The Value Of Four

Apr 1, 2007 12:00 PM, By Ashley Roe

In 2005, Shands HealthCare, a private, not-for-profit system affiliated with the University of Florida in Gainesville, Fla., decided to invest in an integrated security system for its 81-bed, behavioral health hospital, Shands Vista.

Inpatients and outpatients who visit the hospital are treated by psychiatrists from the University of Florida (UF) Department of Psychiatry and Shands mental health professionals for conditions such as substance abuse, memory disorders, anxiety, depression and other disorders. As a psychiatric inpatient hospital, Shands Vista often treats patients who are admitted on an involuntarily basis. As a result, the hospital faced some unique challenges to implementing a security system.

“We were looking for security, but we also wanted a system that had convenience for our staff,” says Jan Harmon, director of facilities and support services for Shands Vista. Harmon wanted to install a system to maximize safety for the facility's patients and staff. Shands Vista sought a solution that would provide monitoring systems to help staff assess and monitor patient safety on a continual basis, would employ electronic “panic” notification during an emergency and would allow staff to monitor access to secured areas, such as the medication rooms and storage areas for patient possessions.

“We looked for a system that integrated access control, CCTV monitoring, alarm capabilities and a paging system,” Harmon says. The hospital chose a customized system from Johnson Controls Inc., Milwaukee.

In addition to the Shands Vista psychiatric center, Shands HealthCare also operates a sister hospital, Shands Rehab Hospital, located in a 100,000-square-foot building on the UF campus. The security system would also be installed at Shands Rehab and thus needed to address its security needs as well.

“The Shands Vista facility is unique in that it serves two distinctly different patient populations under one roof,” says Jay Alix, director of national accounts for Johnson Controls' Fire and Security Solutions. “With half the facility serving physical rehabilitation patients and the other half serving psychiatric patients, the challenge was to design a system and procedural protocol to address the safety, security and risk mitigation for both parts of the facility and to streamline the current safety and security countermeasures to lessen the burden on the security staff.”

At Shands Rehab Hospital, the primary security concern was patient safety, and a combination of access control and CCTV monitoring solutions would help mitigate safety risks. But, according to Alix, the psychiatric center presented more security challenges.

“Patient, visitor and staff safety were paramount, but there was also a need for pharmacy controls to monitor activity within the medication-dispensing areas to help provide safety and compliance,” he says. “All of these issues equal tremendous liability to the hospital.

Shands Vista chose to install Johnson Controls' P2000 Security Management System, which integrates access control, CCTV monitoring, duress alarms and paging systems, thus providing situational awareness of potential threats to patient, visitor and staff safety.

“The P2000 system interoperates well with existing hospital systems, such as nurse paging and intercom systems and hospital duress systems, and has the ability and openness to add future applications,” Alix says.

Access control

For access control, Johnson Controls recommended HID Prox Pro proximity readers from longtime partner HID Global, Irvine, Calif. Readers were placed at primary exits throughout the facility. The medication rooms and pharmacy were also provided with a combination of keypads and readers. According to Shands officials, the internal areas of the facility were the most challenging. Staff required access to areas, but patients and other unauthorized individuals needed to be restricted. Bar-coded cards allow employees and physicians to access secure areas, and authorized users can define access rules by time and location. Authorized users can also review reports generated by the system to further monitor access and investigate theft.

The facility uses a combination of magnetic and strike locks, depending on fire department evacuation codes and the type of application. Johnson Controls installed its CK720 series TCP/IP access controller and an RDR2S access controller with a degraded mode to ensure seamless operation in the event the host computer is compromised.

CCTV monitoring

For CCTV monitoring, the hospital installed a combination of fixed cameras, monitors and digital video recorders. Cameras were placed at entry locations of various secure areas. They were also installed in areas where patients could be monitored in groups or while in isolation rooms. Monitors were placed at each of four nursing stations to facilitate patient monitoring and alarm activation. According to officials, this provided an additional bonus by increasing the staff's ability to monitor patients under normal activity and providing an additional set of eyes during an alarm situation. The hospital uses the Intellex LT Digital Video Management System from American Dynamics, San Diego; a CM9740 Matrix Switch, Genex multiplexers and monitors from Pelco, Clovis, Calif.

Images captured on the cameras can be stored up to 12 months. “We wanted to be able to refer back to actions that happened in the past,” Harmon explains. This ability is helpful in investigating incidents objectively, which is beneficial in a psychiatric setting where the competence of a patient making an allegation might be compromised by his or her mental illness.

Duress alarms

Fixed duress alarms were installed at each entry and exit to and from a secure area. The facility uses a duress system from Radionics/Bosch Security Systems, Fairport, N.Y., and a wireless interface module from Inovonics, Louisville, Colo. The alarms were positioned so that staff members could quickly make a request for assistance when entering or exiting. Alarms were also positioned in the facility's interview/counseling rooms to provide the interviewer with a discreet means of obtaining assistance rather than overtly using a phone or an intercom. Other duress alarms are provided in the form of two-button wireless belt clip-ons and pendants worn by staff members in areas where they interact closely with patients. A command-center keypad is located at each of the nurse stations. When an alarm sounds, staff members are alerted its location and view the CCTV monitors as a first response. The alarm system also allows archiving of transactions for future review.

Paging

In order to alleviate the high-volume traffic that occurs between the time a duress alarm sounds and its response, Shands chose to install a wireless paging and notification system from Visiplex, Deerfield, Ill., and to issue pagers to first responders. Upon activation of a duress alarm, the P2000 converts the alarm and location information into a paging message that is received on a pager. This allows nurses and hospital security personnel to receive the same information simultaneously and results in more efficient response.

“At the center of the facility, dividing the psychiatric and rehab hospitals, resides the command-and-control center where all security monitoring and response activity is coordinated and facilitated by the P2000,” Alix says. “Having automated, centralized management allows Shands Vista security personnel to have actionable intelligence at their fingertips. They know when and how to act when a security issue arises. The P2000 helped them accomplish this without the need for additional security staff.”

System installation was completed in September 2005 and has been a successful addition to the hospital, according to Harmon.

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