Making a list, checking it often
Making a list, checking it often
Categorizing escort zones for clinicians
For many years, the Visiting Nurse Association of Boston relied on staff perceptions to dictate when escorts were needed for visits. But that changed in 1992.
"Before 1992, we didn’t really have any objective criteria in terms of how we designated what street needed an escort for home health clinicians vs. what street didn’t," says Michael Taylor, RN, MS, director of patient services for the VNA of Boston and the chairman of its security committee. "It was done more by perceptions, and that can be dangerous because then you label unfairly based on someone’s judgment or experience."
To alleviate the problem, VNA of Boston hired a security consultant to compile a list of objective criteria to determine area safety:
1. Volume of foot traffic.
2. Number and types of open businesses.
3. Access to major roadways.
4. Access to public transportation.
5. Number of vacant, abandoned or boarded-up buildings.
6. Number of abandoned or vandalized motor vehicles.
7. Known presence or activity of gangs.
8. Large amounts of graffiti with specific messages.
9. Crime watch or neighborhood watch signs or stickers.
10. Access to telephones.
11. Amount and type of residential housing.
12. Known drug and/or prostitution activity.
13. Presence of homeless or transients.
14. High rates of property vandalism.
15. Isolated parking or poorly lit parking area.
16. Types of street activity; groups gathering for no apparent purpose, public consumption of alcohol, obvious drug use.
Taylor notes that once a community is placed in a category, it is reviewed quarterly, such as the South End in Boston that has gone from escort to non-escort.
"If a street is a non-escort area, and a clinician parks their car and notices an increase in any of the above areas, we bring that to the committee’s attention. With input from local police departments, [we] consider whether we need to change the street to escort for the time being, because neighborhoods change," he says.
It’s not up to the staff to evaluate the community. Instead, it is truly a providerwide effort as Taylor, the security consultant, or the Boston Police Department also play a vital role in assessing the above areas and designating a community as escort or non-escort.
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