risk expert and president of Risk and Security LLC in West Palm Beach, Florida, who spoke with some Baltimore hospitals following the riots. She says the high concentration of healthcare facilities within the city has created a collaborative environment, particularly when it comes to responding to disruptive events.

"I think there is a high degree of cooperation since all these security and safety directors know each other," she says. "I think that really helps in something like this."

Healthcare Security Alert contacted all four hospitals listed above. However, only representatives from Bon Secours Baltimore Health System agreed to speak about the security precautions they put into place and security's role in responding to any potential violence. Input from those representatives, along with Ramsey-Hamilton, showed that planning, increased security, and ensuring staff were able to get to work were the biggest issues that hospitals faced during the height of the riots.


Getting staff to work

With four major hospitals situated within a five-mile radius, the biggest issue that hospitals faced during the riots was getting thousands of employees to work safely.

"The number one question is how do you get your staff back and forth, especially on the northwest side where the riots were happening?" Ramsey-Hamilton says. "What they did was some shifting of people based on where they lived to make sure they could actually get to work."

At Bon Secours, some staff members who lived outside of the city called in, but in the majority of cases, hospital officials were able to direct staff members through routes that avoided the hot spots of violence or protests, based on information they got from local authorities, says Matt Ansel, executive director of emergency services and chief preparedness officer at Bon Secours Baltimore Health System. The hospital conducted daily calls with the city to determine where the hot spots of violence were occurring so they could pass the information to staff members driving in.

"They were very appreciative of that," he says. "The first day, before anyone got that organized, some staff just missed some of [the protests], or had people pounding on their vehicles."

Bon Secours also allowed non-clinical staff to adjust their hours to come in early and leave by 2:30 so they were able to leave the city before protestors started gathering.

Initially, there were concerns regarding the 10 p.m. curfew for staff members coming in for late shifts, particularly whether staff members just needed a badge or a letter from the hospital, but it was quickly determined that a badge was sufficient.

Another primary fear for local hospitals was ensuring that staff and visitor vehicles were not vandalized. In some cases, staff members who typically parked in open lots closer to the facility were instructed to park in the garage, Ramsey-Hamilton says.

Ansel says Bon Secours moved approximately 35 hospital-owned vehicles that typically take up spaces in the garage, to corporate offices outside of the city.

"We're fairly tight with parking and a lot of our employees street park and so we were afraid because of everything going on that they weren't going to be street parking and they were going to be coming into our lot," Ansel says. "We knew we would have an increase of employee cars so we didn't want to take up those additional spots."


Increasing security

Overall, the hospitals around the city were largely unaffected by the riots since most of the violence was localized and didn't spill onto any of the hospital campuses. The only real problem Bon Secours faced was a break-in at one of its outpatient drug treatment centers on the night of April 27; however, no one was on-site at the time.

Unsure of what the following weekend might bring, Bon Secours opted to close all off-site facilities for that Friday, Saturday, and Sunday, which allowed the hospital to shift its security resources to the main hospital.

"We basically doubled our security in the hospital for that Friday, Saturday, and Sunday," Ansel says.

The hospital placed two officers at each entrance to the hospital, one to take care of patients and visitors coming in, and another to serve as a second set of eyes, says Nicole Brown, the security director at Bon Secours Baltimore Health System. The hospital also initiated hourly patrols around the exterior of the facility, just in case any of the protests had moved to their immediate area.

"Everyone was required to check in with security to sign in and get a visitor's pass," she says. "Additional officers patrolling the hospital were advised to ensure everyone had on a hospital badge or a visitor's badge, and to make sure they were in the area in which the visitor's badge was noted."

Bon Secours contracts its security through Allied Barton and during contract negotiations the hospital specifically looked for a company that would be able to provide additional resources during emergency situations. Ansel says the company worked with the hospital to provide back-up resources when necessary.

Although some officers were forced to call out, Brown says she adjusted their shifts to 12 hours to make up for a reduced staff. She also knew that the off-duty officers that patrol the ED would not be available, since all police resources were tied up controlling the riots.

Security at Bon Secours also spent the week prior removing any unsecured trash cans and loose bricks that could be thrown through windows and reviewing lockdown procedures.

"We never got to that point, but if it got close enough to us, we reviewed it just in case," Ansel says.


Preparing for the worst

In the last year, we've seen major riots in Ferguson and Baltimore in response to excessive force by police. For hospitals in urban areas, riots and civil unrest should be a chief security and preparedness concern moving forward.

The biggest takeaway, according to Ramsey-Hamilton, is that hospitals are largely on their own during these situations, primarily because local resources are stretched thin in an attempt to control the unrest. That further emphasizes the need for preparedness measures that involve security, and the ability to have back-up resources that you can rely on to help bolster security units.

However, Ansel notes that the city did hold daily calls with area hospitals, and he received calls from Baltimore's emergency planner indicating that the city had plans for every hospital should anything happen.

"They are very well-planned out so we felt comfortable with that conversation," he says. "You feel the resources are there, and at the end of the day, we work hand-in-hand with the police, EMS, and the fire department all the time. So we have a good relationship, and we felt comfortable if we called they would come."

Ramsey-Hamilton expects that this issue will be even more pervasive throughout large cities across the country, particularly those with a historically adversarial relationship with the local police.

"What we tell people is you're really lucky it hasn't happened to you yet, but it's like law of averages," she says. "If it's an industry trend and it's happened at all these other places, it's not less likely it's going to happen to you, it's more likely."

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