Hackensack Meridian Health Palisades Medical Center is situated right on the Hudson River in North Bergen, N.J., with a view overlooking the New York City skyline and Manhattan’s upper west side. The not-for-profit Palisades Medical Center serves a population of 450,000 in Hudson and southern Bergen counties with a 206-bed hospital, a 245-bed nursing home and a rehabilitation center.

Adam Dwyer, Director of Security and Emergency Preparedness at Hackensack Meridian Health Palisades Medical Center, started as a security officer at the health system’s flagship hospital 20 years ago before coming to his current role in 2018. He oversees the emergency preparedness, safety and security of the Palisades Medical Center campus and reports directly to the chief operation officer and regional vice president of the health network.

Dwyer has seen a transition of the department’s role over that time, he says. The more than 40 all-proprietary security staff, screeners, emergency room officers and central dispatch personnel have become an integrated part of the 1,400 team members that make up the Palisades Medical Center. 

He says that open lines of communication with network leadership are extremely important, not only for the security team’s morale and perception among the rest of the health system, but also to obtain buy-in and support for initiatives and top-of-mind issues.

During the past 18 months, some of that support has come in the form of wellness coaches and empathy classes, particularly as security and medical staff have continued to ride the pandemic rollercoaster, seeing an increase in alcoholism, mental health issues and escalated patient interactions. While the health system initially offered wellness and mental health coaching to security staff, Dwyer says that the organization is talking about expanding it to other departments as well.

The medical center’s initiatives on mitigating workplace violence have taken a layered approach, as health systems, hospitals and medical centers around the country and the world have experienced an increase in workplace violence or escalated patient and visitor interactions.

With a nursing home on the campus and changing visitor restrictions throughout the pandemic, friendly, engaging security personnel trained on the nuances of de-escalation have become one of the most critical tools the Palisades Medical Center security team has in their toolkits, Dwyer says.

“We started talking to staff even more, with a focus on recognizing when people are anxious or upset. We’ve handed out lavender-scented lotions and began community policing. Our officers make rounds on the floor, introducing themselves to patients and family,” Dwyer says. Security staff will greet visitors in the main lobbies, introduce themselves to family walking the floors, and sit at the nurses’ stations to remind staff they are there to help.

The initiatives come in handy, Dwyer says, and the security team has found much success building a rapport, not only with staff, but with patients, family and other visitors as well. “We were touring the floor just yesterday, and we introduced ourselves to a gentleman and spoke with him a little bit. A little later in the afternoon, he became very upset. The medical staff called us, and when we got there, he recognized us and calmed down pretty quickly as we spoke with him,” he says.

In addition to community policing, part of the Palisades Medical Center security team’s approach to mitigating workplace violence has been training. The team uses Crisis Prevention Institute workplace violence training for security staff and began opening the training up to nursing staff with a focus on de-escalation and recognizing signs of anxiety or trouble early on. The security team uses incident data to pinpoint the highest risk staff populations and floors to determine where to expand such training. “We want everyone to feel comfortable. It’s easier to do your job if you’re not worried about your safety,” he says. Dwyer says the organization is also looking at expanding training to using other consultants and companies for a varied approach.

“We want [staff] to look for signs and call security early on. We also want to empower everyone with tools and small maneuvers they can use to keep themselves safe and to de-escalate a situation. Most of the time, people don’t have the intent to harm us, so it’s very helpful to be able to calm them down,” Dwyer says.

Last year, at the height of the pandemic, the medical center, like health systems around the globe, experienced some of their highest rates of workplace violence incidents. With the Palisades Medical Center’s layered approach and a focus on empathy, empowering staff and keeping morale up, workplace violence incidents decreased dramatically, on par with numbers before the pandemic, Dwyer says.

While training and staff communication continue to be essential tools for the security team at the medical center, another essential component to mitigating risk and keeping staff, patients and visitors safe is technology.

With support from the C-suite, Palisades Medical Center opened a dispatch center, or security operations center, where personnel monitor threat intelligence software, cameras and security equipment, and even look for signs of agitation or escalation to notify the rest of the security staff as quickly as possible.

With the help of a state office Homeland Security grant, the organization has deployed technologies, including license plate recognition software and video analytics, to help alert staff to incidents, bags left in the lobby or cars parked in non-parking zones.

“It can help with a number of risks. If we have a mental health patient, for example, we can set an invisible barrier on the video software that will pass an alert to us if crossed,” Dwyer explains.

Though Dwyer says he considers the medical center a small community hospital, with support from the greater health system, security team and their initiatives meant to foster a community culture amongst staff, it’s no wonder Palisades Medical Center was recognized as one of Modern Healthcare’s Best Places to Work in Healthcare.

“Over time, I’ve seen a rise in morale and a change in how security is perceived and how professional we are,” Dwyer says. “Everyone knows each other and is friendly. We’re really a family, and we work as a team.”