Enhance hospital security through CPTED principles

Fourth in a series of excerpts from the free executive guide, “The Evolving Importance of Healthcare Resiliency: Preparing Your Hospital for a Crisis.” 

By Mike Zorich 

One of the most effective ways to increase a hospital’s physical security without creating an overly institutionalized aesthetic is by leveraging architectural elements to create secure environments. These strategies are called Crime Prevention Through Environmental Design (CPTED) principles. Here’s how you can incorporate them — as well as other strategies — into your exterior and hospital entrance design. 

1) Restrict the access points to the building. Designated, specific entrances for public access allows for easier monitoring and allows for secure visitor screening. Utilizing vegetation and various architectural elements can help drive people away from entrances you don’t want them to use and toward your main entrance. While you need to have numerous egress doors to be up to code, there are steps you can take to ensure your emergency exits are only used in the case of an emergency. With proper signage, alarms, camera monitoring, and even removing the entrance-side door hardware, you can better control which doors permit entry into your hospital.  

2) Separate visitor and employee parking lots. One of the biggest physical security concerns every hospital should have is for their staff. To limit the potential for dangerous interactions, keep public access points separate from employee access points. By establishing a perimeter boundary for an employee parking lot, you can create a level of protection within the parking area so staff can move back and forth to their vehicles safely.  

3) Utilize effective parking lot lighting. More than brightly lit parking lots, you need evenly lit parking lots. When lighting is too bright in some areas, it can have the effect of making other areas seem darker. Instead of using big, bright lights, aim for smaller, more frequent lights that have a high level of distribution over your parking lots. This can play a significant role in security by increasing visibility and improving camera coverage. 

4) Create vehicular boundaries. Since pedestrian traffic needs to be protected from vehicular traffic, creating a clear separation between the two can minimize incidents. For example, instead of just a crosswalk, consider using pavement changes, lighting changes, and rumble strips to draw attention to the separation. You can also use CPTED principles to restrict vehicle access to buildings through bollards and curbing. Just ensure the restrictive elements you’re using have practical stopping power, rather than just aesthetic appeal.  

5) Limit access to ambulance delivery areas. Separating the ambulance delivery area from the public emergency entrance will limit confusion and ensure an intruder isn’t gaining access to your hospital through a vulnerable and often chaotic area. This can be as simple as creating an environment that the public won’t be drawn to or isn’t readily visible from the front of your hospital, which can be done with additional vegetation or barriers.  

6) Consider how you will handle after-hours traffic. It’s not uncommon for hospitals to have all after-hours traffic enter through the emergency department. While this is a fine solution, it’s still important to consider what this policy does to your parking access. How far away from that entrance are people going to have to park? What kind of exposure will they have while walking to and from their car? In order to make this a safe option, you may need to consider additional lighting and protective barriers. 

7) Utilize glass vestibules as boundaries for secure entry. The entrance to your hospital should be warm and welcoming — but it also needs to be safe. Fortunately, you can increase the security by creating a glass vestibule to act as an additional set of doors necessary to gain entry. Depending on the location of your hospital and your risk for gun violence, you could consider making the entrance glass bulletproof. At minimum you should have laminated glass so it won’t immediately shatter if hit.  

8) Make emergency departments escapable. Admitting and waiting areas in emergency departments are often high–stress spaces in which tempers can flare. To protect your employees working in these areas, create safe points and escapable options in case they feel threatened. For instance, while a desk can act as an initial boundary, having an additional exit behind the desk through which the employee can slip out if threatened adds an extra layer of protection.   

Next: Improve healthcare cyber security with holistic approach to technology design

Also in this series: 

• Resilience in healthcare: How to prepare your facility and reduce risk in the event of a disaster 
• 3 questions to help define the structural integrity of your hospital  
• 4 key areas of MEP resilience reduce healthcare facility risk during a natural disaster 

Download the entire executive guide, “The Evolving Importance of Healthcare Resiliency: Preparing Your Hospital for a Crisis.”