By Brian Uridge, CTM, CHPA, CPP, MPA
Years ago, when I was with Kalamazoo (MI) Public Safety, we had a significant crime issue in the vicinity of the intersection of Ada and Woodbury. We knew that an increase in enforcement would not be effective on its own, so we rolled up our sleeves and got to work.
First, we removed all the blight: broken items and junky cars abandoned in the area. Then we painted over the graffiti and trimmed all of the overgrown trees and shrubs. We worked with the City to ensure all lighting in the area was working properly. We brought in street sweepers to come pick up trash, and walked the streets to build trust with the community.
The neighbors noticed. One day, while I was in the neighborhood helping with the clean-up effort, I turned around and saw a resident walk out of their house, grab a rake, and start cleaning up their front yard.
After completing this project, we saw a significant drop in violent crime at Ada and Woodbury.
The results were dramatic, but this is not just a feel-good story. The transformation that occurred in that neighborhood is not due merely to our goodwill, but countless studies on the impacts of environment on public safety.
Crime Prevention Through Environmental Design (CPTED)
The focus of any security team is to ensure that people in a given environment are safe and feel safe. The multi-disciplinary approach known in public safety circles as CPTED (Crime Prevention Through Environmental Design) seeks to strategically manipulate the physical environment in order to decrease both crime and fear of crime. Lighting, signage, the flow of a facility’s entrance, sightlines in buildings and green spaces—all of these elements can increase safety and are rooted in over 60 years of study and data on the effectiveness of CPTED.
In my view, one of the greatest benefits of the CPTED framework, especially in healthcare environments, is its accessibility. In my experience with employing CPTED strategies, they are often small, simple changes that don’t require a large investment, but make a big impact. Most critical access hospitals don’t have a lot of money to hire security consultants or do a major overhaul of their environment or technologies. CPTED principles offer healthcare organizations a cost-efficient way to increase the safety of their environment for patients, staff, and visitors.
CPTED focuses on four core areas, each with implications for healthcare facilities:
Natural Surveillance
Designing spaces, lighting, and windows to maximize visibility so that staff, visitors, or passersby easily see potential intruders or bad actors.
Lighting has an incredible impact on the environment, whether indoors or outdoors. From the location to the intensity to the color, proper lighting is directly linked to increased safety. In fact, the New York Housing Authority did a lighting study in their urban environment. They found that when they installed high-intensity lighting in a neighborhood, robbery and assaults dropped by 35 percent. That’s a huge improvement.
Sight-lines are also a crucial element of natural surveillance. As a rule of thumb, you never want to have a tree with a branch below six feet from the ground or a bush higher than two feet. Keeping landscaping well-trimmed allows for more advantageous sight lines to ensure the safety of your environment.
Natural Access Control
Guiding people naturally through a facility by clearly marking entrances, exits, and reception areas, while restricting unauthorized access to sensitive or high-risk zones.
The flow of our spaces matter. When someone enters a facility, it should be clear where they should go next and who they can ask for help or for directions.
Points of access into a facility should be limited. This requires more than just signage pointing people to the main entrance or notifying them of restricted sections. Deterrents are also required, such as a locked door and badge scanners for private areas or specific types of foliage planted under first-floor windows that prevent people from accessing the building through the windows.
Territorial Reinforcement
Using physical design features (such as landscaping, distinct paving, signage, and fencing) to clearly distinguish between public, semi-private, and private spaces, creating a sense of ownership and care.
Patient safety and privacy are crucial in healthcare environments. Exam areas should be separated from public spaces like foyers and waiting rooms by multiple layers of walls and doorways.
Additionally, raising the height of desks in reception areas and nursing stations creates a clear barrier between patients and visitors and staff while still allowing for compassionate interaction. Angling the desk or covering it in a slippery material also makes those barriers harder to jump over in healthcare environments that tend to see higher rates of violent crime, such as emergency rooms.
Maintenance and Management
Ensuring that a facility is well-kept. Broken windows, graffiti, and poor upkeep signal a lack of oversight, whereas clean, well-maintained environments deter opportunistic illicit acts.
Evidence of crime, such as graffiti, or signs of poor monitoring by security personnel, like an empty security desk or broken cameras, is an invitation to someone contemplating a crime. Investing in the maintenance of your facility, whether addressing peeling paint, fixing broken windows, or keeping floors and surfaces clean and tidy, discourages crime and increases people’s confidence in the safety of a facility.