To Protect and to Heal : These days, hospital officials worry about more than just tending to the sick. Security measures are being taken to a new level to combat crime--some of it violent.

Image. It’s everything to a hospital.

From what you see on the outside to cutting-edge technology inside. Hospitals thrive by attracting the best specialists, doctors and nurses, and fiercely competing for patients. They want people to feel safe while they’re being taken care of, but these days security is being taken to a higher level.

“There’s a close parallel between the security measures hospitals are taking and the arming of our society,” says David Langness, vice president of communications for the Health Care Assn. of Southern California, which represents 240 health-care organizations, including hospitals. “In the past five years, almost every hospital we know of has taken more measures to protect patients and staff.”

Adds Ron Yukelson, spokesman for Long Beach Memorial Hospital, “Sadly, hospital crime is a comment on our society.”

While hospitals have their hot spots, they are not hotbeds of crime, experts say. However, hospitals are also no longer sacred ground. Violent crime occurs sporadically--making headlines on those rare occasions when babies are stolen or shootouts occur in emergency rooms--but nonviolent crimes are daily occurrences. According to one national survey, theft accounts for more than half of hospital crime.

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These days, good security is part of good image, and hospitals are pushing the limits to provide a safe environment for everyone who comes through their doors.

* At Long Beach Memorial Medical Center, 24-hour bike patrols rove the parking areas. Visitors wear color-coded badges corresponding to the floor they wish to visit. Employees wear bar-coded badges allowing them access to only those areas in which they belong. After 8 p.m., there is only one entrance to the emergency department; the rest of the hospital is locked down.

“Our hospital is a microcosm of the area,” Yukelson says. “Long Beach Memorial isn’t in a bad neighborhood, but it’s not the best, either.”

* At Los Angeles County-USC Medical Center, uniformed safety police are positioned every few yards near the emergency room. (The hospital is the only Los Angeles facility with its own police force--129 strong.) An additional officer is stationed inside the waiting area. At the hospital’s two entrances, guards equipped with hand-held metal detectors check everyone who enters.

Many area hospitals took a second look at their security after the 1993 emergency-room shooting spree at County-USC in which a disgruntled patient wounded three doctors and took two employees hostage for nearly five hours.

And a new state health and safety code, which becomes law July 1, has forced many hospitals to overhaul their security procedures. Incorporating state OSHA standards for violence in the workplace, the legislation requires that all hospitals track criminal incidents, assess their security situation annually and enlist a plan. It also mandates that hospital employees be trained in handling violent situations.

A survey commissioned by the Health Care Assn. and the Los Angeles County Emergency Medical Directors Assn. found the frequency of emergency-department violence escalating and that drugs and alcohol play a large part.

Overall, the survey showed that the emergency department is still a pretty safe place to be, says Mike Pfieffer, executive director of the Emergency Medical Directors Assn. “It’s not unlike any other environment that brings high volumes of people together.”

A 1994 study on emergency-room violence by the Emergency Nurses Assn. found that the most common emergency-department security measures are panic buttons, visitor-control policies and locked access, but patients may just as frequently see bulletproof glass and full-time security officers or guard dogs. Hospitals routinely provide aliases to patients, such as gang members, who may bring violence through their doors. Video cameras are also commonplace.

But Lorene Hansen of Orange says hospital security cameras breached the trust of patient confidentiality and infringed on her right to privacy.

Hansen, 26, is suing Western Medical Center-Santa Ana for not informing her about a camera in the room during an emergency-room visit in which she underwent a breast and vaginal exam. According to Hansen’s attorney, Robert B. Treister, the exam, which occurred in April, 1994, could have been viewed by strangers at the nurses’ station, where at least one monitor is located.

Hansen says she noticed the camera after her exam was completed and she was already dressed.

“I was in disbelief, and then when I saw the red light on I got very upset. I felt so humiliated--like I had just gotten undressed in front of a baseball stadium.”

The hospital says 24-hour surveillance is required for security purposes and that the camera was “obvious.” Hospital attorney Ralph Helton says health-care providers cannot always be in the room with patients, and if something happens they need to know.

But Hansen, a nurse at a convalescent home, disagrees. “The first thing we learned in nursing school is to protect the patient’s right to privacy. Even in department-store dressing rooms, they have signs to tell you if you are under surveillance and then you have a choice. If I had been given the choice of privacy or security, I would rather have had my privacy.”

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Experts maintain that a security presence is one of the best deterrents against crime. It’s one reason guard dogs have become a popular choice at many area hospitals.

“Their strong point is crowd control,” says Bee O’Neil, director of security for Huntington Memorial Hospital in Pasadena. “People may not pay attention to a uniformed officer, but they’ll pay attention to the dogs.”

Gerald Bagley, director of security at Riverside Community Hospital, which uses four security dogs, saw an immediate 30% decrease in criminal activity when the canines joined the security force two years ago. The dogs pull double duty by providing pet therapy in the pediatrics unit.

Hospitals also use technology and design as security measures. For example, many hospitals have moved maternity off the first floor, thus limiting unauthorized access.

According to the National Center for Missing and Exploited Children, infant abductions are rare--19 infants were taken from California hospitals or homes from 1983 to 1994--but many hospitals nonetheless take measures to guard against it. Tagging systems, which attach to an infant’s diaper, ankle or even the umbilical cord and work much like anti-shoplifting devices at retail stores, are one of the best security measures around and can run hospitals as much as $80,000, experts say.

Still, without staff and patient awareness, high-tech security devices can be foiled. When a newborn was stolen last May from White Memorial Medical Center in East Los Angeles, the abductor entered the maternity ward by following an employee through a card-key-controlled doorway and took the baby from the mother’s room. In recent years many hospitals have discouraged new moms from having their babies stay in the room with them. Patients are encouraged to check identification and challenge anyone who wishes to take their baby.

“Technology is merely a tool,” says Bill Nesbitt, a national security consultant. “If you don’t have behavior modification and train people how to use the technology, it’s no use to you.”

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A 1993 national survey on hospital crime conducted by the International Assn. for Healthcare Security and Safety (IAHSS) shows that the greatest incidence of violent crimes against patients and staff occurs in the psychiatric unit. The same survey showed that the most flagrant offense in hospitals is petty larceny. Of 236 hospitals polled, theft made up an average of 57% of all hospital crimes.

“It may seem obvious, but people still insist on bringing valuables to the hospital,” says Mike Stultz, past president of the IAHSS and security expert who lectures nationally on health-care security. “Unfortunately one of the most frequently taken items is wedding rings. Valuables that are attached to the patient probably cause the most amount of distress.” He says losing a sentimental item jeopardizes a patient’s recovery.

And putting your valuables in the hospital safe isn’t the best bet, either. “It’s just a really weak area in most hospitals,” Stultz says. “Your things may pass through many hands before getting to the safe.”

According to the IAHSS survey, reported sexual assaults in hospitals are fairly uncommon. Stultz says more than 50% of the time they are committed by hospital employees. He suspects it is one of the most underreported crimes in health care. “Patients are extremely reluctant to report something like this simply because they feel so dependent on the system,” Stultz says.

But hospital officials say patients should report all criminal or suspicious activity.

“Hospitals have a higher duty to provide a safe and secure environment to their customers than, say, a hotel,” Nesbitt says. “Patients should have that reasonable expectation.”

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Tips for a Safe Hospital Stay

Checking into a hospital any time soon? According to experts the key element to your safety is awareness. Here are some tips for patients:

* If you’re driving yourself to the hospital, park in a well-lighted area.

* Know where the hospital entrance is and go directly to it.

* Leave all valuables at home; carry as little cash as possible.

* If you are brought into the emergency room, get your valuables to a loved one as soon as possible.

* Never get involved in an emergency room altercation.

* Even if you don’t feel well, try and hold your head up and be as alert as possible.

* Make sure hospital personnel identify themselves upon entering your room.

* Be careful who you let know you’re in the hospital.

* Make sure your phone calls are controlled or screened in some way so that your privacy is protected.

* Contact the hospital ombudsman regarding security and your patient rights.

* Upon discharge, use the hospital’s 24-hour escort service to your car.

What Goes Missing

What are the top items that hospital patients report as missing? According to hospital ecurity expert Mike Stultz of the International Assn. for Healthcare Security and Safety:

* Jewelry

* Money and credit cards

* Radios and electronic gear

* Dentures

* Eyeglasses

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What are the top items that hospitals report as missing? According to a poll of several large-bed facilities in the Los Angeles area:

* Linens (including bedding, towels, scrubs, gowns and lab coats)

* Baby formula

* Computer supplies

* Disposable diapers

* Household supplies (toilet paper, tissue, etc)

* Medical supplies (first aid supplies, needles, syringes, implements, rubber gloves, etc.)

* Narcotics

* Office supplies