Same-Day Surgery Manager: Why do we need to respond to alarms?
Same-Day Surgery Manager
Why do we need to respond to alarms?
By Stephen W. Earnhart, MS
President and CEO
Earnhart & Associates, Dallas
It is 3 a.m. when your phone rings. For many of us, our first thoughts are, "Where are the kids?" Nothing good ever comes from a phone call in the middle of the night. Hesitantly you answer the phone, only to hear that it is the security company letting you know that your surgery center’s or department’s alarm system is going off and you need to go down and meet the police.
How often has this happened to you? After discussing it with management personnel around the country and through my own personal experience, the answer is too much.
You arrive at the facility, tired and scared and unknowingly putting your own life at risk just by going to the facility. If you are lucky, the police will be there and escort you into the building. If you are unlucky, they already will be in the center looking for the prowler. One administrator from Indiana experienced this situation when he was tearing into the center, only to have an officer stick a pistol in his face because he thought he was the intruder.
In my experience, you have two types of responses by the police to these types of break-ins: It is either the lazy, stifling-a-yawn attitude that it is just another drug addict and "let’s turn off the alarm and go back to work," or the type who say "let’s take fingerprints off everything and keep you at the center for three hours until we find something cool." Neither type is attractive.
How many times do we have to risk our lives responding to "alarms" in the middle of the night? It is time to stop this practice. Rarely do these alarms mean anything. Most of them are false, and the ones that are genuine — I’m sorry, but those are the ones I most definitely want to stay away from. Am I supposed to accost the intruder and threaten him with arrest? I think not.
There is no "code" or regulation that requires our facilities to be externally monitored — so why are we doing it? You might say there could be some benefit to having alarms, such as they reduce damage caused by vandals and the amount of drugs a thief will take if the alarm sounds. However, I do not wish to risk the life of one of our administrators or staff personnel to catch an agitated drug addict in the process of stealing narcotics. Compare the value of your narcotics in the center against the risk to the person responding to the alarm either through physical danger with the intruder or driving in the middle of the night, still groggy from being awakened.
There is a rash of narcotic thefts going on in surgical departments and surgery centers, but many of these are traced back to inside jobs or to people who have knowledge of the facility. To address these thefts, I suggest you do the following: Go to Radio Shack and buy dummy security cameras. They look exactly like the real thing and even have a cable that connects to the wall. Mounted up on the wall, the blinking red light indicates that they are recording every event they see in the area. Complete the illusion with a card that reads, "These Premises Protected by Off-site Video Recording." Do not tell your staff they are dummy cameras, and no one will ever know. Or for about $50 per month, you can get the real thing, but why bother?
Here is another idea to consider: Take down your "Medication Room — We have lots of narcotics in here" sign and replace it with "Soiled Utility" and stick a "Biohazard" symbol on the door. Complete the deception by placing your "Medication Room" sticker on the soiled linen room door. Confuse them. If you do both, you cover the insider break-ins by "videotaping" the area, and you remove your advertising to the drug addict looking for quick drugs. With proper orientation and required staff meetings, staff will be adequately trained about where to find the medications.
Steps to take when you have a drug theft are different for each facility, but here is an overview of what should occur:
— "QA" the incident. Theft reports are good material to address.
— Notify your medical director and consulting pharmacist upon discovery. (Note regarding "upon discovery": If you don’t externally monitor your facility, you don’t need to get up in the middle of the night and waste your time.)
— Notify the security department if the facility has one.
— Report the incident to the local police department, which will do some type of investigation and probably take statements (at a reasonable time).
— Change locks on all narcotic boxes, the lock on the PACU med room door, and the lock on the anesthesia workroom door.
— Restrict who has access to keys.
— Reevaluate getting an automated dispensing system for sign-out of keys, etc.
— Have the required report issued to the Drug Enforcement Administration in Washington, DC, detailing the theft, names and amounts of drugs, and detailed measures taken to prevent future occurrence as outlined above. (See resource information, below, about how to access the form on-line. To see a sample copy of the form, click here.)
Resource
The DEA Form 106 (Report of Theft or Loss of Controlled Substances) is in PDF format available to print on your printer. You may complete it by hand, sign it, and mail it to the nearest office of the Drug Enforcement Administration (DEA). The form can be printed from the DEA web site: www.deadiversion.usdoj.gov/21cfr_reports/theft/index.html.
The bottom line is that the $300 to $400 worth of drugs in your center have a street value of about $50,000. You do not want to get in harm’s way by accosting addicts or dealers. Let them take what they want. Drugs can be replaced — you cannot.
[Editors’ note: Earnhart and Associates is an ambulatory surgery consulting firm specializing in all aspects of surgery center development and management. Earnhart can be reached at 5905 Tree Shadow Place, Suite 1200, Dallas, TX 75252. E-mail: [email protected]. Web: www.earnhart.com.]
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