The New Healthcare Consumerism and its Impact
on Infant Security Systems and Locked Birthing Units
White Paper, by RF Technologies’ Clinical Education Specialists
The birthing experience can be exciting, but also potentially frightening. Expectant parents are
often left feeling apprehensive and vulnerable, making childbirth a journey they prefer not to
navigate on their own. That’s why moms-to-be historically have chosen their doctors, hospitals
and maternity centers based on the referrals of their support network–their friends and family,
and in recent years, a list of providers supplied by health insurance companies. Now, all of that
is changing.
Two years into healthcare reform, there is a major swing in the healthcare industry where
patients are taking more control of decisions affecting their financial commitments, treatments,
security and comfort. This new trend in healthcare consumer decision-making—referred to as
“The New Healthcare Consumerism”—is having a surprising impact on birthing units and infant
security. As a result, locked birthing units alone no longer meet consumers’ expectations for
infant protection. Additional measures are required to stay competitive today.
The New Healthcare Consumerism of Family Centered Maternity Care
In his ExecutiveInsight newsletter article, “Consumerism: Changing How Hospitals Do
Business: The importance of meaningful online reviews,” author Andrew Ibbotson takes a
deeper look at the new consumerism in healthcare. Ibbotson reports, “With the rising cost of
healthcare and a more open marketplace…Healthcare is being held to the same standard as
any other consumer purchase.” Instead of asking friends and family for referrals to doctors,
Ibbotson reminds us, “Now, consumers head online for most everything. In fact, 29% of
consumers say that viewing online ratings or reviews is the first step in their search to find a
new physician.”1
Tom Jensen, also reporting for ExecutiveInsight, states, “Healthcare consumerism is shifting
more healthcare responsibilities to the patient/consumer as the patient has become more
engaged in their treatment and financial decisions.” He adds,”Less than a decade ago, payers
and employers managed almost all of the health benefit decisions for patients. As a result,
patients were relatively unconcerned with costs associated with their healthcare need.” Now,
“Americans are beginning to see the value of front-end cost estimates as a critical tool to
improve their ability to manage costs.”2
This trend may have begun with cost comparisons, but the popularity and sophistication of
review websites has dramatically changed the criteria for choosing a facility or care provider.
Specific to maternity and delivery care, what are internet savvy patients looking for in birthing
centers? Expectant parents report that they are searching for centers that are committed to
making the birth experience comfortable and secure for mother, newborn and the entire family.
Present-day amenities include, for example:
nnPrivate
LDRP Suites (labor, delivery, recovery and post-partum), which often include
whirlpool tubs, flat-screen TVs, DVD players and refrigerators
nnExtended
visiting hours for parents, grandparents and siblings to share in welcoming the
newest member to the family
nnWi-Fi
and internet access to keep friends and family up-to-date
nnA state-of-the-art
infant security system
3125 North 126th Street, Brookfield, WI 53005 USA
phone: 800.669.9946 fax: 262.790.1784
www.rft.com
The New Healthcare Consumerism and Its Impact
nn
on Infant Security Systems and Locked Birthing Units
nnRestaurant-quality
nnComfortable
nnLactation
food delivered to mom’s room
sleeping accommodations for the father or life partner
services
Current maternity care models expand the relationship between patient and birthing
center by providing a broader, consumer-focused product. This new trend in the birth
experience is commonly referred to as “Family Centered Maternity Care.”3
Safety and Security Protocols of Family Centered Maternity Care
Among the many features expectant parents seek from a Family
Centered Maternity Care unit are comfort and security. Consumer
demands for Family Centered Maternity Care oftentimes result in
expanded family visitation hours and increased foot traffic, both of
which require added vigilance on the part of nursing staff and security
officers in scrutinizing the comings and goings of more people.
The Joint Commission refers to hospital units whose function
presents an environment in which there is a significant potential for
injury, abduction or security loss as “Security Sensitive Areas.” Infant
birthing units, due to their potential threat of abduction, fall within the
“Security Sensitive” category.4
According to Hospital and Healthcare Security, Fifth Edition, “The
security sensitive area must have a written plan to control or regulate
access, including how nonemployees are screened, identified,
and directed to service points specific to the area.” In keeping with
this, hospital birthing units must have a written security plan for the
maternity area, including ongoing security training for staff, a critical
incident response plan, and an enterprise-wide “Code Pink” protocol
in the event of an infant abduction.5
Discussing consumer demands in healthcare,
Christine Paige, Senior Vice President for
Marketing and Digital Services at Kaiser
Foundation Health Plan explains in an H&HN
Daily article,
“…consumers expect a level of service-ondemand and an ease-of-access experience
that many traditional health care organizations
currently are not prepared to deliver.”
She added, “…consumers expect to have
access to information, be able to understand
information provided and use that information
to make decisions. The third dimension,
not to be underrated at all, is sensitivity to
cost,” Paige says. “As people are absorbing
more [health care] costs themselves, this is
extremely important and something that all of
us in the industry have to be thinking about.” 6
Today’s state-of-the-art electronic infant security systems are
specifically designed to meet Joint Commission “Security Sensitive
Area” standards, including clinical and parent education. In the case
of a Safe Place® Infant Security system installation or upgrade,
the company conducts system training for the unit’s nursing leadership, providing
ongoing onsite and online clinical training of staff. Birthing units are also supplied with
informational DVDs, pamphlets and posters to educate parents on the purpose of Safe
Place and Baby Check® security products, plus tips on how to keep their baby safe.
The onsite nurse training offers the nursing staff an opportunity to become comfortable
with using the system by means of hands-on experience. Clinical Education Specialists,
on the other hand, have an opportunity to observe the treatment facilities and protocols of
many and varied birthing units.
In their travels, Safe Place Clinical Educators have observed three security measures that
are most widely used:
nnLocked
nnVideo
units
surveillance cameras
nnElectronic
infant security systems
3125 North 126th Street, Brookfield, WI 53005 USA phone: 800.669.9946 fax: 262.790.1784 www.rft.com
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The New Healthcare Consumerism and Its Impact
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on Infant Security Systems and Locked Birthing Units
Sometimes just one of the above security measures is used, but more often,
two or three security measures are put in place to safeguard the unit.
Limitations of Locked Units
In the not-too-distant past, hospitals believed that locked units alone were
sufficient to protect newborns, families and staff. In fact, RF Technologies’
research shows that about 20% of birthing units still rely solely on locked units.
But there are critical limitations.
Locked units, by necessity, have a dramatic impact on the movement of
caregivers and visitors. As Hospital and Healthcare Security, Fifth Edition,
explains, “All stairwell and exit doors on the perimeter of the maternity unit
should have alarms that will alert unit personnel of their use. …All nursery
doors should be locked. The door utilized for entry and exit of staff should be
equipped with self-closing hardware. The exception to all locked nursery doors
would be when there is an access control person (security officer, receptionist
or unit clerk) controlling and authorizing access.5
Despite these rigorous restrictions, a locked maternity unit is only as effective
as its gatekeeper. Its primary value is in preventing admittance of undesirable
visitors. RF Technologies’ Clinical Education Specialist, Ann Rinehart,
explains, “As a labor and delivery nurse I can speak personally that all the
units I have worked on are locked down and utilize an infant security system.
Having a locked unit allows us to be a ‘gatekeeper.’ With the patient population
on a maternity unit, including drug using moms, domestic violence issues,
paternity/custody battles, restraining orders against family members, etc.,
we keep out a lot of potentially harmful people and we keep in patients who
might otherwise harm themselves; e.g., use their IV access to do drugs on our
watch.”
The Joint Commission has
established best-practice guidelines
for preventing infant abduction in the
hospital, including these steps:
nn
Attach secure identically
numbered bands to the infant
(wrist and ankle bands), mother,
and father or significant other
immediately after birth.
nn
Footprint the infant; take a color
photograph of him, and record
his physical examination within 2
hours of birth.
nn
Implement an infant security
tag or abduction alarm system,
such as a bar-coding system or
umbilical clamp, which triggers an
alarm, locks doors, and freezes
elevators if the infant comes
within 4 feet of an exit or elevator.
nn
Transport infants only in
bassinets; don’t allow them to
be carried or left in the hallway
without direct supervision.
nn
Establish a tracking system to
document where the infant is at
all times.
nn
Require staff to wear up-to-date
conspicuous, color-photograph ID
badges and require staff in direct
contact with infants to wear a
second form of unique ID, such as
a badge with a pink background.
Of key importance, Ann tells us, “Choosing to lock a maternity unit these days has
less to do with infant security and more to do with keeping patients and staff safe.”
What are the disadvantages of relying solely on Locked Units?
nnLocked
units require a vigilant staff to keep out unauthorized visitors.
During times of heavy workload and when short on staff, the movement
of undesirable visitors may be overlooked.
a dedicated receptionist or security officer is needed to
control entry and egress.
nn
Don’t publish birth
announcements in local
newspapers. Don’t post the full
names of mothers or infants
where other patients or visitors
can see them.
nnOftentimes,
nnNotification
of a missing infant can be delayed because their absence
will only be discovered when someone notices an empty bassinet.
(Whereas, with an electronic infant security system, notification is nearly
instantaneous when an infant band is removed or if the child comes
nearby the unit’s exit).
nnAny
delay in initiating a Code Pink for a missing infant could result in
providing sufficient time for the abductor to leave the building with the
infant. (Whereas, an electronic infant security system would respond
nn
Control access to the maternity
unit; for instance, keep all unit
exit doors locked and make
sure they’re monitored by video
surveillance cameras with a date/
time stamp.
Source: The Joint Commission, 2003.
3125 North 126th Street, Brookfield, WI 53005 USA phone: 800.669.9946 fax: 262.790.1784 www.rft.com
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The New Healthcare Consumerism and Its Impact
on Infant Security Systems and Locked Birthing Units
almost immediately to an alarm by locking-down doors to the unit, deactivating
elevators, and generating an alarm – most frequently stopping an elopement before
the infant is removed from the unit.)
nnGatekeepers
need to be attentive to tailgaters – unauthorized persons coming or
going from the unit in close proximity to authorized guests.
nnStaff
needs to be cognizant of persons attempting to exit the unit carrying bags and
packages large enough to contain an infant.
Even with the most vigilant staff, a locked maternity unit is vulnerable to abduction
attempts. It is widely accepted that the faster a notification and response are, the greater
likelihood there is for a positive outcome.
Video Surveillance as Part of Infant Security Strategies
Video surveillance is frequently part of a multi-faceted security strategy and is often
layered on top of locked unit protocols. In fact, RF Technologies’ personnel have
observed that most Infant Care Units have a video surveillance system in place. The
Joint Commission considers infant abduction to be a sentinel event, requiring a specific
access control plan. One reason for this is that it provides nursing and security personnel
with real-time views of a potential unauthorized intruder. Another is that the successful
recovery of an infant is largely based on having a video surveillance system installed to
obtain a color, full-face view of everyone who enters and leaves the unit, providing critical
evidence in the event of an abduction.
Hospital and Healthcare Security, Fifth Edition, offers the following Video Surveillance
Strategies for Family Centered Maternity Areas. 5
Infant Security Video Surveillance Strategies
nnFull
surveillance of each exit point from the unit to observe each entrance, exit,
nursery entrance, hallway, stairwell and elevator door on or near the infant care unit
nnCameras
nnPosition
images
nnAll
may be “live” on a continuous basis or activated upon door use
color monitors at nursing stations in locations so the public cannot see the
cameras are in color and recorded (a 10-day library is recommended)
nnProminent
signage stating that all persons are recorded for security purposes
Source: Hospital and Healthcare Security, Fifth Edition
The National Center for Missing and Exploited Children (NCMEC) points out that most
potential abductors “shop” the local birthing centers and hospitals before actually
attempting an infant abduction.7 Video surveillance systems help nurses and security to
keep an eye out for suspicious habitual visitors. Complicating the situation, however, is
that many abduction attempts are committed by a person known to the infant’s family,
such as an estranged husband or other family members.
Just like locked units, video surveillance has its limitations. As part of a prevention
strategy, video surveillance is completely dependent on vigilant monitoring. In addition,
its secondary merits—as evidence or to aid recovery—are only of value if an abduction
occurs.
3125 North 126th Street, Brookfield, WI 53005 USA phone: 800.669.9946 fax: 262.790.1784 www.rft.com
nn
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The New Healthcare Consumerism and Its Impact
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on Infant Security Systems and Locked Birthing Units
Creating a Comprehensive Solution with Electronic
Infant Security
The National Center for Missing and Exploited Children (NCMEC) collected evidence
that 56% of hospital infant abductions occur from the mother’s room. In 1991, there was
a total of 17 infant abductions in the United States; 11 of those were from hospitals and
healthcare centers. As of May 2015, there were no healthcare center abductions for a
32-month period. The NCMEC attributes the recent decline in infant abductions from
healthcare to the preventive education programs provided to staff and parents.7
Safe Place Clinical Education Specialists agree that staff and parent education is
important to preventing abductions, and the company provides tools for both. In addition,
it has been proven that the very presence of an electronic infant security system can be a
key deterrent to infant abductions.
In MCN: The American Journal of Maternal/Child Nursing, Joanne M Cox,
MS, RNC, writes, “In my opinion, the best defense against infant abduction
is a vigilant staff, educated parents, and a well-choreographed response
to the perceived or real threat of infant abduction.” She adds, however,
“Electronic security systems play a key technological role in supporting
a hospital’s infant security program through monitoring, surveillance and
response time.” 8 [Emphasis added]
The various electronic infant systems available in the marketplace function
differently from one another. Their basic configurations vary as well; e.g.,
many use wireless ankle bracelets, others use umbilical clips.
Following are some infant security system features that today’s state-ofthe-art electronic infant security systems include.
nnSmart
Transmitters – Offers the ability to sense not only cut band
and tamper, but skin sensing to detect the tag is properly applied and
the infant is protected. When the band is no longer in contact with the
infant, staff is alerted.
There are two key advantages of
electronic infant security systems in
comparison to other measures:
nn They rely less on staff oversight,
thereby reducing the impact
of variables such as workload,
staffing levels and human error.
nn Notification is nearly
instantaneous. Without an
electronic infant security system,
an abduction could go unnoticed
for minutes to hours, greatly
decreasing the chances of a
positive outcome.
nnTag
Supervision – Infants are fitted with small, lightweight
transmitters that continuously “check in” to the system. If a transmitter fails to check
in, staff is notified immediately to ensure the infant is still being protected.
nnComfortable
Banding – Protecting the infant’s fragile skin must be a priority, not
only to avoid irritation, but to ensure concerned parents don’t remove the tag.
nnEgress
Monitoring – If an infant wearing a protection tag is brought too close to
a monitored exit, doors will lock, elevators will deactivate, an alarm will sound, and
staff members will be notified almost instantly—all through wireless technology.
nnSystem
Failsafes – In the event of a power, network or computer failure, a back-up
system must continue to protect the birthing unit by notifying staff of alarms and low
battery indicators, and maintaining basic pager notification functions.
The Safe Place Infant Security Solution delivers an additional layer of protection not
available with all electronic security systems on the market. When it is used in conjunction
with the patented Smart Sense® technology banding, the infant or child has multiple layers
of tamper detection.
3125 North 126th Street, Brookfield, WI 53005 USA phone: 800.669.9946 fax: 262.790.1784 www.rft.com
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The New Healthcare Consumerism and Its Impact
on Infant Security Systems and Locked Birthing Units
Despite the advantages of electronic infant security systems, it is not unusual for hospitals
to maintain a locked unit. Laurie Schumacher, a Clinical Education Specialist with RF
Technologies, tells us, “The Dallas hospital I’m employed at remains a locked unit, even
though it has had an electronic infant security system for at least the eight years I’ve
been there. And I find that most of the sites I’ve visited continue to follow whatever door
policy they had in place before install.” The addition of an electronic infant security system
creates a complete solution.
Is Your Hospital Ready to Respond to Consumer Demand?
This white paper is intended to raise awareness of the new healthcare consumerism
and its impact on birthing units. Online search capabilities have wholly changed the
consumer mindset in terms of expectations. When shopping for family centered maternity
care, today’s consumer-oriented expectant couples demand to have the same range of
selections for their birthing experience, as is available to them for other products they
research online.
In her article, “Is Your Hospital Ready to Answer Consumer Demand?” which appeared
in H&HN Hospitals and Health Networks,” Lola Butcher says, “Hospitals are dramatically
reshaping what they do — and where and how they do it — as Americans become more
demanding, cost-conscious, impatient and sophisticated about their health care.” 6
Of all the birthing experience amenities sought by expectant parents, none weighs more
heavily than the safety and security of their infants. Penny Johnson, a Clinical Education
Specialist for RF Technologies, emphasizes, “Expectant parents put a lot of time and effort
into choosing the facility where they will deliver their baby. They are looking for the highest
quality medical care and the best possible birthing experience. However, while these
things are important to them, the quality of the care for the baby is their utmost concern.
They not only expect the baby to receive the best possible care, they also expect the
highest level of security to ensure their baby’s safety. It is my experience that parents feel
reassured when they see our security tag on their baby’s ankle. They enjoy much greater
peace of mind and are better able to relax and recover from the delivery experience.”
A locked unit alone will no longer support consumers’ requirements for family
centered maternity care. An electronic infant security system is required today,
in combination with the other security methods discussed, to meet these higher
expectation levels. It’s a just a topic healthcare can no longer ignore.
References
1
Ibbotson, Andrew. “Consumerism: Changing How Hospitals Do Business, The importance of meaningful online reviews.”
05 October 2015. Advance Healthcare Network, ExecutiveInsight, Advanceweb.com. Web. 30 November 2015.
2
Jensen, Tom. “The New Era of Consumerism: Financial Management in the Midst of Healthcare Reform.” 04 May 2015.
Advance Healthcare Network, ExecutiveInsight, Advanceweb.com. Web. 30 November 2015.
3
Phillips, RN, EdD, Celeste. Family Centered Maternity Care: The Business Case. White paper. Santa Cruz: Phillips + Fenwick,
2007. Document.
4
Joint Commission. Root Causes: Practical approaches for preventing infant abduction. Position Paper. Illinois: Joint
Commission, 2003. Document.
5
Colling, CPP, CHPA, Russell L. and York W., CPP, CHPA, Tony. Hospital and Healthcare Security. Fifth Ed., ButterworthHeinemann Publishing, 2009. Textbook.
6
Butcher, Lola. “Is Your Hospital Ready to Answer Consumer Demands?” H&HN Daily, Hospitals and Health Networks 10
February 2015. Periodical.
7
NCMEC National Center for Missing and Exploited Children. “Newborn/Infant Abductions.” 7 May 2015. Missingkids.com.
Web. 30 November 2015.
8
Cox, MS, RNC, Joanne M., “Pro Position on the question: Does an Electronic Infant Security System Ensure a More Secure
Hospital Environment?” MCN: The American Journal of Maternal/Child Nursing (2004): 280-281. Journal.
3125 North 126th Street, Brookfield, WI 53005 USA phone: 800.669.9946 fax: 262.790.1784 www.rft.com
LIT-70402 Rev A 12-15 ©2015 RF Technologies, Inc.
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