“It’s impossible to distinguish who’s who,” points out Mark Howell, director of fire safety and protection services for Providence Healthcare in Vancouver, British Columbia. “Everything from toilet paper to general hospital supplies has been stolen. Even computers have gone out the door, but that isn’t much of an issue anymore.”

It has ceased to be an issue because, with over 6,000 employees, nine locations, plus thousands of visitors each day, Providence decided early last year to update its photo identification system at all of its sites and include access control at its largest facility, St. Paul’s Hospital. Since the installation of access control, Howell says the theft rate has decreased by about 70 per cent.

A healthcare centre of this magnitude must be able to identify all personnel from the doctor and nurse through to the housekeeper, dietitian, pharmacist, maintenance engineer or lab technician. More than that, they must be able to allow or deny access to specific areas within a hospital such as administration, surgery, labs, hospital supplies, the pharmacy or the morgue.

Providence Healthcare is a fairly new entity, in which independent hospital services have been amalgamated within the past two years. Of the nine sites – St. Paul’s Hospital, Holy Family Hospital, the Administrative Services Office, Mount Saint Joseph Hospital, Youville Residence and the four wings of St. Vincent’s Hospital (Arbutus, Brock Fahnrni Pavilion, Heather and Langara) – only St. Paul’s is electronically accessed; the other facilities still use lock and key.

Though all the sites use photo identification, insufficient funding prevents an overall conversion to the electronic access system for the entire healthcare group. Providence is developing a plan to consolidate many of its services onto fewer sites. This means that some facilities may close, so money for upgraded security will not be invested in these sites.

When the final decisions regarding closures are made, Providence will have to restructure its operation again, but eventually, Howell’s goal is to have the remaining Providence Group using its “smart” electronic access control system throughout. It would rely on proximity cards rather than the swipe cards presently used, however, because there is no wear on a proximity card reader.

“You just hold the card up to the panel,” explains Howell, “and it automatically reads your access level and grants you entrance.”

The system now installed in St. Paul’s Hospital applies a hi-energy magnetic stripe for encoding information on the card for the access control system. How this works is that the card only allows employees and volunteers into areas where they are authorized to go and will not admit them anywhere else.

Identicam Systems supplies St. Paul’s with a FARGO Pro PVC card printer with built-in magnetic stripe encoder, a video camera for quick photo captures, an additional rental system for the initial staff photo-taking, and EPISUITE card-design and database software. According to Garry Radons, the former leader of protection services, organizing access control at St. Paul’s was an onerous task that involved over 100 different levels of authorization.

“Every staff member has access into the building 24 hours a day; however, there are countless areas in which access must be restricted to only those with responsibilities there. An added challenge is that, in some cases, such as with housekeepers, areas of responsibility may change all the time, so different accesses have to be granted frequently.”

More specifically, Howell observes, “An intensive care unit nurse doesn’t need access to stores while a stores porter does because he or she has to deliver supplies everywhere.”

Human resources and the heads of different departments determine the clearance level for each employee and sign authorization.

“When new employees for St. Paul’s are hired, they come in to get their photos taken and are assigned to the seventh floor or the tenth floor,” Howell begins to explain. “Let’s say they are assigned to the ear, eyes and nose clinic. They will only have access to the exterior doors and the doors that will get them into the designated area.”

“Everybody works everywhere at certain times, so it’s a regional type of access control that we run,” Howell notes.

That makes central control of access, which the Providence’s security department manages exclusively, a major advantage over the old lock and key system. Now, if an employee loses his or her card or leaves without returning a card, the central access system can be changed to deny access.

It also prevents human error, Howell stresses, “especially afterhours, if somebody forgets to lock the door behind them.”

Because photo ID is so vital to the daily management of the healthcare system for all nine facilities, wearing pictures allows every staff member to act as a watchdog. With over 6,000 employees, it is impossible to know everyone.

“I don’t know everybody and, even though my face and name are well recognized, many people don’t know me unless I have my photo ID,” confirms Denys Carrier, leader of the emergency preparedness program for Providence Health Care.

An emergency operations centre is located in each hospital. An incident command team calls staff in for duty and looks after the re-direction of patients to other hospitals, if necessary.

Though the photo ID and access system is a crucial part of the security system, Howell admits, “It’s only as good as the users.” To reinforce the importance of photo ID, he says he and Carrier both give a speech during a two-day employee orientation program that every new staff member must take.

“We talk about the difficulties and remind them that uniforms can be bought anywhere, so it’s very important they wear their photo ID. We talk about the risks associated with not wearing their ID and leaving personal belongings unsecured. We also remind them that if they see someone in their area who is not wearing photo ID or refuses to show them their ID, they are to contact security.”

Carrier says he uses humour to get his point across. “I reinforce they must wear their ID. I also let them know that we’re not the motor vehicle licensing department, so if they don’t like their picture, we will re-take it.”

“The photo ID system generally works,” notes Howell, “because of the number of ‘suspicious’ calls we get, but it has also failed in a few cases because we still have theft in the areas where there is no access control. Particularly when people are busy with other duties, they can’t be wary of who’s coming and going.”

By adding electronic access control, however, “we’ve been able to funnel traffic control. If somebody steals something on the tenth floor, they can’t run down the stairwell and out the door. They have to go to the elevators and take the elevators down,” Howell concludes. “We look forward to the time when our whole security system will be centralized for all the facilities so we can see what’s going on at the other sites as well.”