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The Proper Prescription

In the healthcare industry, contract security officer retention rates can be low because wages and incentives may be inadequate, with many security service providers—and the clients they serve—still failing to realize the importance of this investment in human resources. It doesn’t have to be that way. It is possible to establish a cost-effective contract healthcare security program where all parties benefit. The key to success is good recruitment, proper screening, effective training, well-placed incentives, and long-term commitment on the part of the company and client.

Recruitment. The first step in building a good security officer force is recruitment. It is becoming common for even the largest multiregional or international security service providers to use a network of locally based dedicated recruiters. These individuals are familiar with the healthcare facilities of the community and seek applicants for security positions based on an understanding of the local job market, as well as average pay and benefits for the area. Recruiters look for candidates at educational institutions such as high schools and community and junior colleges, as well as at social and community-based organizations and veteran’s groups.

At the major international security service provider for which author Joseph Gulinello is a consultant on healthcare security services (hereinafter referred to as “the client”), healthcare security applicants are brought in by an employee referral program. Additionally, the client organizes and promotes community job fairs. When it becomes the security force provider for a previously proprietary operation, it also tries to bring aboard as many of the incumbent security personnel as can pass its strict screening standards and hiring practices.

Preemployment screening. Healthcare security candidates recruited by the methods discussed for the client are at least 18 years of age for a nonarmed position and 21 for an armed position in many state and city jurisdictions. This is typical in the industry. Candidates considered by Gulinello’s client also have a high school diploma.

Drug tests. At the client’s company, the preemployment screening process begins with a completed application for employment, followed by drug screening. Healthcare clients usually require a more in-depth drug-screening process for their candidates. In these cases, the company uses an expansion of the test. This ensures that the contracted officers are screened to the same standards as the facility’s work force.

Background checks. Applicants who pass the drug screening must also undergo an in-depth criminal records check and past-employment verification, which extend back a number of years, as well as other types of checks including a Department of Motor Vehicles’ driver’s license search and a personal references verification.

Psychological profile. Gulinello’s client uses the Stanton Survey—a screening tool that focuses on prospective employees’ attitudes toward work-related theft and theft in general, as well as on company policy violations. According to the test’s creator and marketer, Secure Point, of Charlotte, North Carolina, applicants who score low on the Stanton Survey tend to be easily distracted, unpredictable, impulsive, unable to delay gratification, rebellious, and nonconforming. Gulinello’s client has found the survey results to be an effective tool in identifying candidates with integrity, an important consideration given healthcare facilities’ abundance of objects of value.

Interviews. Multiple interviews are also conducted with applicants to determine whether they possess the interpersonal skills important in healthcare settings. Security officers in a healthcare environment regularly encounter people in need of empathy. Frantic, frightened, upset, or grieving, these people must be treated with kindness and respect without compromising security’s mission. It is not a condemnation of an applicant to conclude that, although he or she is an otherwise excellent security officer candidate, the applicant lacks a personality that connects well with people in crisis. In such a case, the candidate may be better suited for service in another type of organization to which the corporation provides security services.

During the interviews, prospective officers are clearly told what kind of an environment they will work in. Some candidates may not have fully contemplated a job environment where there are blood-borne pathogens, infectious diseases, trauma, death, and the potential for violence. During discussions, these applicants may decide that a health­care security assignment is not for them. Eliminating these applicants helps to ensure that those hired will stay, which will reduce turnover and improve performance, serving the long-term interests of the officers, the service provider, and the client.

Candidates who are chosen must be vaccinated, or prove that they have been vaccinated, for tuberculosis. They are also offered the hepatitis B vaccination. Additionally, some facilities require a physical examination and other tests as a matter of policy for all workers at the facility. In these instances, contract security personnel should also adhere to the same policy. These requirements are in accord with OSHA and the Joint Commission on Accreditation of Healthcare Organizations (JCAHO).

Training and development. As a matter of practice, hired officers by Gulinello’s client are not deployed to their assignments until all drug-screening, criminal, and reference checks come back positive and until they complete preassignment training.

Training is in two areas. Basic security training is given to all personnel hired, regardless of the industry to which they are assigned. In addition, officers hired for a healthcare account are given a 15-module course designed for healthcare security.

Topics addressed in basic training include the role of security officers and their legal powers and limitations, communications and report writing, public and client relations and customer service, diversity, and ethics and conduct. Other issues discussed are emergency and disaster management, access control, safety and hazardous materials, and post orders.

The healthcare-specific 15-module course covers subjects such as blood-borne pathogens (for example, what an officer should do if he or she receives a needle stick), infection control (such as always carrying and regularly using latex gloves when handling patients), and the structure, culture, and concerns of healthcare organizations.

Once on site, new officers receive on-the-job training that includes an overview of the client organization; a facility orientation; and a discussion of site-specific security objectives, post orders, and responsibilities. Other issues covered are security scheduling, reporting procedures, emergency procedures, a safety overview, and cross- training. It is also vital for representatives from the organization to meet with the security officer provider to make sure that other aspects unique to the site are included in the on-the-job training. As a matter of practice, the client is encouraged to participate in the design of this program to ensure that all necessary issues are covered.

Although security officers are contract employees, they attend the same new-employee training as all hospital staff, where issues such as human resources, risk management, and institutional policies are discussed. The officers are also required to attend yearly hospital staff refresher training. This practice enables the officers to be perceived as fellow employees—a part of the healthcare team.

In general, when conducting surveys of healthcare facilities, JCAHO looks for the security department to be involved in ongoing education and development programs. At Gulinello’s client, continuing training for security officers begins with a proprietary program known as Advanced Certification Training (ACT) 1, 2, 3. Officers receive books and study guides designed to give them more advanced knowledge of topics such as theft prevention, evidence gathering and preservation, crime scene security, crowd control, effective report writing, security awareness, and workplace violence. When officers have successfully completed the ACT series, they may receive a monetary award, staff recognition, and a special patch to wear on their uniform.

As a best practice, the International Association for Healthcare Security and Safety (IAHSS) basic healthcare security officer training and certification program is offered to clients who understand the value of the program for ongoing development of security personnel. This course includes study of self-protection and defense, professional conduct, crisis intervention, interviewing and investigation, and employee/labor relations. Officers also learn about the judicial process, courtroom procedure, and giving testimony, as well as the security needs of units such as the emergency department and psychiatric unit. They also learn about fire prevention and response, equipment usage and maintenance, bomb threat procedures, and the effects of narcotics and other dangerous drugs. At the conclusion of this study, the officers must pass an examination to gain the IAHSS certification. (If the IAHSS program is not adopted by a particular client, a program for ongoing development that best fits the client’s needs will be designed through a cooperative effort.)

Officers next undertake IAHSS’s advanced healthcare security officer training program. The course covers security awareness and crime prevention, patient risk groups, enhanced customer service, security and patient interactions, premises liability, special security concerns, methods of patrol, security in sensitive areas, investigative techniques, reports and procedures, security technology, off-campus security and safety, critical incident response, workplace violence, and professionalism. Officers who successfully complete the training receive a certificate of completion. (Again, if this is not adopted, the healthcare security officer provider will create a program for ongoing development in cooperation with the client.)

Supervisors. Gulinello’s client also requires the completion of its own supervisory training program. The modules taught are service excellence, the role of the supervisor, business process improvement, process improvement, implementation and measurement, and performance management. Annual refresher training is mandatory.

In addition, officers promoted to the supervisor level may pursue IAHSS supervisory training as part of the leadership development process. The IAHSS provides a course that includes an introduction to supervision, effective communications, and management skills. Supervisors also study contemporary issues in healthcare, self-improvement, supervisory responsibilities, civil liability, employee relations and appraisals, safety, authority and control, budgeting, leadership, customer relations—including handling complaints and grievances—and other aspects of supervisory duties in a healthcare setting. In cases where the client does not use this program, alternative development training is offered.

From a best-practices perspective, it is essential that contract security personnel participate in facility-related training given to all hospital staff in areas where security often plays a role. One example would be de-escalation training for emergency department assignment or psychiatric department staff training on managing aggressive, disoriented patients.

Benefits. While the healthcare security industry as a whole suffers from an extremely high turnover rate, some security force providers have learned that to retain officers, a company must take care of them, motivate them, and reward them. For example, at Gulinello’s client, it is common for security officers to move up through the ranks. In fact, there are a number of vice presidents, branch managers, and regional staffers who began as security officers. Many of these individuals have been with the company or its affiliates for a number of years.

The high retention rate is encouraged by a benefit package that includes a reasonable salary with regular and merit-based increases. The challenge in client relations is to continually reinforce that a reasonable salary and benefit package equals retention, motivation, and loyalty. Clients who do not understand this factor may settle for the lowest bidder and fail to purchase the desired services. A fact of life is that security personnel, like individuals pursuing other vocations, will seek the best pay and benefits for their services.

In Gulinello’s client, officers are provided with uniforms, a 401(k) savings plan, life and accident insurance, holiday pay, paid vacations, an employee assistance program, an Excellence in Service Program, Sons and Daughters Scholarship Program, and other incentives and benefits.

The Excellence in Service Program recognizes healthcare security officers by bestowing Years of Service Awards, Customer Service Awards, Awards of Merit, and Medals of Valor. There are also commendations given to the hero of the month and year and to the supervisor of the month and year as well as an award for national service hero of the year for performance, and national service hero of the year for heroism. Such recognition is highlighted in one of the company’s publications.

Gulinello’s client encourages the CEOs of companies using its contract officers to participate and to hand out these awards to show how much the company appreciates the officers and their commitment to the organization. It is also common for a ceremony to be held for officers who complete the IAHSS certification training or other development programs.

Wages. Gulinello’s client is also straightforward with its own clients during contract negotiations, explaining that low or minimum wage is not appropriate for healthcare security officers because of their additional training and unique responsibilities. Low wages only motivate high turnover among security staff. Much of the cost effectiveness of a contract security force is lost, they are told, because of the continual replacement and training of officers. It is up to the client to help the provider hang on to these well-trained and responsible officers, as it is in everyone’s interest to maintain the security staff to ensure stability and provide consistent security service.

In addition, and as a best practice, personnel are hired and dedicated to the healthcare account. This is difficult to accomplish when turnover is too high. The company continually strives to educate clients that higher pay leads to a stable work force and the long-term desired quality of service.

Resources. The company also works with clients to provide officers with the tools and equipment they need to do their jobs—for example, adequate communications systems and a reporting software system that allows security personnel to capture all necessary information easily and accurately. Other needs include a steady supply of latex gloves and face masks to protect against contamination and infection in a healthcare environment.

With careful selection and training, contract healthcare security officers can provide as much of a beneficial effect on a medical facility as a dose of regular medicine. With proper rewards and cultivation, the effect on an organization’s bottom line can be equally efficacious. The key is to educate all involved parties and develop a relationship of understanding and a team spirit to provide the best quality services at an acceptable cost.

Joseph J. Gulinello consults on healthcare security services for Securitas, Inc.’s U.S. national strategic accounts in Denver. He is chair of the ASIS International Council on Healthcare Security. Ann Longmore-Etheridge is associate editor of Security Management and editor of Dynamics.