By Colonel (R) Bill Edwards / Special to Healthcare Facilities Today

The COVID-19 pandemic of 2020 has challenged our global society in many ways. It is truly a unique and unprecedented situation of our time, which requires communities around the world to come together to defeat the virus. 

In an effort to support overcrowded hospitals, we have seen the advent of military field hospitals and public venues turned overnight into care facilities. The Javits Center in Manhattan, Colorado Convention Center in Denver and other spaces designed for public assembly have been transformed to support the fight against the pandemic. Army field hospitals are deploying and establishing hospital footprints in New York and Washington State.  

As these facilities take shape, it is important to have teams of experts that can support secure and safe operations for our medical professionals and their patients. In order to accomplish this, multi-functional experts from our engineering (structural, protective and civil disciplines) and security communities should come together to perform on-site assessments prior to the facilities going to full operational capability. By doing this, we can set the conditions for a smooth transition of these facilities into their new use, and help ensure the security and safety our caregivers need to cure the ill. To do this, it is important to follow these six fundamental steps:

Identifying vulnerabilities

Step 1: Conduct a realistic threat assessment 

In this step, security professionals will review a myriad of sources to determine the threat level. This analysis should be quick and detailed, covering the realistic threats associated with the location the facility will operate in. Understanding the area is the first step in setting up a secure care facility.

Step 2: Conduct a rapid threat, vulnerability and risk assessment (think prevention) 

Based on the expedited timeline needed to get these facilities up and operational, select a highly competent security professional to conduct the rapid TVRA. Having third party support in this process frees up law enforcement and medical professionals to focus on their primary duties. The multi-functional team will effectively provide an unbiased and uninfluenced security assessment. This will drive smart decisions on security investment and create a better opportunity for a positive return on that investment in vulnerable situations. Good stewardship of time is critical here as the team will have five days to conduct the assessment and two to put together a report. A professional TVRA will provide recommendations to mitigate risk, focusing first on no/low-cost recommendations as a matter of general practice thereby creating another opportunity for rapid operational capability. A prompt TVRA product sets conditions for prudent electronic security system identification, equipment specification and integration of both.

 Step 3: Secure the perimeter and establish access control

First, clearly define the perimeter. The threat by hostile vehicles is a common tactic for nefarious parties. Look no further than the recent train derailment in Los Angles to highlight the need for a secure perimeter. To do this, hasty barriers and the use of crime prevention through environmental design (CPTED) principles will allow the team to set up the initial defense. Over time, the perimeter can increasingly be hardened if the facility will operate over an extended period.

Second, determine access control policy and procedures. The establishment of a testing or screening area should be considered. Additionally, the ability for emergency vehicles to enter smoothly should be part of the perimeter plan. The perimeter is the first line of defense and should have an established communications plan that facilitates patient arrival with the care facility medical professionals. The multi-functional team can address these functions as the first step in facility security.

Sensor – Data - Analysis

Step 4: Electronic security system identification, equipment specification and integration (integrated systems and data layer add-ons)

Identify and specify electronic technological systems while including the possibility of integrating existing technologies, and adopt new technologies that are capable of expansion and upgrades over the operational span of the facility. This is where options are presented that support the facility’s purpose and can build the bridge to a more mature system if the facility maintains functionality over an extended period. Existing facilities will go through a technology audit, while temporary facilities will require a quick technology package that integrates within a matter of days rather than weeks. In this step, the security professional identifies surveillance, access control, communication, intrusion detection requirements and how the security operations/monitoring will take place, i.e., by contract or proprietary security personnel.

Step 5: Operational functions and standards — intelligent security operations center (ISOC)

The ISOC is the analytical center where sensors and collected data meet to help security personnel have a better overall understanding and situational awareness. Information is turned into intelligence in the ISOC and sets the facility up for proactive responses to security situations. The ISOC is the “the brain” of the security function, the beginning and the end in terms of analysis, proactiveness and decision making. The design of an ISOC is a critical step in thinking holistically about security monitoring. It can be done in several ways, but ultimately, a centralized location to monitor the facility and the land around it is critical to a sensor, data and analytical mindset.   

Step 6: Establish the ISOC battle rhythm and staffing requirements — plan for a surge

 This step is all about operations, standard operating procedures, quick reaction forces, external support relationships and first responder coordination. ISOCs will have different levels of manning and purpose. The operations tempo will be determined by the needs of patient treatment. Setting a tactical ISOC up for the possibility of expansion is critical in this step. Physical space, workstations and smart organizational design are all areas that should get close attention. Communications is one example. Ensure that decision-makers are positioned in the ISOC with direct access to the communications platform. A simple mistake of having communications on the opposite side of the ISOC away from leadership is all too common and can lead to increased security risk and vulnerabilities to the staff, patients and structures. 

We all need to do our part during this pandemic. Follow the rules, provide support where you can, and give our medical professionals (the true front line in this war) the ability to do their jobs in an environment that is secure and safe for everyone. 

Colonel (R) Bill Edwards is an associate principal at Thornton Tomasetti.