While securing a health care system is no small task, Alan Butler, CoxHealth’s system director of Public Safety and Security, says a successful approach means mastering the basics.

The good news? CoxHealth is well-positioned in the fundamentals, and is making strides in key areas.

Butler says a successful security approach is rooted in three foundational blocks: Officer presence, integrated security systems, and trained hospital staff.

It is the final block where there is the most opportunity. That’s why Butler and his team are committed to ongoing training for all staff – including for workplace violence and active shooter scenarios – in the coming months.

Making sure we are all security aware and doing our part is how we create a safe environment, for both staff and patients.

“Every one of our employees has a role in how we secure this organization,” Butler says. “That can mean everything from de-escalation training to simple things, like not allowing someone to piggyback through a door that they are not allowed to come into.”

Butler recently took a few minutes to talk with us about how CoxHealth is doing. Here is what he had to say – on each of the three foundational blocks, and on where we go next:

Officer presence: Having trained officers in the right place at the right time

CoxHealth has committed tremendous resources to recruiting, training and retaining our Public Safety staff, a commitment that exceeds what is typically seen in health care. That commitment puts our organization ahead of most others in terms of preparedness and integrating Public Safety into our daily operations.

“I think we have an exceptionally good security presence,” Butler says. “We are making sure we hire, train and retain the best we can get.”

Having Public Safety staff visible in our Emergency Departments, hospital units and public spaces reinforces an environment of safety and preparedness. Those perceptions, in turn, help reduce crime and in particular, the threat of patient-generated violence.

Butler says new approaches, like the addition of our canine units, are stepping up visibility even further and enhancing safety.

“The data makes it clear that the presence of the dogs does have a positive impact on patient-generated violence,” Butler says. “And, from a perception perspective, the canine team directly improves staff perceptions of safety.”

The department continues to focus on ongoing training for the entire team. Butler says this is vital, since all Public Safety staff members are responsible for serving our patients, guests and staff.

“We are constantly training because service is delivered at the point of contact,” he says. “It doesn’t matter how good I am, or how good our leadership team is, it is our officers in the moment interacting with a patient or a family member who deliver that service and there is very little room for error.”

Integrated security systems to augment our presence

It is a simple fact: even with the best Public Safety team, security officers can’t be everywhere. CoxHealth has 12,500 employees, and dozens of facilities. Covering them all would be a challenge for a security team of any size.

That reality is why it is vital that officers be supplemented with technology. Butler says CoxHealth is above average with our security systems. That alone is impressive given how quickly technology changes and how challenging it is to remain current.

At CoxHealth, integrated technology includes video surveillance, electronic access control, officer-worn cameras, personal panic buttons worn by staff and more.

“We have had panic buttons in health care for years, usually under a desk or on a wall,” Butler says. “Now, we are able to put them on an individual and you can know someone’s location. The personal panic buttons also help us prioritize our response to calls. The alarms are dispatched via officer radios and are paged overhead, letting our officers reprioritize and go where they’re needed immediately. In the perfect scenario, our systems work together to create a safer work and care environment for all.”

Trained, security-aware people: we all have a role to play

Given that security teams simply cannot be everywhere, Butler says the single most important factor in securing a hospital system is having everyone well-trained and security aware.

“Fully staffed, there are fewer than a hundred Public Safety staff and more than 12,500 total employees,” Butler says. “While those numbers are adequate for a health system our size, it also means that on any given day our staff could be confronted with a situation that won’t result in a timely, drop-out-of-the-ceiling Public Safety response. In those moments, we want our staff to be able to fall back on their training.”

Butler says the security issues seen in Emergency Departments and hospitals frequently reflect ongoing issues in the community, and those issues are amplified by the stress of health care.

“We see it all, up close and personal, at people’s worst moments,” he says. “Our job is to be able to train our staff to create safe, compassionate solutions when presented with difficult circumstances.”

That’s why CoxHealth offers a structured aggression management program that is designed to recognize the signs of aggression and then reduce the risk of violence.

“The true problem in health care is patient-generated violence. That’s where our staff members routinely get hurt. We want to teach them ways to manage their environment and the difficult individuals that are sometimes part of that environment.”

Training offerings include de-escalation and aggression management; situational awareness and personal safety; and, most recently, a plan for active shooter training.

“We teach that everybody should have their own proactive personal safety plan, thinking through all the things they do, from the time they get in their car in the morning until the time they get home at night,” Butler says.

Butler and the Security team are actively working to expand and enhance ongoing training to reach all staff at CoxHealth.

“If our training can successfully teach staff the principles of de-escalation and aggression management and pro-active personal safety -- all of a sudden you have a much more informed and engaged staff that have the ability to take care of themselves or help a colleague.

“We all have a role in securing this organization. When you see someone wandering on a unit and they look like they don't belong, it's as simple as saying, ‘Welcome to CoxHealth, can I help you find something?’ Being welcoming is part of our culture and just paying attention to people is a huge part of our security plan.”

Where we're going next: active shooter training and enhanced perimeter access control

In the coming months, our security team plans to enhance CoxHealth’s active shooter training.

Butler says CoxHealth will be taking a risk-based approach to active shooter training aimed at touching all parts of the organization. Training methods could include a single delivery approach or a combination of online HealthStream modules, classroom training, table top sessions and practical exercises.

The program will also introduce active shooter training during New Employee Orientation and annually thereafter to all staff.

While only 3% of the active shooter situations in this country have occurred inside health care, Butler notes that the training is vital for everyone, even when they are outside CoxHealth walls.

“If I can give you active shooter training at CoxHealth as an employee, but tomorrow you're in the grocery store and something goes terribly wrong, you'll fall back to that training no matter where you are.”

Controlling entrances and hospital access

In addition to active shooter and other training, CoxHealth and Public Safety are also working on implementing entrance controls at hospital to better manage foot traffic in and out of our facilities.

“We will be heightening our approach to after-hours visitor management for our campuses that are open 24 hours,” Butler says. “Patients and visitors may be redirected to a different entrance than would normally use during regular business hours, creating a controlled access point.”

The overall goal is to put eyes on and have a conversation with our visitors after hours and that can be managed better through limited entrances.

Security supports our mission

Ultimately, Butler says all of the efforts around public safety feed into our vision of being the best for those who need us.

“People need to feel comfortable that they can come here and know not only will we provide them exceptional care, but we'll provide them care in a safe environment,” he says.

This approach toward a fully “security-engaged” staff supports our mission of creating a culture of safety and being a best place to work.

“One of the reasons I came to CoxHealth is that our leadership team understands the importance of creating a safe work and care environment,” Butler says. “If we want to be an employer of choice, one of the core basics is creating a safe work environment. If our staff can feel safe and know the organization has their back, that allows them to pay attention to what is most important: taking care of our patients.”