St. Lukes Hospital

Jun 1, 1997 12:00 PM, By KATE DOHERTY

In the late 1800s, Bethlehem, Pa., helped fuel the American industrial revolution with its factories and mills. The city's St. Luke's Hospital, built in 1872 by the Episcopal Church, was intended to meet the needs of congregation members who worked for Bethlehem Steel, one of America's largest steel mills. Now, more than 100 years later, many of the factories have been closed, and Bethlehem has emerged as a thriving center of high-tech commerce. Along with the city, St. Luke's has burgeoned into a renowned 435-bed facility specializing in cardiac care, oncology and women's health. It also boasts a teaching hospital, a school of nursing and a heliport. The hospital campus includes the main building and dozens of outlying buildings. Maintaining vigilant security is integral to St. Luke's reputation, and the burden of responsibility falls on John Hrubenak, director of security and transport services for the hospital.

Guard services Hrubenak believes in a proactive approach to security and keeps 15 proprietary officers on staff full-time. The officers patrol the main hospital, off-site buildings and parking lots wearing jackets and ties - dress that indicates they are there to help, says Hrubenak.

When we are visible, the staff knows we're security, so they feel more comfortable. It also enables us to solve problems before they happen. For instance, we staff an officer in the emergency room. Part of his job is to help process people in and out of the emergency room, including families. People don't realize that while we're doing that, we're keeping an eye on the emergency room, so that long before someone gets agitated or starts acting out, we've addressed the potential problem, says Hrubenak.

The officers serve a public relations function as well by interacting with patients, families and visitors to help them feel safe. If a patient becomes aggressive, the officers secure their valuables for them. All officers undertake the International Association of Hospitals Security Training certification program, into which Hrubenak incorporates training specific to St. Luke's such as bomb threat and emergency heliport procedures.

Officers cover their bases Hrubenak says a common perception among hospital staff was, Security never comes through my area, when, indeed, security officers were making their rounds according to schedule. He wanted an accountable reporting system, so he replaced the old system - initialing index cards - with a Protrac bar code system by Tiscor.

He chose a bar code system to produce documentation of officer rounds that could be shared with management, and for employee relations. Security is always thought of as `the bad guys.' We tell employees where they can and cannot park, we're responsible for auditing narcotics, and we're the ones they call when there is a problem. When everyone is busy, they don't see the security officers making rounds. We're invisible until they need us, says Hrubenak.

The old system wasn't sophisticated enough and it could be breached by falsifying information. I wanted something that didn't require downloading at the end of every shift. I didn't want a forest-worth of trees in paper storage showing everything was normal.

With the new system, security rounds are downloaded to a computer disk and then to cassette tape. Events can be recalled by date, and at the end of the year, three cassette tapes hold a year's worth of data. The system consists of about 200 bar code scanners that are scanned by the officers as they make their rounds. Bar codes are located in nursing stations, the ends of each unit, strategic lookout points, the emergency area and parking lots. There are also bar codes in security vehicles. Hrubenak says the system has also helped him report time spent on duties such as watching combative patients. He compiled a report showing that, in one year, security had spent approximately 4,000 hours on patient watch. Such documentation helps us make decisions about adding more employees or changing procedures, he says. In the future, the system may be used to track rolling stock equipment such as wheelchairs, stretchers and beds.

System solutions The hospital's long and rich history presents unique security challenges, because the varying architecture that marks points in its development impacts physical security. An array of equipment solves the problem:

* Access control. A Simplex electronic card system controls access to off-site buildings. Card readers and magnetic locks enable the system to automatically lock and unlock a couple of dozen access points. According to Hrubenak, there is still a need for expansion. When I first looked at buying a system, I had $100,000 worth of need, but I knew there was no way I could get that money budgeted, he says. But if I spend $30,000 a year for 3 1/2 years, eventually I'll be where I want to be.

The system has the capability to be integrated with other systems at a later date. St. Luke's owns large outpatient facilities as far as 25 miles away, and Hrubenak plans to start tying those into the access control system in July.

* CCTV. CCTV cameras are manned by staff in the units where they are used. Currently, St. Luke's does not have a central monitoring station, but that could change; an upcoming renovation of the emergency area will include construction of a security base station. Hrubenak is beginning to price cameras and multiplexers that would supplement the Sony, Ikegami and Burle cameras and Gyyr time-lapse recorders already is use.

The psychiatry department does a lot with CCTV to monitor patients and visitors coming on and off the units. We also use cameras at the school of nursing and in the ER; most are 24-hour. We also use covert security - something we're quite good at installing ourselves - if we have a problem such as narcotic theft, he says.

Using time-lapse recording, the security staff has caught employees stealing narcotics, as well as people from outside the hospital stealing from the gift shop. Once, says Hrubenak, we knew we had an employee stealing narcotics, but we couldn't prove it, so we put covert cameras in a work area where medications are prepared, and each day we set the time-lapse for the shift the employee worked. Indeed, we caught the employee stealing drugs.

Security reviews the tapes when there is cause and also does random spot checks. The nursing school, for example, poses many of the same security problems as a college campus. CCTV monitors the exterior of the building, and officers randomly pull tapes to ensure there have been no physical security breaches that could endanger the students.

* Fire and emergency. Simplex fire equipment guards against fire, and the hospital has just started putting in emergency equipment, including three callboxes, in parking areas. Hrubenak asked the administration for three callboxes a year, rather than for 15 at once. He implements equipment in increments to become comfortable with the technology, and because financially, it's an easier pill to swallow for the hospital administration.

Getting the callboxes did not go smoothly, however. We first put in a radio frequency callbox, which was disastrous because of all the radio interference. I couldn't expand it to any other points in the hospital. So I took a chance with another company that had sent me its literature, and that, too, was a failure. From the time I signed the purchase order, it took almost eight months to have the callbox installed. Now we use a local company called Gytronics. We're hardwiring the boxes using telephone lines, which I strongly recommend - even moreso than cellular. In an area like mine, cellular use is booming, so every now and then you can get interference or a busy signal. Obviously, that's no good for emergency callboxes, says Hrubenak.

Future integration Security at St. Luke's is headed in the same direction as the rest of the security industry these days: toward integration. Hrubenak would like to integrate the access control system with the fire system, cameras and callboxes - a task that will be facilitated once the new security base station is built in the soon-to-be-renovated emergency area. Security officers stationed there will be able to monitor the integrated systems. At St. Luke's, as in Bethlehem, progress marches on.

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