How safe is your pharmacy? Be on the lookout
Impostors raise red flags about overall hospital security
The Joint Commission on Accreditation of Healthcare Organizations recently sent out an alarm about three instances in which impostors posing as surveyors tried to gain access to different hospitals. The impostors left the hospitals when questioned or pressed for identification.
The incidents did not seem to involve the pharmacy area, says John Fishbeck, associate project director of the Joint Commission’s Division of Standards and Survey Methods. Per Joint Commission standards, hospitals need to make sure they can identify their staff and visitors. (For further instruction about possible impostor situations, see box below.)
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Be on alert for hospital impostors Take these steps if you have a concern In an e-mail sent to all Joint Commission-accredited organizations on March 3, Joe Cappiello, Joint Commission’s vice president of accreditation field operations, advised hospital personnel to make sure they verify the credentials of anyone reporting to be Joint Commission surveyors. Cappiello recommended hospital personnel take these steps:
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"We allow each organization to take a look at the risk associated with the services they provide. It’s fine if they take a look at what’s needed and then implement it," Fishbeck says.
With the red flags being raised about the impostors, Drug Formulary Review decided to review the state of pharmacy security today. Fred Roll, CHPA-F, CPP, president of the International Association for Healthcare Security and Safety (IAHSS) in Glendale Heights, IL, weighs in on this issue.
DFR: What is the biggest safety concern today for hospital pharmacy directors and managers?
Roll: Diversion. You can have diversion in the pharmacy proper or, more likely, on the floor. To track diversion problems, more hospitals are going now to automated dispensing systems such as Pyxis and to Pyxis CII Safe for their narcotics. As long as they effectively use either the Pyxis-provided software or other software that works with Pyxis dispensing, it’s going to help identify areas of potential problems.
I would suggest they consider an automated system if they can afford it and, more importantly, use the software that tracks potential diversions and med errors.
DFR: What is another security problem for hospital pharmacies?
Roll: Access control issues — letting the wrong people have access to the pharmacy. [Pharmacy staff], for example, will let staff members in the house come into the pharmacy while the pharmacy staff is getting the product ready for them, rather than keep the hospital staff at the perimeter and only have authorized people within the pharmacy.
Hospital pharmacies may also lock their doors, but have problems at the transition windows. The windows can be left open, allowing someone to jump over the counter and come in. If product is left on the counter, someone can reach in and take it.
DFR: What types of protection options are available for transaction windows?
Roll: I have seen pharmacy windows be open and have nothing for protection to what I call a "customer-friendly" partition, which is usually a piece of Plexiglas that only keeps someone from jumping over or crawling under. On the other end is bulletproof glass and thin trays and bullet-resistant metal behind the fascia — a real fortress. There are all of these different levels. I am a big proponent in what is reasonable and appropriate in a given environment. When I assess security for hospitals and look at the pharmacy, I am primarily concerned with access control and with the pharmacy being able to deliver the product back and forth.
DFR: What about protection methods for other access issues?
Roll: There are several methodologies for securing access control: You can give everyone a key. You can give everyone a computerized card. You can combine a card with a PIN number, such as with an ATM.
A crook, who often is [mistaken about the type and quantity] of drugs he can get from a hospital pharmacy, may wait around in the hallway for the door to open. Or he may knock on the door; customer service then opens the door to see who is knocking. Once you open the door, you have breached the perimeter and it is an open portal.
I like to see TV cameras viewing the hallway outside of all exit points from the pharmacy with a small monitor close to eye level inside the pharmacy. If someone is knocking on the door, a pharmacy staff member can then look at the monitor. He or she can even check the monitor before leaving to see if anyone is lingering in the hall.
Some people use the cheap solution of putting a peephole in the door. In my experience, I have found that people don’t generally use that. They don’t like to put their eyes close to things. Overall, the camera and monitor is not an expensive project these days given technology costs.
If you are keeping the wrong people out and only granting access to the appropriate people, you are meeting access control and are also making the staff more comfortable and safe.
DFR: Do you recommend any type of alarms?
Roll: I am a big believer in having hold-up alarms at the transaction area of the pharmacy. If it’s a large pharmacy, I like to see those same kinds of buttons strategically placed throughout the area.
If a pharmacy is not 24/7, I also really like to see an intrusion alarm in that area. Satellite pharmacies around the hospital are a good application to have intrusion alarms as well, because the satellite pharmacies may be tucked away [in areas that don’t have consistent traffic]. If you are going to install an intrusion alarm, it is a good idea to add a hold-up panic alarm, too.
DFR: What about staff training?
Roll: The staff needs hold-up training so they know what to do, how to do it, etc., in case anything happens. If they don’t have some kind of formalized training, [someone in the pharmacy may try to control the situation]. Pharmacy managers and supervisors, therefore, should have a discussion about this with their staff.
DFR: Do these types of robberies happen often?
Roll: Robberies in hospital pharmacies don’t happen often, but when they do, they are a major deal. Security protocols that have been implemented have prevented many problems.
The Joint Commission on Accreditation of Healthcare Organizations recently sent out an alarm about three instances in which impostors posing as surveyors tried to gain access to different hospitals. The impostors left the hospitals when questioned or pressed for identification.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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