Most U.S. hospitals are designed to be open and accommodating to their patients, staff and visitors. Comfortable furniture, medical equipment, phones, as well as the focus on customer service by both medical and security staff are all intended to help the infirm and their family and friends have as positive an experience as possible while at the facility.
But then your hospital is thrown a curve ball: a forensic patient (an inmate from the local prison or a suspect who has just been arrested) is brought in by police or corrections for medical treatment. How can your institution provide the necessary care for this challenging type of patient while keeping other patients, staff and the public safe?
Here are some mistakes many healthcare facilities make when managing these individuals:
1. Poor communication among hospital staff
“What I see most is a breakdown in communication as to when a forensic patient enters the institution,” says Kevin Weeks, who formerly worked as a hospital nurse and is now ADT’s director of marketing for healthcare solutions.
Often, the nursing unit admitting the patient won’t let hospital security staff know an inmate has arrived. When this happens, security doesn’t get the chance to let the law enforcement or corrections officers accompanying the inmate know about the procedures required by the Joint Commission.
“There should be certain parameters in place in regard to patient oversight,” says Weeks.
2. Security, nursing staff and law enforcement don’t know what to do when they are in the presence of a forensic patient
Because the sizes, locations and types of hospitals vary greatly across the country, there is no one set of rules for managing inmates who must receive medical treatment in a hospital. Even officers from the same jurisdiction sometimes handle forensic patients differently.
“You might have one officer from an agency stay with a forensic patient, while another one from that same agency feels more comfortable leaving him there and coming back later,” says Bryan Warren, who is director of Carolinas Healthcare Systems Corporate Security.
And even when the law enforcement or corrections officer stays with the patients, hospital staff and the officer might not know who is in charge or what is expected of them.
“The biggest issue I see is a lack of communication between hospital security and local law enforcement as to what their roles and responsibilities are and should be, and what training is being given to security and police on common issues that are going to affect the forensic patient,” says Warren. “Ideally, we should have a good relationship with local law enforcement to make sure they stay with that patient as much as possible, understanding that they have a lot of other things to do.”
3. Not enough police or corrections officers guard the patient
According to San Antonio Community Hospital Director of Safety and Security Darren Morgan, the law enforcement agency handling the transfer of the forensic patient must assign the appropriate number of persons to the job.
“In each case I’ve look at [where an inmate has escaped from a hospital or caused an incident], especially when I was on the East Coast, there wasn’t enough staff,” he says. “There was either one police or corrections officer who became a victim and was overpowered because their weapon was taken from them and used on the officer or others. It’s important to have a minimum of two police officers if the forensic patient is deemed to be a significant threat. Those officers should be with that patient as much as possible.”
To address this issue, a risk assessment of the prisoner should be conducted prior to him or her being admitted. Obviously, someone who has been arrested for DUI or a misdemeanor poses less of a risk than a murder suspect. However, Warren provides this warning: forensic patients can be unpredictable.
