By Paul Swan / Special to Healthcare Facilities Today

The landscape of health, safety and security concerns that healthcare facility managers face is both broad in scope and narrow in specifics. These often large, multi-building/multi-level facilities operate 24 hours a day, seven days a week, all year long — there is no downtime for a hospital.

In most cases, healthcare facilities allow staff members, patients and their families, vendors, and emergency and support teams to move throughout the facility freely. With a mix of common areas including restaurants, gift shops, and pharmacies as well as some private and restricted areas, healthcare facilities have a diverse set of needs.

To meet the requirements of these specific spaces including aesthetics and sound management, inventory and equipment control, communicable disease suppression and a range of security and liability concerns, healthcare facilities often deploy an array of door, door hardware and access control technologies.

Following are several key areas where door openings are critical for healthcare facilities — as well as some best practice ideas and a look at available solutions to help address concerns within these areas.

The building envelope

Entry doors not only welcome patients, staff and visitors, they also must accommodate those with injuries, advanced age, or disabilities. Door controls — including door operators and closers — are commonly used on ADA-compliant openings to provide seamless access to a facility. Simple to install and use, heavy-duty, low energy operators are intended for high traffic manual opening applications, like the main entry ways of hospitals and healthcare facilities. An often-overlooked benefit that door controls provide is the reduction of heat transfer at the building envelope, which over time will help reduce energy costs in the building, keeping the interior of the space cooler in summer and warmer in the winter.

For secondary doors, that don’t have high traffic automation requirements, but instead occasionally require automatic operation, energy-regenerative door operators that are able to store their own energy for operation are an innovative and energy efficient solution. A regenerative power system charges an onboard battery pack that eliminates the need to run electrical wiring to the unit. When used in automatic mode 25% of the time or less, the operator will self-generate enough power to charge the battery pack for up to 12 years.

Additionally, electromechanical door operators are used in applications where automatic mode (activated by wall switches, motion sensors, etc.) is the primary function. These quiet, low-energy, cost-effective door operators are designed for moderate to high traffic doors and again, are ideal for any application designed to meet ADA-type access functionality.

Electromagnetic locks (maglocks) provide optimal security solutions for healthcare facilities because of their flexible integration options. Maglocks keep door openings secure by releasing only when Request to Exit sensors are triggered or with keypads or card readers. Many maglocks can be programmed to allow free egress and ingress during regular business hours and require access control credentials at all other times.

When looking at egress, there are many exit device options that work either independently, or as an integrated part of an access control solution. In many healthcare facilities, exit devices are programmed with delayed egress to alert staff members when someone is trying to exit the facility. This gives staff members time to respond if a patient is trying to leave without authorization.

Pharmaceutical storage 

One of the biggest concerns in healthcare facilities is securing medical supplies and pharmaceuticals. Healthcare facilities need to track inventory on the premises, when it is used, and by whom. Access control can be implemented to grant credentialed individuals access to pharmaceutical storage rooms and cabinets, and provide audit trail data.

Due to security concerns, many healthcare facilities are changing procedures related to storing inventory and controlled materials. Instead of a central pharmaceutical room that houses all of the supplies and medications, healthcare facilities are decentralizing pharmaceuticals and making their storage and delivery mobile.

Cabinet locks are a versatile security solution for healthcare professionals, and help to safely transfer pharmaceuticals around the facility and store them in patient rooms without additional risks.

Cabinet locks have the same access control and audit trail capabilities as many access control products, but can be installed on stationary or mobile solutions. By mobilizing pharmaceuticals, healthcare professionals can gain quicker access to important supplies and medications, especially in emergency situations.

Patient rooms

 The patient experience is a medical facility’s top priority, and recovery rooms are an integral component. Regardless of the security needs, it’s important for patient rooms to be stress-free, quiet, and healing environments that support each patient on the road to recovery.

A well-designed acoustical environment can improve overall patient healing. For birthing wings, intensive care and patient recovery rooms, to name a few, acoustic door solutions can significantly reduce the transfer of sound from busy corridors, minimizing noisy distractions and allowing patients to rest comfortably.

Additionally, the security of a patient’s personal items during their visit is also a concern in healthcare facilities. Healthcare facility managers can easily install cabinet locks in recovery rooms for patients to secure their personal items. This allows patients to rest easy without any added stress.

It’s essential to consider the door hardware used in hallways adjacent to recovery spaces as well. One of the most vital aspects of a healing environment is to create a space that allows the patient to rest. Some exit devices are built with impact bumpers to reduce sound when doors are opened and helps to maintain healing environments while doctors and nurses check on sleeping patients.

Behavioral health areas

Healthcare facilities are tasked with treating patients and getting them on the road to recovery as quickly as possible, while also providing the appropriate amount of safety and security to prevent flight and self-harm.

The big push in this space is toward ligature-resistant hardware, including specialty hinges, door accessories, maglocks, door closers, and locking trim, designed with the safety of patients and healthcare professionals in mind. Complete door assemblies for both busy hospital wings and patient rooms as well as uniquely designed hardware provide durability while minimizing risk, helping to contribute to patient safety while addressing common concerns in hospitals and behavioral health environments. Careful consideration is required to ensure the products selected address these specific requirements while also working to provide both aesthetically sound and secure solutions for behavioral health facilities.

Public and common spaces

A healthcare facility must also foster safe and clean public spaces. Gasketing is often an overlooked door accessory that should be installed to reduce dirt, dust, heat and sound from entering a space. Overall cleanliness and comfort of lobbies, waiting rooms, and refreshment areas creates a healing environment and improves patient experience.

To keep the spread of germs at bay, many doors throughout a healthcare facility are equipped with push buttons or motion sensors, requiring little to no physical contact, to “automate” or open a variety of interior and exterior doors. These solutions help prevent germs from spreading, making an excellent solution for cafeterias and restrooms.

Exit devices offer a variety of features and it’s important for healthcare facilities to seek out the products that specifically fit their needs. Rugged exit devices are built to withstand abuse from high traffic areas. Many openings in healthcare facilities are exposed to rushing doctors and gurneys and must be able to withstand the constant harsh impact. Alarmed exit hardware can also be installed throughout a healthcare facility’s interior to signal a violation when an opening is used without authorization.

Office and staff-only areas

Healthcare facility managers must be able to identify and control where staff members are permitted throughout a healthcare facility. Wireless electronic access control is a cost-effective solution that not only is easy-to-install and maintain, but also provides additional benefits such as audit trails. Employee badges can be monitored and used to allow access to authorized areas throughout the facility.

For areas that may require infrequent or limited access, such as janitorial closets and server rooms, wireless access control is an option that is easy to install and also eliminates the need to update PIN codes on each lock. Another option is intelligent keys, which can be programmed to provide access to certain areas or openings within a healthcare facility, as well as audit trails. Intelligent keys can be quickly and easily installed and programmed to work with eCylinders in place of traditional mechanical locks.

More information

Because every healthcare facility opening differs based on its usage, employing a single solution configuration throughout a facility is not possible. Careful consideration of each opening based on requirements allows for proper selection of doors, door hardware, and the level of access control to enhance the convenience and safety of the facility, and help keep costs in line.

Whether it’s a new construction or a retrofit project, it’s important for healthcare administrators and facility managers to work with proven integration and manufacturing partners to ensure they know about the latest technologies available and select the best product for the application required

Paul Swan is the Director of Healthcare BD & National Systems, ASSA ABLOY Door Security Solutions.