How to Regulate Access and Traffic Flow in Hospitals
The intricate and purpose-led design of a hospital layout is a delicate act. Broadly, the practice balances staff efficiency with patient outcomes, but the dynamic nature of healthcare and the unpredictable behavior of diverse groups within a high-stress environment can be challenging to manage effectively.
Technological advances in machine learning and computer-aided design and manufacturing (CAD/CAM) have changed how modern hospitals are designed and the treatments they provide. However, these advances in architectural understanding provide little benefit to facilities that lack the budget or logistical capacity to implement them.
Physical security remains an important consideration in the construction and management of healthcare spaces. In 2024, U.S. healthcare providers reported 114 incidents of unauthorized access resulting in data breaches, exemplifying how physical security and cybersecurity are linked. While that figure remained steady year over year, the number of exposed records almost doubled. An estimated 25 percent of all cyberattacks, a significant threat of the past decade, involved unauthorized physical access, highlighting the importance of strategic access and traffic flow strategies in combating physical and digital intrusion.
Strengthening Access Control at Primary Entry Points
Managing entryways is the first step in developing a hospital security strategy that effectively regulates traffic flow. Because certain departments, including emergency and outpatient services, are always open, hospitals must balance public access with safety. Effective access control in these areas can reduce unauthorized entry, lower conflict risk, and support data collection on traffic patterns to inform future strategies. There are certain access control features that should be considered or included for public entryways.
Clear designation of public, staff, and restricted areas. Funneling pedestrian traffic through clear checkpoints reduces the risk of accidental or intentional misuse and keeps foot traffic at manageable levels, creating clear and unobstructed lines of sight for security staff.
Sign-in procedures. Requiring visitors to provide identification and sign in at a front desk, whether digitally or manually, normalizes accountability and reduces the threat of tailgating or anonymous entry.
Staff access tiers. Assign staff appropriate levels of clearance, ensuring clinicians, administrators, and contractors can only access areas relevant to their roles and functions.
Trained security personnel. Public-facing areas, such as hospital entryways, can be challenging to monitor remotely due to data and privacy laws. On-site security staff can serve multiple purposes in these areas, including assisting with de-escalation, recognizing early signs of concerning behavior, and helping visitors with directions and guidance.
Clear signage. Hospital environments can be confusing for visitors, even after they’ve visited multiple times. Clear and consistent directions can assist distressed guests, reduce congestion, and keep traffic away from high-priority zones and restricted clinical areas.
After-hours protocols. Consistent rules for night shifts, such as which doors can remain open, improve oversight and reduce vulnerability during times when staffing levels are lower.
Combining Access and Flow for Safer Hospitals
Many of these principles extend to other visitor-heavy areas, such as lobbies, waiting rooms, and corridors. Lines of sight, staff and visitor credentials, and clear guidelines for incident response and after-hours periods strengthen workplace safety efforts when implemented consistently throughout a facility.
Success of these security features relies largely on training. Both the International Association for Healthcare Security and Safety (IAHSS) and the Joint Commission specify that comprehensive onboarding and annual refresher training are a baseline requirement. Within this, access control procedures, de-escalation, and emergency response protocols should be front and center, with the IAHSS recommending additional training when access policies are changed or new security technology is introduced. Other security professionals, including those published by Security Management and ASIS International, also stress the importance of training nonsecurity staff in access policy and incident escalation, and, pertinent to internal risk mitigation, providing refreshers on staff turnover and evolving risk profiles.
Frontline staff who understand behavioral indicators, escalation patterns, and visitor protocols create an environment of accountability and ease the burden on any one team by spreading responsibility.
Combining access controls with staff training and intuitive strategies helps hospitals reduce unauthorized movement, respond to incidents early enough to prevent escalation, and create a more secure space for all who enter.
Michael Davis is a security technology executive with more than 28 years in sales leadership, strategic partnerships, and market expansion for innovative safety products. As senior director at Motorola Solutions, he drives growth for the company’s smart sensor products, like HALO 3C. With a degree from Oklahoma State University and certificates from Cornell University, he is also a member of ASIS International and often speaks about advancing security innovation.
