Healthcare Security’s Built Environment – Doors

Continuing the theme of my last blog, “Healthcare Security’s Evolving Built Environment.” I want to turn attention to specific aspects of the security-built environment that have plagued me throughout my career. For me, doors have continued to be the weakest link in my security program. Broken, propped, or improperly installed all contribute to major breeches within the security program. Stairwell exit doors that have been poorly maintained over the years and have rusted out, smokers who prop exit doors open so they can go outside to smoke, doors propped so that staff can have a short cut into the building, Entry doors that are worn out from use and don’t lock, and poorly installed doors misaligned so they don’t close or latch properly all contribute to a negligent security program.

From these examples, I see three causes resulting in poor portal security. The first is people. Their lack of education on the importance of closing and locking doors. Second, is improper door maintenance. Doors that are used frequently or very infrequently which are not properly maintained, checking these doors on a regular basis, and immediately repairing them when found broken. Third, is improper installation. Many times, I have found doors installed that do not line up within the frame because the frame is bent, or hinges that are not installed correctly leaving doors that stick and are hard to open or don’t latch when closed. Access control doors all too often have door hardware and strike or magnetic locks that do not match up correctly and end up not working effectively. This is especially true when an existing door and frame are modified to include a strike or magnetic lock.

In healthcare, unfortunately, there are many, many doors. Too many, and as the hospital expands doors are added creating more points of failure. New entrance foyers, staff entrances and exit stairwells, the number of doors within a healthcare facility can be overwhelming. And the more they are used to more likely they are to be propped open, unlocked, or broken.

So how do you manage the security of doors within the healthcare-built environment?

The best way to ensure a door is closed and locked is to inspect the door on a continuous basis. This can be done through technology and manpower. Technology can be used by placing a camera on the door. However, depending on the view, the camera may not be able to show if the door is ajar or unlocked. There are alarm contacts which can let you know when a door is opened, but probably not if it is ajar or unlocked. You can install an audible alarm which will tell you when the door has been opened, but if no one hears the alarm or ignores the alarm then the door will stay open or unlocked until it is discovered.

Another way to ensure door closure is through manpower. Security officers can check doors to determine if a door is unlocked, propped open, or broken. However, even if checked every tour, a door could remain open for several hours before discovered allowing access by an unauthorized person. In my experience it is all the above working together that can help to ensure the security of a door. But these options together can be costly and financially take away from other important security functions. To resolve some of the financial burden and provide a more effective approach, data analysis can be a helpful tool in determining the risk and provide solutions associated with door security within the security-built environment. Analysis helps to focus security resources on doors that present the highest risk to the hospital and helps to determine the best resolution available to minimize that risk. Remember earlier I mentioned doors that are used most frequently or not at all. This is the starting point in assessing the risk associated with door security.