When an administrator tells me the hospital’s security is handled, what they usually mean is that there is a guard contract. Officers are posted at the emergency department entrance, someone patrols the parking structure at night, and the vendor sends a monthly report to facilities. On paper the campus is covered. Yet the same administrator can often name a nurse who was assaulted last quarter, a visitor who wandered into a unit where they had no business, and a survey finding about workplace violence prevention that nobody quite knew how to answer. The reason hospital security cannot be left to the guard force is sitting in that gap.
I want to say plainly that this is not a criticism of the officers. I have worked alongside contracted security officers for much of my career, and the ones posted in hospitals are doing one of the hardest jobs in the industry for modest pay and little recognition. The critique is structural. A guard force is a resource. It is the visible part of a program, and a hospital that has a guard force without a program has hired people to stand in front of a plan that does not exist.
What a Guard Force Is Built to Do
A contracted security force is designed to fill posts, follow post orders, respond to calls, and document what happened. Those are the terms of the contract, and the vendor is evaluated on whether they were met. The officers at the ED entrance are there to observe, deter, respond when called, and write a report. They are trained by the vendor to the vendor’s standard, which is generally a broad standard for many kinds of sites and rarely a deep one for healthcare. They are supervised by the vendor’s site manager, whose first obligation is to the company.
None of that includes deciding what the hospital’s risk actually is. It does not include writing the visitor management policy, designing the infant abduction response, setting the behavioral health escort protocol, auditing the pharmacy access list, or telling the ED that its triage layout puts nurses within reach of every angry visitor. Those are leadership decisions. When no leader makes them, the officers work from whatever post orders the vendor wrote when the contract was signed, and those post orders were written by someone who had never walked your maternity unit.
Why Hospital Security Cannot Be Left to the Guard Force
Consider what the officers cannot see from their posts. They see the ED entrance and the parking structure. They do not see the outpatient entrance three buildings away that is unlocked because the clinic manager finds the badge reader inconvenient. They do not see the incident reports HR keeps about a nurse who has been threatened by the same family member three times. They do not see the pharmacy’s after-hours access log or know that a former employee’s badge still works. They do not see the pattern across a year of ED incidents that would tell a leader the problem is concentrated on two shifts and one triage area.
They also cannot change anything they do see. An officer who notices that visitors are walking past the desk at shift change can write it in a report, and that report goes to a vendor supervisor, who forwards it to a facilities manager, who has no authority over the unit in question. The observation dies in transit. In a hospital with an executive-level security owner, that same observation becomes a policy change within the month. This is the difference between a guard force and a program, and the difference is leadership.
The Reporting Line Is the Tell
In most hospitals the guard contract reports to facilities. That arrangement tells you everything about how the hospital thinks of security. It is a building service, evaluated like janitorial or landscaping, and trimmed when the budget tightens. The facilities director is a capable person with a full-time job that has nothing to do with workplace violence, and they did not ask to own it. So the vendor is measured on filled posts and cost, and the questions that matter, whether the officers are trained for a healthcare setting, whether they know what to do when a behavioral health patient becomes violent in a corridor, whether the post orders reflect the hospital’s actual risk, are never asked because no one in the chain is equipped to ask them.
Accreditation and regulatory bodies have noticed. Expectations for workplace violence prevention now assume a hospital has assessed its risk, built a program, trained its people, and reviewed the results, and that someone owns all of it. A guard contract is evidence of none of those things. When the surveyor asks who is accountable and the answer is the vendor, the hospital has just described its own gap.
Test It, Because It Is Only Assumed
The doctrine I wrote Until Tested: Security Is Only Assumed around is useful here because the guard force is where most of a hospital’s assumptions live. Leadership assumes the officers check credentials rather than wave at familiar faces. It assumes the panic button in triage reaches an officer who will arrive in time. It assumes the night patrol actually reaches the top level of the parking structure. It assumes an officer would recognize an infant abduction in progress. Every one of these can be tested in an afternoon, and in my experience, in a hospital with no security leadership, several of them will fail. That is not the officers’ fault. No one defined the standard, trained them to it, or checked.
What Leadership Owes the Guard Force
The officers deserve a program to be part of, and building it is leadership’s job. Start by putting one accountable owner over security who sits above facilities and reports to the COO, and move the vendor relationship under that person. Have that owner rewrite the post orders to match your hospital’s real risk, with specific guidance for the ED, behavioral health, the maternity unit, pharmacy, and the parking structures, and have the vendor train to them. Require that the vendor’s incident reports go to the owner, alongside the reports HR, the ED, and pharmacy keep, so patterns can be seen. Walk the campus at night with the owner and watch what happens at shift change. Then test the assumptions listed above, one at a time, and fix what fails. When you do this, the same officers you have today become far more effective, because for the first time someone has told them what the hospital actually needs and is standing behind them when they deliver it.
Go Deeper
For hospitals that cannot yet fund a full-time security executive, the fractional model gives the guard force the leadership it is missing without a full-time salary, and I explain it in What Is a Fractional Security Director? The Complete Guide. My book Fractional Security Director lays out how a part-time executive owns the program, directs the vendor, and gives the board one name to call.
Commissioner William Epps is a former elected Fire Commissioner, federal law-enforcement supervisor, and firefighter since 2006, with instructor credentials in Hazardous Materials response, Active Shooter preparedness, and Stop the Bleed®. He spent seven years in federal law enforcement in physical security, executive protection, and incident command, and now serves organizations as a Fractional Security Director. He is the author of The Spirit of Saul, The Spirit of Pharaoh, and other practical books on security, leadership, and faith, built around one idea: knowledge should be practical enough to use when it matters.
Leave a Reply