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No more open-door policy. Hospitals are tightening control of vendor and visitor access to ensure regulatory compliance, cut down on unauthorized interaction with medical and other staff, and enhance patient and staff safety. The efforts are aided significantly by technology, particularly visitor and vendor management systems that provide organizations with a view of everyone who enters the facility and his or her purpose for being there.

Health Facilities Management and Hospitals & Health Networks conducted a survey recently to explore hospital vendor and visitor access. The survey found that policies to control access are becoming the norm. Eight-six percent of respondents to the survey have some form of vendor credentialing program in place. Sixty-five percent of respondents reported having a formal check-in process for all other visitors.

Vendor credentialing, driven by compliance with the Joint Commission and Centers for Disease Control and Prevention regulations, is credited with reducing supply chain costs and enhancing the quality of care through better access to products and a reduction in variation. "Our organization suffered from an open-door policy," says Randy Hall, administrative director, supply chain, University of Utah Health Care, Salt Lake City. "We had very little control over vendor access and no program for how to introduce new products to the organization." University of Utah Health Care launched a vendor credentialing program in 2007 to control and reduce supply chain expense while maintaining and improving the quality of care. Vendors must preregister for visits and provide a photo and other background information, including record of a flu shot.

Hall says the program received little pushback from physicians. In fact, most physicians welcomed the policy because it limits interaction from vendors making sales calls at physician offices. "You need solid processes and policies so people understand what they need to do," he says. The vendor credentialing system has helped the organization to standardize products and reduce the overall number of vendors, allowing for vendor discounts. "It's been a really important component of our supply chain cost-management program," Hall says.

Lee Memorial Health System in Fort Myers, Fla., launched a Fast-Pass program in 2010 to gain control of visitor access. "We are not trying to restrict visitors," says Raphael Ortiz. "We want to know who is inside the facility." Visitors must present state-issued identification upon entering and each is given a temporary photo badge to wear while on-site. Since the program was launched, the organization has seen a drop in pedestrian traffic and loitering, as well as a drop in pilfered items. Reports of suspicious persons have dropped to zero.

This gatefold shows the results of the 2013 Hospital Vendor & Visitor Access Survey.

Visitor Check-In

Tightening visitor access is primarily a safety issue for health care organizations. The challenge is to tighten access while also maintaining an open, welcoming environment. Visitor check-in lets organizations know who is inside the facility at all times. It also helps screen visitor for contagious diseases, such as common colds and influenza, to prevent them from exposing patients and staff. ID management programs can be added that connect with electronic health records so as soon as a patient is discharged, any visitor for that patient would be notified and would be denied access. Check-in stations should be available at all public entrances to the facility and may be staffed with volunteers, customer service representatives and security personnel.

Access Control

Hospitals across the country are assessing their security protocols and systems in light of mass shootings and acts of violence within hospital walls. The move to enhance security is bolstered by technology developments that enable organizations to tighten access control for visitors, vendors and employees. Sixty-nine percent of respondents to the 2013 Vendor and Visitor Access Control Survey say their organizations use an integrated security system, such as video surveillance, access control, alarms and intrusion protection. Another seven percent said they plan to have such a system in place within the next 24 months. Twelve percent of respondents said they have the ability to capture video of visitors at check-in, while 16 percent require visitors to show photo identification at check-in.

Vendor Credentialing

Vendor credentialing enable health care organizations to better control supply chain protocols, improve patient safety and quality, and reduce costs. Vendor management systems requires vendors to preregister and schedule visits to the organization. Vendors must check into the facility at a kiosk, which verifies that the vendor has preregistered and is authorized to visit. Mobile apps have recently been developed to allow vendors to check in via their smartphones instead of at a kiosk to further streamline the process. The primary motivation for vendor credentialing cited by respondents to the survey is compliance with the Joint Commission and Centers for Disease Control recommendations (63 percent), followed by compliance with laws and regulations (56 percent) and creating a safer environment (54 percent).

Technology facilitates change in managing access to health care facilities

Technology is a game changer in managing vendor and visitor access to health care facilities. The question is how far organizations will take it to track the movements of people inside their doors, experts say.

Nearly three-fourths of respondents to the 2013 Health Facilities Management/Association for Healthcare Resource & Materials Management/American Society for Healthcare Engineering Vendor and Visitor Access Control Survey, or more than 500 organizations, said they use a vendor management system to screen, badge and track every vendor. And 38 percent of respondents said they use a visitor management system to screen, badge and track every visitor.

Sixty-nine percent said they have an integrated security system such as video surveillance, access control, alarms and intrusion detection. And 12 percent said they capture video of visitors at check-in.

While vendor management systems have been around for about eight years, only in the past few years have they been widely adopted at health facilities, says Lisa Pryse, president of the International Association for Healthcare Security and Safety, and president and chief of company police at ODS Healthcare Security Solutions in Richmond, Va.

Typically, vendors check into a facility at a kiosk, which verifies that the individual is prescreened and authorized to visit the facility. The kiosk also issues a temporary photo ID badge for the day. The systems usually are available to health care facilities at no cost and are funded via fees for vendors to have their credentials stored in the software systems. "These systems have just widely started to come online," says Pryse. The reason is partially due to word of mouth. Indeed, 52 percent of respondents to the Vendor and Visitor Access Control Survey said they consulted other hospitals when crafting their vendor credentialing policies.

Greg Goyne, vice president of marketing at IntelliCentrics, Flower Mound, Texas, which offers a vendor management system solution and underwrote funding for the survey, says in the near future, such products will be more and more integrated. The company recently released a mobile app that allows vendor representatives to do secure facility check-in directly from their smartphones instead of requiring them to use a kiosk.

"Hospitals have a duty to provide a safe environment not only for their patients, but also for their employees and the communities they serve," Goyne says. "Moving forward, we're going to see more integrated credentialing systems that not only help verify who people are, but also provide real-time monitoring to ensure compliance with facility requirements in real time."

Examples of hardware integration include security cameras, biometrics and fingerprint readers.

Integration is the name of the game today, agrees Joseph Bellino, system executive of security and law enforcement services at Memorial Hermann Health System, a 13-hospital system based in Houston with about 5 million visitors each year.

Memorial Hermann is considering integrating its vendor credentialing and access system with check-in processes for other people coming through its doors, such as construction workers and patient visitors.

"That would allow us to have a database that is more robust," Bellino says. So, for instance, if a hurricane or tornado struck one of its facilities, officials could know exactly who was on-site at the time of the disaster, he says. ID management programs can be added that connect with electronic health records so as soon as a patient is discharged from a facility, any visitors for that patient would be notified and could be denied access.

Other technologies include systems that read bar codes on drivers' licenses. So, a visitor would swipe his or her driver's license when checking in to visit a patient. "This gives us authentication from another reliable source," Bellino says.

Video surveillance and video capture also are becoming more commonplace in health care facilities, Bellino and Pryse say. Memorial Hermann facilities post signs in areas with video monitoring to let people know the cameras are there. "Generally, it acts as a deterrent," Bellino says. "And most people these days understand wherever you go, you are being monitored."

These systems can help to identify suspects if an incident or attack occurs. And video management systems with analytics can alert security teams to concerning behavior, like a package or briefcase left unattended for too long, Bellino says.

Pryse says she would like to see more use of video capture and surveillance, especially in areas that tend to have less foot traffic.

"From a safety standpoint, there are a lot of materials that are hazardous or dangerous at loading docks," she says. "It is often the least monitored and the most accessible area."

At most health facilities, gone are the days when a paper log of visitors was sufficient. With all this new technology comes an even trickier balancing act between safety and access.

"We need security to keep people safe, but also [to] retain a high degree of customer service and patient satisfaction," Bellino says. — Rebecca Vesely


Health Facilities Management and Hospitals & Health Networks magazines, in conjunction with the Association for Healthcare Resource & Materials Management and the American Society for Healthcare Engineering, surveyed a random sample of 6,278 hospital supply chain directors, materials managers, facility managers, security directors and others to learn about trends in vendor and visitor access. The response rate to the survey was 13 percent, or 824 completed surveys.

HFM and H&HN thank the sponsor of this survey, IntelliCentrics, Flower Mound, Texas.