Category Archives: accountability

What’s the Risk of Backing Newt Gingrich?

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Hundreds of the shakers and movers in the Republican party AND the Democratic party are doing their risk assessments this week on who to openly support, and doing the risk calculation on whether it is better to wait and see what emerges, or make their comments/endorsements now and worry about the fall out later!

Here is the kind of risk model for politics that people use, often unconsciously- to make those decisions. Political risk is especially tricky because there are 2 stakeholders to consider:

1. what’s good for ME personally
2. what’s good for THE PARTY, DISTRICT, or COUNTRY.

Here’s a list of threats that politicians worry about in a situation like this:

1. Lose my current position
2. Lose my Power in the Party/Coalition/Media
3. Lose campaign contributions
4. Lose voters
5. Lose tea party support
6. Lose respect from peers
7. Lose future election
8. Lose income
9. Look wrong in the media
10. Create bad sound byte
11. Face Reprisals Later from Establishment
12. Lose Media Support (however it exists).

More tomorrow on how to value the assets of an ongoing campaign.

Crime and Punishment II – Sentencing of Rod Blagojevich

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Today marks a historic day in the State of Illinois.  While the previous governor is still in prison on corruption charges, out-going, loud-mouth Rod Blagojevich is in court to receive his sentence on federal corruption charges.

This is a great moment for the judge and the judicial system to hand out a sentance that will help PERMANENTLY end the endemic corruption in the Illinois executive branch.

Americans always point out corruption issues in other countries — but this is the MidWest — the Heartland of America.  In fact, I know people who ONLY hire people from the midwest because they think they are more honest and more hardworking.

So I hope that this verdict will uphold justice because I firmly believe that a country is only as good as it’s justice system.  It defines everything else that happens (read my previous post on the SEC failures to enforce).

Every judicial decision, even a non-decision, sends out a strong message to the next potential corrupt politican that the State of Illinois, and the US as a whole, cannot allow corruption in our elected officials!

 

HAS 60 MINUTES EXPOSED THE SEC SECRET – No Penalties for Big Banks?

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On Sunday evening, December 5th,  60 MINUTES aired what I think is a ground-breaking bit of investigative reporting on how the SEC allowed big banks and mortgage companies to violate Sarbanes Oxley (SOX) requirements with total impunity.

Since the American public is still suffering from the mortgage meltdown – they are looking for answers and looking for punishment.  Crime and punishment usually go together in the Justice Department and law enforcement communities.

“You do the Crime – You do the Time”.

So one person is arrested for a victimless crime, like shoplifting a candy bar, but a big company, like Countrywide, or Bank of America, can crash a worldwide economy, lie on federal forms, commit perjury and saw intense financial destruction to millions of people, and they are allowed to keep the fortunes they made through this risky behavior, and, even better, there’s no jail time, no fines commensurate with crime, and no penalty for openly flaunting federal laws!!

WOW – what kind of message does this send?

For me, concerned day after day with helping organizations comply with federal mandates and laws, like SOX, and HIPAA, and OSHA, this makes a parody of compliance enforcement.

Companies spend millions of dollars to comply with these regulations, which are passed to protect the American public from exactly what just happened.  To find that the regulators are the ones who ignored the falsified attestations, forgave the lack of compliance and let these 21st century robber barons keep their ill-gotten gains makes me, and about 200 million other people, sick!

 

OSHA Starts New Enforcement Initiative for Workplace Violence Issues

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On September 8, OSHA issued a new directive about enforcement activity on workplace violence issues.  This directive (CPL 02-01-052) takes effective on Sept. 8, 2011 and is called Enforcement Procedures for Investigating or Inspecting Workplace Violence Incidents.  It details new procedures for the OSHA inspectors, but it is also a valuable document to show employers what they can expect.

The directive follows the shocking news that in 2010, 18% of workplace fatalities were caused by assaults and violent acts, while only 14% were caused by falls, according to the Bureau of Labor Statistics.

Workplace violence incidents are even higher in the hospital and healthcare industries.

The new inspection directive shows how OSHA inspectors are going to look at employers to see whether they have performed a workplace violence analysis.  These assessments follow the security risk assessment model and should take into account the threat level at the organization, the history of incidents and examination of trends, and whether ‘accepted’ controls have been implemented at the place of employment.

Some of the ‘accepted controls’ they will be examining include:

  • Having a recent workplace violence analysis
  • Having a formal workplace violence training program in place
  • Showing the employer had incident reports to identity possible threat levels
  • Methods the employer used to inform employees of the risk of workplace violence
  • Evidence the employer has a workplace violence prevention plan in place
  • Evidence the employer has a current security plan
  • There are also a set of recommended physical controls that include proper lighting, cameras, curved mirrors, etc.

For more information, or a copy of the document, email info@riskwatch.com.

Starting a Hospital Security Risk Assessment

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How to make sure your Security Department is Working for the Hospital.

Security Risk Assessment are not just Required by the Joint Commission – they are required in many states as a preventive measure to help prevent and reduce workplace violence.

The Risk Assessment also helps managers and administrators assess their security program, directly measure it’s effectiveness and helps determine
cost effective methods that can give you a great deal of protection for the lowest possible cost — something we call “bang for the buck”. 

The recent increase in violence comes as a surprise to doctors, nurses, managers and administrators, too.  Violence is not a concept that people usually associate with hospitals.  For years, hospitals have been seen as almost a sanctuary of care for the sick and wounded in our society.   However, the perception of hospitals has been changing over the last fifteen years due to a variety of factors.

 1.  Doctors are no longer thought of as “Gods”.  This means they are
      are more easily blamed when a patient’s condition deteriorates.

 2.  Hospitals are now regarded as businesses.  This perception has been
       been aggravated by television in shows like a recent “60 Minutes”, as well as
       by the effects of the recession on jobs and the loss of health insurance.

3.  Lack of respect and resources (funding) for hospital security departments
   .  Rather than being seen as a crucial protection for the hospital staff and
      patients, many security departments are chronically underfunded and used
      for a variety of non- security functions, such as making bank deposits for
      the hospital gift shop, driving the education van, etc.

The federal government  issued a guidance document for dealing with violence issues in healthcare,  called OSHA 3148.01R, 2004, Guidelines for Preventing Workplace Violence for Health Care & Social Service Workers.  You can download a copy at www.osha.gov/Publications/osha3148.pdf

Playing Footsie with the Haqqani Crime Network

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I am a risk analyst and risk assessment expert, certainly not a diplomat.  In fact,  my friends might say I am probably really un-diplomatic most of the time.  I like the direct approach.

But watching the U.S. State Department and the Obama administration playing footsie with the Haqqani network in Afghanistan and Pakistan is worse than enduring waterboarding.  What a waste of American dollars — paying off these criminals to finance construction projects that Americans are doing to build up Afghani infrastructure.  

I have watched for years as the U.S. State Department props up brutal dictators, only to see them toppled overnight.  Of course, Mubarak and Quaddfi come to mind right away.

But to try and win a WAR, while paying off criminals and murderers who are launching attacks on our embassy, letting them run our relationship with Pakistan, is just wrong.

What has this got to do with risk assessment?  PLENTY – because the problem here is large amounts of unaccountable cash.  Cash passed out by the State Department, USAID and the intelligence services, theoretically, to ‘grease’ the skids and get something done, but instead, these wholesale PAYOFFS just finance and empower our enemies, while ruining the U.S. reputation and maddening the citizens who provide this money in the first place.

I would vote for anyone who could put REAL ACCOUNTABILITY back into the U.S. spending abroad.  As the Arab spring proved — this kind of diplomacy never works!

How to Correctly Analyze 100-Year Threats for Risk Assessments

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Starting a risk assessment in northern Virginia and going through the threat list they say, “You can take earthquakes out – we don’t have earthquakes here”!

Hey, Haiti didn’t have earthquakes!

Vermont didn’t have major floods!

Connecticut doesn’t have tornados!

Like Murphy’s Law, as soon as you discount a threat, and think, “it will never happen here”, it happens!   The earthquake in the mid-Atlantic in August was a wake-up call for those who that they would never have earthquake damage.

One of the reasons that security risk assessment is so highly valued as an analytical took, and why it’s required by so many governments is because it DOES take into account the 100-year flood, the 75-year drought, etc.

Natural disasters can be so overwhelming, and catastrophic, that they must be considered in any proper risk assessment.  This is why some areas are not suitable for building housing tracts, because they are in a 100-year flood plan.

Because human memories are short, just because YOU haven’t experience a flood
along a meandering creek, doesn’t mean it will never happen.  

Always check the long-term probabilities when you start a risk assessment and make the numbers work for you!

Should Hospital Staff Brings Guns to Work with Them?

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Should hospital staff bring guns to work with them?

At a time when many hospital security departments have unarmed security officers, and some departments don’t even allow the use of mace, changes in state laws allow hospital staff in some states to bring their guns to work with them.

This turn-around, where the nurses may have guns – and security officers do not, has created a big, contentious debate in the security community.

In a recent paper printed in the Journal of Healthcare Safety and Security, my co-author, Jim Sawyer and I discuss the different elements of this debate and whether this is a constitutional issue, or a real threat-risk issue.

Here’s an excerpt,

Violence is not a concept that people usually associate with hospitals.  For years, hospitals have been seen as almost a sanctuary of care for the sick and wounded in our society.   However, the perception of hospitals has been changing over the last fifteen years due to a variety of factors.

or you can read the entire article (below). 

Critical Issues on Gun Violence in the Hospital Workplace

By James Sawyer and Caroline Ramsey-Hamilton

 Background

 Every reader knows that violence in hospitals is increasing at an increasing rate.  The Joint Commission has issued Sentinel Alerts, the Journal of the American Medical Association, the bastion of the American healthcare system, published an article in October, 2010, written by two doctors about the murder-suicide at Johns Hopkins Hospital in September of 20101.. 

This article started as a guest blog from a security professional at a west coast children’s hospital.  After the blog appeared, we received dozens of notes, letters and angry outbursts, as well as emails arguing for a more reasoned approach.  This article will explore those issues, and includes quotes from the emails themselves.

Why Violence in Hospitals is Increasing

Violence is not a concept that people usually associate with hospitals.  For years, hospitals have been seen as almost a sanctuary of care for the sick and wounded in our society.   However, the perception of hospitals has been changing over the last fifteen years due to a variety of factors.

  1.  Doctors are no longer thought of as “Gods”.  This means they are
          are more easily blamed when a patient’s condition deteriorates.
     
  2. Hospitals are now regarded as businesses.  This perception has been
           been aggravated by television in shows like a recent “60 Minutes”, as well as
           by the effects of the recession on jobs and the loss of health insurance.
  3. Lack of respect and resources (funding) for hospital security departments
       .  Rather than being seen as a crucial protection for the hospital staff and
          patients, many security departments are chronically underfunded and used
          for a variety of non- security functions, such as making bank deposits for
          the hospital gift shop. 

A Dirty Little Secret about Reporting
The U.S. Department of Labor tasks OSHA with workplace violence information, but there is not one sanction against it, it says right on the OSHA web site that this is solely left up to the employer.  It makes it hard for hospitals to justify spending money on workplace violence prevention, if it is not a standard, and a major compliance issue (as it should be).  And here is a dirty little secret for looking at the statistics, OSHA does not count domestic incidents (like homicides) that take place in hospitals as officially “workplace violence incidents”, instead they are counted in another system.  Similarly, many hospitals don’t count staff to patient violence incidents, or patient to patient incidents.  These practices create a false impression of the actual number of violent incidents, by reporting only a fraction of the actual events.

 Gun Violence Represents a Significant Security Challenge

The prevention of gun violence in hospitals and the hospital as workplace may well be the most challenging issue for hospital security professionals in the foreseeable future.  What are some of the reasons for this growing concern?  There are many and they include:

 1.   The sheer numbers and easy availability of guns.  There are over 270 million guns in circulation in theUnited Statesand the numbers continue to grow.  After the 2008 election,  gun ownership surged and in some areas of the country, guns sold at such a pace that retailers literally ran out of ammunition. 

2.  Approximately a 100 people a day die from gunfire in the United States and an individual is shot approximately every twenty-two seconds.

3.  One in four Americans suffer from some form of mental illness, according to the Federal government. 

 4.  The U.S. is living in an era of economic instability, following the 2008 recession and the erosion of the middle class.  The Wall Street-triggered economic meltdown has propelled what was a slow steady decline into economic apocalypse for millions of Americans.  This has resulted in an environment of record home foreclosures, record personal debt, record banktupcy, record unemployment and record numbers of homeless individuals.

5.  The reluctance on the part of many hospitals to install magnetometers and limit entrances to hospitals so that the flow of guns into hospitals can be controlled.

The U.S. gun lobby has been very successful in pushing and supporting state legislation which permits guns in the workplace, and on college campuses.

It is a serious mistake for security professionals to deride,  make light of, or dismiss this surge of pro-gun-at-work-and-school legislation.  These laws are getting passed (see Texas, Indiana, and Tennessee), and the likely result is that we will see an ever greater numbers of guns at work, and if our work is in the hospital, then the guns will be coming to work here, too. 

Guns aren’t just increasing in numbers, but they are getting more lethal and currently 30- shot clips and armor piercing bullets are readily available for the civilian population.  Citizens can now buy weapons that rival what is found in military armories.   These lethal weapons again present a sentinel challenge to security professionals.

 Most security directors remember life when Space Invaders was the only video game around.  Now children are exposed to violent images from a very early age.  Children and teenagers sit entranced watching endless hours of violent programming where gun violence is choreographed in slow motion action scenes where the scripted hero’s miraculously avoid injury even while they are dispatching the prime time  villains while showcasing their amazing gun prowess.  

By the time they show up at your hospital, the average child over 18 years of age will have viewed over 45,000 murders and 200,000 acts of violence just on television! This grim tally does not account for the high octane bloodshed and slaughter that make up the majority of the most popular video games.  

All of these factors suggest that the prevention of gun violence in our hospitals will become our premier challenge.  Many hospitals are already hosting ‘active shooter’ seminars to teach hospital staff how to deal with  “shooters in the workplace”.  This subject promises to become a cottage industry for consultants and violence prevention professionals.

As hospital security professionals, there are some strong, prevention-based practices that we can implement and develop that drastically reduce the chances of gun violence in the workplace.  Some of these best practices include:

 1. Acknowledge the reality and the persuasiveness of the U.S. gun culture.

 2.  Develop a strong, multi-department workplace/domestic violence response team at your facility, and make sure that both Human Resources, and Security are part of this team.

 3.  Develop a written workplace violence plan that is reviewed annually.

 4.  Do an annual  baseline workplace violence assessment that you can build on.

 5.  Have your workplace/domestic violence response team respond and meet within 4 hours of any  reported incident.  Have a response plan/action plan in place within 24 hours.

 6.  Encourage reporting of all workplace/domestic violence incidents to the police – without exception.

 7.  Run background checks of individuals of concern.  Information is light and a background check may provide you with crucial information. Obtain orders of protection – anti-harassment orders against individuals of concern.  Security should take the lead here.

 8.  Flag problem patients – problem families – have a “red alert” or a “red flag” program that alerts – tips off – advises both the care team and security that a potential problem exists.  This is especially important if the patient/family member has a history of violence.

 9.  Build a workplace culture where verbal threats are reported.  Have Security immediately investigate all verbal threats.  Make sure that Human Resources is fully informed of any situation involving threats.

 10.  Post  large, prominent“No-Weapons” signs at your facility – especially in parking lots, perimeter areas and all main entrances.

 11.  Officially prohibit staff from bringing firearms to work.

 12.   Offer annual violence prevention and threat awareness training to all staff.

 13.   Require workplace violence training – either on line or via classroom training for all new staff and annual retraining.

 14.   Have security involved and part of the planning for all “problem” terminations.   Note – Advise Human Resources to never terminate a disgruntled staff without strong pre-planning.

 15.  Screen all hospital patients and visitors.  Develop a major entrance screening program for your institution.  Knowing who is inside your facility is a critical part of any good prevention program.

 These pro-active solutions  will support and enhance a hospital gun violence prevention program.  Let me state again, it is critically important to have a hospital gun violence prevention program in place.

 AND IN RESPONSE

 Here are some of the comments that were received by other hospital security professionals around the country, after the original blog post.

 “Please remove me from your mailing list immediately.  Apparently the letter below blames the firearm and not the person holding it and putting 5-7 lbs of pressure on the trigger with their index finger.  I find it difficult to separate the “Spirit of the Security Community and our commitment to safety and protection” from this attack on my Second Amendment rights.”               

                                                           — Hospital Security Director in the Northwest

“I believe we should focus our attention, and when I say attention I actually mean money, on mental health resources (or the lack there of) and domestic violence issues, which quite often lead to fatal shootings.  Our emergency rooms have become a revolving door for patients with drug abuse, depression and other psychological issues and there appears to be very little our legislators and community/government leaders are doing about it.  To me, that is the real injustice and crime related to the firearm issue!                                              
                                                                   — Hospital Security Director in the Midwest

 “I would agree with the individual that I don’t believe there is a place in hospitals, government buildings and places of worship for guns; however if there had been guns on some of the college campuses, maybe there wouldn’t of been the blood baths they turned into.                                                       
                                                                –  Security Analyst – Washington DC

“As for firearms being banned from the workplace, I agree.  Policies and procedure should dictate along with a severe disciplinary, then handle accordingly.  Just that simple.”
Let’s clean it up, let’s clean up America!  Let’s lessen the need for firearms to be in the hands of thugs as well as those who just want to feel safe.    The FIRST STEP would be to BAN and make it ILLEGAL for businesses to sell paraphernalia, pornographic anything, strip clubs, places that promote alcohol and drug use, etc. 

Let’s Clean That Up!  …something that is tangible and promotes drug and alcohol use as well as many other criminal actions just to run these types of businesses.  Let’s make that illegal.  Let’s get Americans involved in the real issues of illegal firearms and drugs coming into this Country.    All law enforcement know that it takes big money to keep drugs coming into this Country.      Disarming America. RIDICULOUS.    Keeping firearms away from the workplace, understandable.

                                                    — Ex Army, Ex-Police, Hospital Security Officer

 

 Conclusion
While the issue of “gun control” is both a “hot button” and simultaneously,  a topic that is seemingly a forbidden or taboo matter for hospital security professionals.  It should not be this way.  Questioning the wisdom of allowing citizens to buy 30-round clips for semi-automatic handguns and keeping assault rifles at home is not a crazy liberal rant, it is a reasonable, non-political position.

Challenging the wisdom, if not the sanity, of the current flood of legislation that both allows and actually encourages guns in the workplace is neither “liberal” or “radical” – but pragmatic and grounded.   Hospital security professionals are the vanguard for progressive crime prevention education and development in the United States.  This is a mandate and responsibility that we all share.  How we respond and learn to protect our staff, our hospitals and our patients from this senseless violence may prove to be our greatest and most important challenge.

 www.riskwatch.com               www.caroline-hamilton.com

Put your Hospital Security Department on a Low Fat Diet

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Hospitals are reeling from potential losses in funding related to state budget cut-backs
and potential cuts in Medicare programs.  Every area of the hospital budget are being scrutinized, looking for areas to cut and reduce costs.

Instead of waiting for a memo about cuts that affect YOUR department, be a
pro-active manager and right-size your security department and show management
the changes you want to make.

It is possible to have an efficient, accountable security department without having costs run out of control.  It has to be based on real dollars, on real risks and it has to have the ability to show management WHY you need each element in your program.

The already-required risk assessment is the first start in this process.  When regulators come in to a hospital, they want to see the risk assessment first, and then they look to see if you followed the remediation plan identified in the risk assessment, which means they want to see you made the right improvements, based on the plan.

By including program elements in the risk assessment, and mapping it back to your actual budget, you can easily say that the Return On Investment is for each part of your program.

AT RISK – YOUR HEALTH – Check out the antidote for overweight Baby Boomers – The Juice Reboot solution featured in new movie, ‘Fat, Sick & Nearly Dead”. It convinced me!

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Fat Sick And Nearly Dead: A Movie Review from Dr. Whimsey

Recently, I watched the movie “Fat, Sick, and Nearly Dead,” available on Netflix. The film chronicles the real life adventure of Joe Cross, an entrepreneur from Australia, who decides to go on a 60 day juice fast. Cross had a series of medical conditions that included obesity, and an autoimmune disease commonly referred to as “Chronic Idiopathic Urticaria.”Cross’s decision to go on a juice fast, is based on the idea that his lifestyle choices made him sick. In fact, many healthcare providers now believe that much of America’s epidemic of obesity and chronic disease have more to do with diet and lifestyle choices than anything else.

The film was shot in the United States, and depicts Cross traveling across the country asking people about health and diet, while discussing the current medical epidemic of obesity and chronic disease that has lead to Americans consuming more prescription drugs than any other nation on earth. Along the way Cross meets a truck driver named “Phil,” Phil is 425 pounds and suffering from the same debilitating disease. Phil decides to go on his own juice fast and not only recovers his health but looses close to 200 pounds (for his part, Cross lost around 90 pounds during his fast).

This film is amazingly inspirational, and I highly recommend people watch it. Not just because it demonstrates how diet and exercise can cure disease, but because it addresses, what I have come to believe, are gaping holes in our current healthcare system. Mainly, the lack of emphasis we have placed on diet and lifestyle changes to cure disease in this country, and have opted instead for the “quick fix,” medications can offer instead.

The film maker argues that juicing is better than eating foods raw because it would take far too many fruits and veggies to equal the amount of nutrients found in a single glass of juice. Therefore, in order to maximize the amount of micronutrients available in vegetables it is better to juice them.

This is not a perfect film. I am not a huge proponent of a juice only fast. One of the main reasons I don’t like this type of fast is because it eliminates fiber from the diet. Fiber is vital to our health for a number of reasons. For starters, fiber bulks up our stool helping us to have healthier and more frequent bowel movements (preventing constipation, and decreasing our risk of diverticulitis and polyps). Fiber is also thought to reduce our risk of colon cancer and type II diabetes. Fiber also helps keep our blood sugar stable. It does this by slowing down how quickly sugar can enter the blood stream; preventing the elevated levels you can sometimes get from consuming high sugar content food items like soda pop and white bread.

Instead of the juice only diet seen in this film, I advice people to do both a juice fast combined with nutrient dense foods like plenty of raw veggies, brown rice, and beans. This keeps the blood sugar stable during the fast, while still gaining all of the added benefits of taking in nutrient dense juices.

Like every article we write on Anderson Health Watch, we always want you to ask your doctor before starting any diet or exercise regime to see if it is right for you.

 

See the original Dr. Whimsey review at:

http://andersonhealthwatch.blogspot.com/2011/07/fat-sick-and-nearly-dead-movie-review.html