Hospitals can be dangerous places. From 2012 to 2014, healthcare institutions reported a 40 percent increase in violent crime, with more than 10,000 incidents mostly directed at employees, according to a survey by the International Association for Healthcare Security and Safety (IAHSS).

In 2014, 52 percent of hospitals reported their security personnel carried handguns, while 47 percent reported arming them with Tasers, according to a national survey cited by The New York Times. Those numbers are more than double the estimates from just three years prior.

Among the organizations moving in the direction of arming officers has been Parkview Health in Fort Wayne, Indiana, which currently has 45 police officers and 75 non-sworn public safety officers across 11 facilities, most of them hospitals but also including the corporate offices and a couple larger clinics and physician offices, says Thomas F. Rhoades, chief of police and corporate director of public safety for Parkview Health.

Rhoades first arrived at Parkview nearly a decade ago after 18 years as a police officer in both Fort Wayne and Plainfield (IN), serving as quadrant captain, head of both internal affairs and the training academy, and captain of a homicide squad in Fort Wayne.

Among those are the possibility that perpetrators of gunshots, stabbing and other violent felonies might try to “come in and either finish the job they started, or try to maybe intimidate folks,” Rhoades says. The workplace violence that healthcare workers face, in general, was not something he had been fully aware of, nor was the possibility that even the joyous occasion of a new life coming into the world might bring together extended family members who don’t get along.

The rise in opioid addiction has produced another challenge for healthcare security workers over the past decade, Rhoades says, and the incidence of domestic violence has a disproportionate impact on the healthcare sector since so many employees are female.

The Decision to Arm — and the Legislation Needed

About five years ago, with the mission of providing a safe and secure healthcare environment front and center in his mind, Rhoades decided that continuing with an unarmed security force would no longer suffice. But he wasn’t sure that simply arming the security force would be the right answer, either, as opposed to creating a sworn hospital police force.

The concerns facing Rhoades, besides “the concern of weapons in the hospital – or the general need to provide for a safe and secure environment for the hundreds of patients, visitors and co-workers every day” was the role of law enforcement in the hospital. “The healthcare environment is different from the environment on the street. So if you look at a lot of instances around the country, again, where a patient has died, or been seriously injured at the hands of security or law enforcement, the majority of times that I’ve seen, those have been from municipal agencies, working part-time at the hospital. And it’s not that the officers do anything wrong, but they are operating under a different set of policies and procedures than what you would in a hospital environment.”

With those thoughts in mind, Rhoades decided he wanted to create a dedicated internal police force that knew the healthcare environment and was accountable to hospital leadership. This required a change in state legislation, on which he worked with State Senator Dennis Kruse, based on sample legislation in other states. After educating Kruse on the risks inherent in healthcare, Rhoades worked with him on a draft; “we tweaked it here and there and came up with what I thought was a really good piece of legislation,” he says.

In addition to enabling hospitals to arm officers, the legislation provides healthcare police the authority to arrest people on campus as needed. It requires the officers to attend the Indiana Law Enforcement Academy just like any municipal officer would, Rhoades says.

Parkview saw a five-percent reduction in crime on its campuses in 2017, and Rhoades hopes to continue that trend.

Technology and Training

In addition to creating an armed police force, Parkview has provided the financial support for a “robust” camera system across the healthcare enterprise as well as a “very thorough” access control system across all hospitals, Rhoades says. Rhoades asked Security Manager Rick Dufresne to oversee all security needs for new construction projects and renovations across the system. He works to “make sure we’re meeting our standards and protocols, or providing the cameras and access control, and making sure they’re all part of the same system,” he says.

Parkview has not elected to distribute body cameras for officers due to issues like how to manage the electronic storage they would require, but Rhoades hopes this year to begin handing out lapel “push buttons” for workers who fear domestic violence or who have another safety concern to be able to sound an alarm as needed.

To face the issue of workplace violence, the system launched in the past year a Workplace Violence Subcommittee chaired by the police lieutenant and safety coordinator at each site, which reviews any incidents from the previous month to discuss what can be learned and ensures that the system is capturing data and tallying accurate numbers.

Most importantly, Rhoades says, is making sure that nurses and others who might be the victims of patient violence know that they need to report such incidents and not accept them as simply part of a day’s work, as healthcare culture sometimes pressures them to do.

Parkview has worked hard to ensure that police officers have the highest training and qualifications, too, starting with a structured hiring process that attempts to bring in people from a law enforcement background, rather than simply upskilling former security officers, Rhoades says.

His staff currently includes four former chiefs of police from the Fort Wayne region, a former sheriff, and four former Indiana State Police sergeants, two of whom ran detective units. “We just have a really diverse, experienced group of officers that were ready to leave their other careers and do a different type of policing,” Rhoades says. “And they have just been able to take us so much further than what we ever could have imagined originally.”

The hiring process includes two interview panels, one comprised of law enforcement personnel and the other of hospital leaders and board members, to ensure that Parkview is hiring “an individual that can operate in both worlds, realizing that two percent of the time you may have to be a police officer, but the other 98 percent of the time, you have to be a healthcare co-worker, and understand what excellent service looks like, and how we operate in a healthcare environment.”

One aspect of training that Rhoades emphasizes perhaps even more than municipal departments, especially given the presence of dementia patients and those with mental health issues, is a full suite of de-escalation tactics. In fact, he says, Parkview Police Lieutenant Nicki Ferguson, who leads the organization’s mental health facility, has done national training on how to incorporate such techniques.

“I try not to be a Monday morning quarterback, but I try to learn from the situations that we read about involving patients and law enforcement across the country,” Rhoades says. “And I think there’s so many times where we can really back off and let things cool down before we start having to use a certain level of force. And again, that’s a really tough lesson for police officers to learn.” But after two years of carrying Tasers, Parkview officers have yet to deploy them, a fact that makes Rhoades proud.

“Our officers understand,” he says. “The tools we carry on our belt are really not in any way because of the patient population. What we carry – and the way we respond – is to make sure that we can handle any external threat that may find its way into the hospital. When it comes to patients, we’re still going to handle things the way we’ve always done that.”