Case Study: Strict Entry Procedures at St. Joseph’s Hospital of Buckhannon in W.Va.

In 2019, leaders at St. Joseph’s Hospital of Buckhannon in West Virginia, a critical access hospital, realized they needed to strengthen their security presence and add safety controls to their facility. This need came to a head when a patient slashed his own wrists with a knife during an emergency room (ER) visit and in front of a nurse. This was traumatic to that nurse and troubling for the entire staff.

“He could have just as easily lunged at [the nurse],” said St. Joseph’s President Skip Gjolberg. “This event caused us to reassess the safety of our staff and patients.”

In response, the organization doubled its safety team, adding security officers among other staff. While Gjolberg said that convincing him and other leaders to spend more money “took some work,” it was worth it.

As a result of the investment, security staff monitor the facility and grounds 24/7. Two security officers are on duty during each hospital shift, with one dedicated to monitoring the ER entrance. Leaders Security team at St. Joseph’s Hospital also added extra security cameras and security lock boxes outside hospital entrances, where local law enforcement and fire department officers can access keys to the facility, maps of the building, badges and other necessary items in case of emergencies.

In addition to the extra security, leaders implemented a workplace violence training program called AVADE (Awareness, Vigilance, Avoidance, Defense and Escape/Environment), to educate staff and security officers on de-escalation techniques.

Leaders also train security officers on how to use gel-based pepper spray — aerosol spray can infiltrate the ventilation system — and handcuffs. The officers do not use firearms or stun guns.

In 2020, leaders limited access to the building, requiring badges or codes for visitors, patients and staff at all entry points. They ordered the front lobby closed after 5 p.m., when visitors and patients must enter through the ER entrance. This area features a controlled access door that requires an additional badge or access code.

Leaders also regularly survey staff about their safety concerns and address those worries on a consistent basis.

Gjolberg said these measures have improved the security of the facility and the safety of patients and staff.

“[Staff] feel more confident in their duties, and they just feel safe in at the hospital itself,” Gjolberg said. “Just walking out to the parking lot at night and knowing that there’s security present” makes a difference.