Last fall, the Emergency Nurses Association (ENA) released data from an ongoing survey aimed at assessing theprevalence of violence against emergency room nurses. The study surveyed more than 7,000 nurses nationwide. Thirteen percent of nurses surveyed reported experiencing physical violence in past seven days. More than three-quarters (82 percent) of incidents of physical violence occurred in a patient’s room. Twenty-four percent occurred in a corridor, hallway, stairwell, or elevator.

The study found that only one environmental control measure (ECM) was tied to lower odds of physical violence against nurses. It wasn’t bulletproof glass or enclosed nurses’ stations. It wasn’t mirrors placed in hidden places or security signage. “Only one ECM was significantly associated with lower odds of physical violence--panic button/silent alarm,” according to the study.

For National Hospital Week (May 6-12), Security Management recently interviewed Mark Jarman, president and CEO of Inovonics, a company that produces high-performance wireless sensor networks for commercial and life safety applications. Jarman, who has more than 20 years’ experience in the security and wireless industries, spoke on the benefits of enterprise mobile duress systems in healthcare settings and how EMD technology expands on the concept of having a panic button.

What is an Enterprise Mobile Duress System?

True EMD is different than what people typically call a panic alarm button because with mobile duress they have the ability to send an alarm from anywhere in a building and throughout the same workplace. Further, it’s not just being able to capture that there is an alarm, but also brings responders to that place because of the ability to locate where the mobile device was pushed.

Those are some of the key features of Radius (an EMD solution by Inovonics)--with a mobile button you can cover large premises and locate that alarm event and, through a variety of adaptive notification methods, indicate where security officials should respond on-site.

Why is this system beneficial in a hospital setting?

The hospital is an environment where it all can happen. You can have overcrowding, understaffed workplaces, psych patients, noncompliant patients, gang members, criminals seeking access to drugs--there’s a host of things that can bring a workplace violence event into a hospital because of its 24-hour open nature.

We came across one example in an article that was published just last month. It was a California state facility that got fined. It’s called Atascadero State Hospital and they gotfined for safety violations because it just didn’t have enough operational safety policies in places, like buddy systems, etc., and substantially because it didn’t have panic alarms in enough places.

I think the incident that sort of brought it to the floor was a female staff member who suffered pretty serious head injuries and broken facial bones because she was beaten inside a restroom where an emergency alarm wasn’t present.

The benefit of having mobile alarms is that the mobile alarms can go with staff members at a facility that deems to be at risk. A 2011 study by the Emergency Nurses Association about violence in emergency departments found panic buttons were the only security measure that had a measurable impact on violence reduction. Imagine nurses and staff being able to take that button with them everywhere on the hospital campus--that is pretty powerful.

It’s interesting because even the HR department at a hospital is usually very aware if there’s a potential domestic violence condition that can find its way into the workplace because of that 24-hour open to the public nature of a hospital’s mission. Even if an employee isn’t involved in the caregiving, but they have a restraining order on a spouse or partner, that’s important for the HR department to know because it’s really easy for that spouse or partner to know where the person is, when they’re going to be at work, and then find their way into that workplace.

Has there been any recent legislation regarding these systems?

There’s no doubt that it’s coming, but I don’t know of any specific legislation yet at this time.

It’s certainly an active area. There are some very substantial guidelines that are developing from security associations. One in particular is the International Association for Healthcare Security and Safety (IAHSS). They’ve published some guidelines that do tend to be followed. TheJoint Commission[4] has quite a bit of scope and power and does a significant amount of regular auditing.

Even without laws that require EMD is the use of these systems becoming more common?

The demand is certainly driving interest. And by demand I mean that the incidents of very violent events have skyrocketed in the last few years. You’ll see in the news that it’s a weekly thing. So the adoption curve is building. We currently have between 10 and 20 installations of Radius, but more importantly we’re very busy in various phases of proposals and quotations.

Hospital security personnel have known for a long time about the workplace violence issues. You can’t speak to a healthcare provider and have them say that’s not one of their primary operational issues. In fact, that’s what I think drove the 2011Emergency Nurses Association study. I think that’s one of the key pieces of market research that either will be a foundation for legislation or some Joint Commission driven rules around hospital security.

If you look at the Atascadero incident, what happens is that if there aren’t certain obvious known security solutions in place, the hospital can be held liable.

So although it isn’t a legislated thing yet, there certainly are implications for institutions who aren’t utilizing available technologies.

Do you see any trends outside of healthcare, such as other businesses taking interest in EMD, like schools or banks, etc.?

Those are both great applications, and each is similar in requirements to the hospital application. You even can step back and at a higher level say that any place where there’s a cash transaction between the public and a business, those are opportunities for EMD. It’s not a bad place to highlight the difference between what historically has been deployed by the security industry and an enterprise mobile duress system.

Historically, duress buttons have been available and they’re often fixed under a desk or under cash transaction counter and they’re attached to a building security system. A building security system is not set up for a mobile employee or for the protection of people traveling between one business location and another within a single corporate system. The EMD combines functionality to address all of those mobile employee activities and yet can integrate with a building security system. An EMD really is a system in and of itself, designed to accommodate the employee’s need to be very mobile and still indicate that there is a potential for, or an actual, workplace violence event.

More on Radius from Inovonics CEO Mark Jarman:

One of the key things about the Inovonics Radius solution is that it’s a really low touch installation in that it’s a completely wireless sensor system. We have a matrix of repeaters that can be set up from a single department to several, very large, tens of thousands of square-foot buildings, or even entire campuses. And all those repeaters require is a local power line for them to “light up.” There’s an operating system on all of the repeaters so they can communicate with each other and with the Radius appliance.

You can get extremely high quality wireless coverage and location notification because it’s really an RF system that’s optimized for alarm transmission and not data transmission. It’s designed for transmission of alarm data - very small amounts of data across a facility. So you have an umbrella of coverage. Whoever in the facility is carrying a mobile duress alarm button, whether it’s on their wrist or on a lanyard or a belt clip or the pocket of a smock, they can reach in and silently press that alarm button and the message will get through in a very timely way.

The appliance can be connected to any of a number of other notification solutions. It can be attached to the onsite VOIP phone system, to 2-way radios, to pagers, send text messages, emails, or make cell telephone calls. That alarm information goes back out to a defined population in the facility indicating what’s going on and what kind of operational steps need to be taken. And that’s all configurable by the institution.

photo byalberto Coutinho/AGECOM