How to Create a Hospital Investigation Unit

Published: October 4, 2010

With 639 licensed patient beds, more than 800,000 patient visits per year and four million square feet to patrol, it’s safe to say that Boston Medical Center has a lot of activity. Although most of it involves patient treatment, with so many individuals entering and exiting the urban campus’ 41 buildings, the occasional crime is bound to happen.

Whether an incident involves a bike theft or assault, the hospital’s two investigators are on the case, reviewing video surveillance footage or access control records, processing a crime scene or interviewing witnesses. But their jobs don’t end there.

They may be helping local police on a case that happened just outside the facility; ordering the installation of bike cages (which, by the way, resulted in a 60-70 percent drop in bicycle theft); or responding to calls for assistance from social workers or patient advocates who have patients with legal or custody issues. Perhaps the investigation unit officers need to complete a risk assessment on a visitor. Maybe they’ve received intelligence about a gang issue in the community that may come on to their campus.

All of these issues must be addressed or resolved in a timely manner, and Boston Medical Center’s investigation unit has the respect of hospital staff and other law enforcement agencies because its officers do their job right.

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Here are the steps Boston Medical Center’s Director of Public Safety Connie Packard and Investigations Manager Brian Raymond recommend that other hospitals take when they set up a unit of their own.

1. Determine if your hospital needs an investigation unit:

If the hospital conducts an assessment and there appears to be a pattern of crime, an investigation unit may be necessary. Additional physical security measures, however, may be all that is needed.

For smaller hospitals that can’t afford an investigation unit, Packard believes an appropriate alternative might be to train one or two officers on how to conduct investigations. “There’s plenty of training for that out there,” says Packard. “We’ve seen smaller hospitals take one supervisor and make him or her kind of the whole unit. That way, at least they’re reviewing some video and card access audits.”

2. Add physical security carefully:

Raymond advises other hospitals considering the implementation of video surveillance and card access to make sure those solutions are properly supported so they will be effective. “If you’re only going to do card access and CCTV in certain areas and you don’t monitor what they are doing for you, it’s really not that successful.”

3. Network with other stakeholders on campus to create a public safety group:

HR, patient advocacy, and environmental health and safety are just some of the other departments that can help improve campus security. “You want to get this diverse group together because, quite frankly, we’re not know-it-alls,” says Packard. “They have to teach us things, and we have to give them feedback.”

4. Conduct risk assessments:

Raymond recommends that hospitals quantify from year to year the number and types of crimes that are occurring, which will help administrators determine the number of investigators required to address the security needs. “Are [the incidents] things like someone’s missing a phone from their room, or did someone physically go in and remove it?” he says.

5. Don’t try to emulate law enforcement or get too big:

“Start with what your needs are, and then determine if you need more staff, equipment or training, and then go get it,” says Packard. “Our local law enforcement has specific departments like the sexual assault unit and  bank robbery unit. If you have a small healthcare investigation unit, you can’t do that. You really need to do a little of everything.”

Although many hospital investigation units employ sworn law enforcement officers, the units must address the needs specific to healthcare organizations. Staff must be skilled at investigating a wide variety of crimes, such as computer crime and sexual assault. They also have the additional responsibility of providing customer service.

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