Forced into lockdown, Boston hospitals balance operations, safety

For hospitals in Boston, this week has been far from business as usual. With a massive manhunt for a second suspect in the Boston Marathon bombing underway Friday morning, hospitals were joining schools and local businesses on lockdown to ensure the safety of patients, family and staff.

"When hospitals operate in lockdown mode, this refers to either prohibiting and/or carefully monitoring the entry and exit of individuals from the hospital," Jesse Pines, a FierceHealthcare Editorial Advisory Board member and director of the Center for Healthcare Quality at George Washington University, told FierceHealthcare today.

For instance, only patients with appointments and employees with IDs can enter Brigham and Women's Hospital, the Boston Globe reported. And until around 10 a.m., the hospital was prohibiting people from leaving, although now people can exit from a secondary entrance.

Boston Children's Hospital also locked down its main campus, cancelling all patient appointments and not discharging inpatients until further notice, the hospital said this morning in a news update. It noted that the lockdown is intended to keep the roads clear.

"It is important to recognize that during a lockdown, the normal patient care activities of the hospital continue uninterrupted," Pines added.

Boston Children's, for instance, acknowledged that the hospital remains fully staffed to provide continuous care for patients and emergent care remains open.

Under similar directives from the governor, mayor and law enforcement officials, Massachusetts General Hospital is restricting access to its main entrance so only staff with IDs can enter, according to a hospital update this morning.

While Boston hospitals seemed to respond quickly to directives, locking down an entire hospital is not an easy task. It can take as long as an average of 11 minutes for hospitals of all sizes to secure their entrances and exits, according to an August 2009 study by Campus Safety Magazine. Moreover, that survey showed 7 percent of U.S. hospitals can't lockdown their facilities at all.

To quickly and efficiently lockdown, hospitals need a security culture that balances tolerance and control, suggests a whitepaper from Dynamic Controls. However, that balance involves more than just a sophisticated access control system--hospitals must be able to identify subtle problems like a courteous employee holding a door open for a "tailgating" criminal.

For more:
- read the Globe article
- here's the Children's news update
- here's the MGH update
- check out the Campus Safety Magazine study
- download the whitepaper (.pdf)