For my last blog on doors within the built environment and their exposure to security, I would like to add several other remedies within the healthcare security-built environment. As I focused on last month, data analysis is one way to ensure doors are closed and locked. However, there are other methods which can increase the level of security for both internal and external doors.  

As security professionals we frequently discuss education and training. In the case of door security, education and training to staff, door installers, contractors, and maintenance personnel can reduce the potential for broken, poorly installed, or propped open doors.   

Healthcare staff should be educated on door security during orientation and annual education. This education should include:  

• The processes for reporting broken doors.  
• The need to keep doors locked and not prop open doors. 

• Any penalties related to violating door security policies. 
• Reminders on the authorized routes to areas most often used by staff like parking lots, restaurants, and pathways to other hospital buildings. 

For internal maintenance personnel training and certification on door returns, hinges, door repair and of course door strike installation and repair can reduce the potential for poorly installed and the effective repair of broken doors. Many healthcare institutions do not know that manufacturers provide in-service training and certification to in-house personnel, usually at no cost. Security staff should participate in this training as well. Not to conduct repair but to diagnosis, making maintenance personnel’s job a little easier.  

Standardization of door hardware is a great way to provide increased security for doors as well. Healthcare institutions should have a written set of standards for lock types, hinges, door returns, door strikes, and even doors. Including specific manufacturers and model numbers. These standards should be available to in-house design and construction personnel, vendors, contractors, and of course security personnel. Training in these standards should be conducted so that all parties are familiar with the standards. The use of standardized devices also allows healthcare institutions to minimize continued training on new products and allow for consistent installations. While developing standards, healthcare institutions should feel free to experiment with different products and models to see which works best for their specific healthcare institution. Additionally, institutions should continually evaluate and assess products based on lifetime use, ease of use and installation, and failure rate. Data analysis will help in determining the products that are most effective in providing consistent operation and the effectiveness of security within the institution.   

Another way to ensure door security is using factory authorized installation/repair personnel. Using only certified installers and repair personnel for doors and door hardware. This requirement can be written within RFPs or contracts as well as requesting documents confirming certification. At one of my institutions our security integrator used a certified locksmith to install all strikes and magnetic locks. The locksmith would also call in a certified door repair person when existing and new doors did not function correctly. From the day that process started, we had zero problems with access control doors and if a door did need repair, we used the same company since they were already familiar with our doors, our hardware and our processes. 

Signage on doors identified as high risk can be helpful as well. Signage should reinforce door closure policies. The sign can also provide staff with authorized routes and door use to parking lots, restaurants, etc.  

So, I think that I have talked enough about doors and their impact on healthcare security. I think it is important to understand the impact a broken or propped open door has on facility security. As part of every security program, the continued evaluation of door operations and use can dramatically reduce the potential for institutional crime including workplace violence or the threat of an active assailant. Door security should be a major part of the healthcare security program. Securing the perimeter and internal high-risk areas ensures the safety and security of healthcare employees, patients, visitors and all persons who visit a healthcare institution.