Hospital workers need better security

The armed assault at Johns Hopkins last week was the latest in a list of violent and sudden homicides at hospitals in the United States. This year alone fatal gun crimes took the lives of care providers and visitors to hospitals and medical centers in Knoxville and Memphis, Tenn.; Jacksonville and Winter Haven, Fla.; Mayfield Heights, Ohio; Las Vegas and Hempstead, N.Y. On the Monday before the John Hopkins shooting, a 36 year old man entered a patient ward and shot his estranged wife and her boyfriend as they visited the woman's son who was hospitalized in the Baton Rouge (Louisiana) Medical Center. Those targeted in these incidents were professionals, support staff, patients and visitors.

And this past June the Joint Commission, an organization that reviews the performance health care facilities in the United States documented increased violence. A Connecticut hospital was fined for not providing adequate on site security precautions. The commission recommended that facilities control access points employing guards, fencing, inspections of bags and security lighting.

The Occupational Safety and Health Administration (OSHA) documented nearly 25 cases in a five year period in which medical facility employees assigned to emergency rooms, general medical departments and psychiatric wards were injured by patients.

The American College of Emergency Physicians noted the lack of "adequate security personnel, physical barriers and surveillance equipment and other security components" at health care facilities.

In 1999 I was appointed to Louisiana's Task Force on School Security. During public comment sessions teachers and administrators sounded the alarm that increased and visible security would destroy the open and trusting environment that is an essential and integral part of the community based educational institution. It was thought that armed guards, metal detectors and school bag inspections would somehow damage the self-esteem of students by inferring they are criminal and not worthy of trust. Somehow it was forgotten that since Charles Whitman climbed the tower at the University of Texas at Austin on August 1, 1966 and executed 16 people in sniper-like precision that there had been 41 documented spree shootings and mass murders on elementary school, middle school, high school and college campuses in the United States. But like most states and school districts, the movement in Louisiana to empanel a school security working groups or task force was inspired by the murder of 13 people at Columbine High School in Littleton, Colo., on April 20, 1999. How many deaths and horrific injuries could have been prevented if school administrators, teachers and parents had gotten out in front of this dangerous and clear trend toward mass and spree shootings on school campuses?

As a forensic security consultant, I spent a great deal of time analyzing violence in a number of settings. Most of the incidents could have been prevented or minimized if site operators and administrators had acknowledged the clear unmistakable trends at the facility, at similar facilities and the culture of violence in the community.

I practice security consulting and criminal incident analysis in one of the most violent cities in America — New Orleans. According to the FBI New Orleans had the highest murder rate in 2008 — 63.6 killings per 100,000 people. Baltimore was in fourth place with 36.9 murders. These rankings strongly suggest personal disputes and slights are very likely to lead to deadly and near deadly responses. At these levels, sudden unprovoked gun violence will likely play out in seemingly unlikely settings — schools, workplaces, parking lots, churches and medical institutions will not be exempt from incidents of sudden senseless violence.

Medical providers in the normal course of ministering to the sick have to make tough decisions under the most trying circumstances. These decisions will sometimes adversely affect or seem to adversely affect already stressed and distraught people who often believe violence is the only solution. Like their counterparts in education, those responsible for running hospitals desperately want to believe the myth that maintaining a "welcoming and open" environment trumps public safety and security. As the public watches the evening news and takes in the images of yellow police tape, crime scene investigators and homicide detectives, one has to ask, "How is that welcoming and open environment working for Johns Hopkins?"

Larry Preston Williams Sr., New Orleans

The writer is a former New Orleans police officer and a forensic security consultant.

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