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An intruder in the operating room

by Andrew Jones

An intruder in the operating room; healthcare security; hospital security

In the past two years, we have written about the security challenge known as "tailgating." This is the practice of following an authorized person into a restricted area or past a certain checkpoint. (This is also sometimes referred to as "piggybacking.")

It’s time for a follow-up.

Earlier this month The Boston Globe published a story about an intruder in the operating room at Brigham and Women's Hospital in Boston. She then tried to infiltrate two other hospitals in the city.

According to The Globe, last May Cheryl Wang, 42, was dismissed from a residency program at Mount Sinai St. Luke's Hospital in New York City. Last September she applied to the residency program at Brigham, forging recommendation letters that enabled her to shadow a surgeon there for two days. While at Brigham, she apparently obtained scrubs that she wore when she returned in December, gaining access to five operating rooms over two days to observe procedures. Once doctors realized she was not authorized to be there, she was confronted and escorted off the premises. The very next day she tried to attend a meeting at Massachusetts General Hospital; unsuccessful, she was followed to Boston Children’s Hospital, whose security team was notified.

"The incident," reported The Globe, "highlights a vexing security problem called 'tailgating.' As is the practice at many hospitals, Brigham operating room staff hold their identification badges in front of an electronic card reader to gain access to surgery suites. According to video surveillance and staff accounts, the woman tagged along behind employees during shift changes, slipping in as groups of operating room staff held the door for one another."

The newspaper article goes on to say:

"This individual looked and acted like she belonged in our institution. She was wearing our scrubs, knew her way around, understood the hospital culture and terminology, and was familiar with people’s names," (spokeswoman Erin) McDonough said in a written statement. "Because of this, we let our guard down. We know that in addition to best practice healthcare security measures, the safety and security of our hospital requires the vigilance of everyone who works here. All involved are fully committed to providing a secure [operating room] for our patients and staff."

Tailgating during shift changes is a common problem in hospitals, said Martin Green, president of the International Association for Healthcare Security & Safety and head of security at Baycrest Health Sciences in Toronto. "It's very difficult to prevent."

Because people naturally want to hold the door for others, "we always have to teach people to go against the way they were brought up," said Bonnie Michelman, executive director of security at Mass. General.

Ms. McDonough said that the intruder did not participate in patient care, The Globe reported. "Ms. Wang was an observer," she said. "She did not touch, treat, or provide care to a single patient." The paper added that, as a result of this incident, "the hospital said it has strengthened its hospital security policy for allowing observers into its 47 operating rooms … It also plans to educate staff about the dangers of tailgating."

Here are links to our three previous blog posts about this topic:

Part I — The prevalence of tailgating (survey results)

Part II — Tailgating: what it is, why it is a problem, and how to prevent it

Part III — Physical security tools to solve tailgating

How does your organization prevent tailgating to help healthcare security? Feel free to comment below.

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