When it comes to the physical security of hospital buildings and the well-being of workers, healthcare reform brings with it the likely risk of increased traffic into the nation's ERs.
ERs are among the top locations in medical centers for violence between patients and staff, generally because ERs act as funnels into the rest of the facility.
"You have overcrowded emergency rooms right now," says James Blair, FACHE, president and CEO at the Center for Healthcare Emergency Readiness in Nashville. "You're going to make 30 million people eligible [for insurance]. They won't be coming hat in hand."
But when people believe they have a right to medical care—"And that's what the rhetoric has led everyone to believe, that everyone in America is covered," Blair says—some individuals may be hard to physically control when they find out at the ER that they have to wait until 2014, when many provisions for covering the uninsured kick in.
That dilemma puts ER nurses, physicians, and security officers on the battleground of dealing with potentially upset, confused, or even violent patients who don't fully understand the healthcare reform laws passed last week.
Hospital security expert Fredrick Roll, MA, CHPA-F, CPP, agrees.
"I think a greater number of folks will show up and push for their 'entitlements,'" which will up the ante for workplace violence in medical centers, says Roll, president and principal consultant at Healthcare Security Consultants, Inc., in Frederick, CO.
Roll will speak at HCPro's 4th Annual Hospital Safety Centers Symposium May 6-7 in Las Vegas.
Supply preparation is needed
There are also patient surge issues, both immediate and long-term, associated with healthcare reform that mirror concerns about an influx of patients from a community emergency.
Although not a potential disaster in the traditional sense, healthcare reform, by bringing more people into hospitals, will challenge facilities by depleting them of supplies more quickly, Blair says.
It's already tricky enough determining just-in-time inventories of surgical masks, latex gloves, food, and other provisions. Hospital planners and emergency managers will soon need to get a firmer grasp on how healthcare reform could tax the supply chain, he says.
"It's a matter of numbers," he adds.