Hospitals house very expensive equipment, controlled items such as drugs & other supplies that have to be kept safe from theft. The use of CCTV systems is accepted practice for healthcare facilities around the world. CCTV is an effective tool for increasing security & controlling costs. CCTV surveillance works to protect staff & patients from security breaches as well as provide valuable visual evidence that can be used to increase productivity & prevent dishonest claims.

Hospitals use CCTV surveillance extensively, especially for keeping high value items like drugs & infants safe. CCTVs are used everywhere, but as a matter of funding priority high-traffic areas are covered first. Public entrances, corridors, waiting areas & garages are specifically mentioned as priorities, regardless of hospital size or geographic location.

All kinds of people come through hospital doors. Hospitals need to protect vulnerable or at-risk populations, including babies, children, people with Alzheimer’s or dementia, gang members, domestic violence victims, psychiatric patients. Hospitals are also places where there are escalated emotions & people who are not rational as they may be impaired or in pain.

The use of CCTV facilitates the apprehension & conviction of individuals involved in criminal activity.

Benefits of Hospital CCTV Surveillance

Increase overall security & safety – Security cameras positioned throughout a hospital helps to prevent crimes & break-ins. It allows operators to watch for troubled patients as well as monitor for unauthorized visitors in restricted areas.

  • To serve as a deterrent: The potential offender becomes aware of the presence of CCTV; assesses the risks of offending in that location. If the cost is assessed to outweigh the benefits, the potential offender may choose to not offend or to commit the crime elsewhere.
  • Fear of detection: CCTV cameras capture images of offences taking place. In many cases this leads to arrest & punishment. CCTV cameras provide invaluable visual evidence for investigations of criminal activity & other specific events that have taken place within or around hospitals.
  • Capable guardian: The ‘Routine Activity Theory’ suggests that for a crime to be committed there must be a motivated offender, a suitable target & the absence of a capable guardian. Anything that prevents the convergence of these elements will reduce the likelihood of a crime occurring. CCTV as a capable guardian, may help to reduce crime.
  • For efficient deployment: CCTV cameras allow those monitoring the scene to determine whether police assistance is required. This ensures that police resources are called only when necessary.

Improve productivity – The presence of surveillance cameras can improve communications between hospital departments or buildings, allowing for increased productivity.

Prevent dishonest claims – In instances where patients or visitors falsely attest to injuring themselves on hospital property, evidence from security cameras can dispel such false assertions, thereby saving the hospital from costly insurance claims.

Resolve disputes – Staff disputes are easily resolved when clear visual proof is available. CCTV cameras can shed light on incidents in question.

Continuous real-time monitoring – IP surveillance allows authorized hospital employees to monitor critical areas in real time.

Digital storage – Hospitals that choose to install IP-based video surveillance systems reap the benefits of digital storage. IP systems enable the user to store recorded footage digitally on network servers, hard-drives or NVRs, where surveillance video is easily accessible to authorized users & offers improved searching capabilities. Remote monitoring is an extremely helpful tool in medical facilities. IP surveillance allows hospital staff to view security camera footage remotely from any PC with network access.

The main areas for CCTV surveillance are

Narcotics & medicine storage areas. CCTV is important for verifying proper access, mitigating theft of high-value drugs & auditing who is using medicines for what purpose. CCTVs monitor & safeguard pharmaceutical drugs & make sure nobody is tampering with them or stealing them.

Infant/maternity wards. CCTV cameras are typically deployed to keep tabs on newborns. The goal is to maintain a clear chain of custody & proof of care for all infants born in a hospital. Hospitals are chaotic places & you never know when an attempted infant abduction will occur.

ERs, Trauma Treatment Rooms & waiting areas. These areas are designed as 24- hour care centers. Having proper CCTV coverage is critical for patients, staff & visitors. There have been fistfights & stabbings in the ER waiting room – continuation from an accident or mishap. The ER has by far the most diverse & uncontrolled population compared to other areas of a hospital. In Trauma Treatment Rooms where crowds may be highly emotional & conditions dire require CCTV coverage to keep tabs on patients & their escorts. There are patients who are mentally ill, high on drugs &/or have been brought in by the police. These patients become a problem if they decide to hurt, threaten, scream, push or aggressively assault nurses, doctors & security personnel.

ERs, Trauma Treatment Rooms & waiting areas. These areas are designed as 24- hour care centers. Having proper CCTV coverage is critical for patients, staff & visitors. There have been fistfights & stabbings in the ER waiting room – continuation from an accident or mishap. The ER has by far the most diverse & uncontrolled population compared to other areas of a hospital. In Trauma Treatment Rooms where crowds may be highly emotional & conditions dire require CCTV coverage to keep tabs on patients & their escorts. There are patients who are mentally ill, high on drugs &/or have been brought in by the police. These patients become a problem if they decide to hurt, threaten, scream, push or aggressively assault nurses, doctors & security personnel.

Parking Lots & Garages. Areas where vehicles are parked must have comprehensive CCTV coverage. CCTVs in these areas provide post incident information & live viewing for safety. In parking systems that are vast, with lots of blind corners, cameras promote safety for visitors & staff. Valet cameras are used to dispute damage claims. CCTVs are also used in fire lanes for illegal parking & traffic monitoring. Cameras that record images of vehicles should be placed where vehicle license plates are clearly visible & legible. Additional exterior cameras covering wider fields of view can provide additional vehicle information.

Entrances & exits. There must be at least one camera for every exit. These exit cameras should be aimed toward the interior of the facility & each should be located where it can obtain unobstructed frontal view of the head & shoulders of every individual exiting the facility. The lenses on exit cameras should be configured to have a depth of field that extends from 3-10 feet from the camera in order to provide images of exiting individuals that are in focus. Exit cameras that have a depth of field extending from 3-feet to beyond 10-feet will have the added benefit of providing overviews of the interior & head-to-foot views of people as they enter & exit the facility.

Out Patient Departments (OPDs). There must be at least one camera at each OPD. Cameras should be adjusted to ensure that they are focussing at the location that a patient/visitor is expected to stand. If a window or other obstacle is present, care must be taken to position the camera in a manner that minimizes reflection, glare & other obstructions that can interfere with a clear view of the persons or objects being recorded.

However, if the combinations of exit & OPDs cameras do not provide complete coverage of the specified interior of the establishment, it is recommended that additional cameras be installed for that purpose.

Records Sections. CCTV coverage is needed to discourage the unauthorized removal or tampering of confidential patient records.

Revenue Sections. CCTV should be mounted above the register to monitor & observe all activity taking place at the register.

Stores. CCTV coverage is needed to discourage the unauthorized removal of expensive hospital stores.

Kitchen. CCTV cameras is needed to discourage unauthorised personnel entering the kitchen to pilfer food stores or tamper with the food.

Other critical areas that houses expensive equipment & other public access areas deemed important.

Positioning of CCTV Systems. Health facilities have a variety of CCTV camera coverage & field of view (FOV) needs based on risks identified through a security risk assessment.

CCTV cameras should be placed to capture pedestrian as well as vehicular entrances & exits. They should provide coverage & FOV of entrances, exits & entire length of passageways, including stairways, ramps & elevator lobbies. Multiple entrances & exits would require cameras at each location. Consideration should be given to bidirectional flow. CCTV cameras must be placed to observe & monitor certain locations to maintain a safe & secure environment for patients, staff, operations, critical infrastructure, equipment & supplies.

Camera placement should be optimized to avoid obstruction by other structures & by foliage. Cameras’ FOV should not be obstructed in any way. For foliage, the size of the planting at maturity & seasonal changes should be used as baseline.

Consideration should be given to ensuring adequate lighting is provided so that the cameras can provide the best image possible. However, the cameras should not be pointed directly at bright light sources such as picture windows, spot lights, etc. If bright areas cannot be avoided, cameras with backlight illumination or compensation adjustments are preferred to optimize the resulting image.

Care should also be exercised to ensure that cameras are not located in places where they may be subject to tampering &/or accidental adjustments.

Number of CCTV Cameras The number of cameras needed for any hospital depends on the specific security needs of each facility & the recommended area(s) to be monitored. Every hospital should have sufficient cameras to provide an overview of the facility.

Cameras should be placed where they can record images with an unobstructed view of each recommended area of the facility. Cameras that provide overviews of the interior & exterior aspects of a facility is useful in an investigation but generally cannot be relied upon to provide images suitable for identification purposes.

Moveable dome & pan/tilt cameras can be used to provide additional room coverage through automatic alarm pre-setting & parking.

Motion detection or door contact alarms can automatically initiate camera pre-sets to provide high-resolution views. This provides un-manned, additional target coverage. After a pre-determined time, the camera can return to a pre-set parked position or to a scanning pattern to cover site locations not viewed by the fixed devices. If the system contains a matrix switch with a joystick controller, a guard or observer can manually track a suspect giving a tightly zoomed, high resolution image of the suspect. Variable speed control & automatic focus are recommended to facilitate smooth target tracking. When in the parked position, the unit can serve as an additional fixed camera.

Setting FOV comes from understanding the intended mission of the camera. In practice this rarely goes beyond the setup of the detection area. However, as cameras become higher in resolution, there are more missions to consider.

A common mistake is to include “interesting areas” in the FOV, versus areas of interest.

For detection, it is typically better to have a FOV that is taken from a higher vantage point. This helps to avoid occlusions, allows for better understanding of the target’s current track & potential trajectory. However, a higher vantage FOV is not always conducive to facial or clothing identification, where the face or clothing are seen at an angle or blocked by a hat.

The opposite holds true, where a lower FOV results in better identification, but potentially poorer tracking & detection.

The problem in most instances is not whether to have a high FOV or low FOV, it is not understanding the benefits & drawbacks of each & not using the camera’s mission to drive the most appropriate height when setting the FOV.

Dome cameras are notoriously sensitive to both low & high amounts of light. As such, it is important to accurately assess how much light is in the area. The perfect area will have medium amounts of light. It is crucial not to mount dome cameras next to a light, as this will cause it to go in & out of focus as it tries to work out the optimum lens size to monitor the area. If an area is too dark for dome cameras, replace it with low light cameras, although the pictures produced will usually be black & white.

For most low light surveillance applications many opt for dome cameras with infrared LEDs. The LED’s allow the cameras to secure all areas with little or no light. Once the camera senses the lighting conditions are too poor for it to perform, it will trigger the LED lights & create its own light.

The likelihood of dome cameras being tampered with has to be taken into consideration too. Dome cameras are available in tamper & weather proof options. It is important to understand that CCTV cameras are not robust pieces of equipment & the best way to ensure that they are not damaged is to place them high up on a wall or on a pole.

The efficacy of CCTV monitoring & its impact on crime reduction in urban areas have already been questioned by the UK Home Office’s own research, which concluded that CCTV is an ineffective tool if the aim is to reduce overall crime rates & make people feel safer.

The impact of such technology on psychiatric wards is also open to question. The introduction of CCTV monitoring on psychiatric wards may be justified on the grounds that it might reduce the amount of violence & aggressive behavior in the same way as CCTV monitoring of streets. Psychiatric wards are unsafe environments for patients & staff who are working in them is not in dispute.

Patients & staff are more likely to access ward communal areas if they feel safe. Achieving a balance between safety & privacy for patients is indeed difficult. Mental health professionals have the right to be protected from those patients whose behavior is severely disturbed &/or who have become aggressive & violent. CCTV surveillance can also be used to protect patients from abuse by other patients & staff. Stored CCTV footage has the advantage of providing visible evidence where incidents of abuse have occurred.

It must be noted that in evaluative reviews, there have not been conclusive evidence that having CCTV cameras in place guaranteed a safe environment or prevented violent incidents from occurring.

Nonetheless, CCTV monitoring is perceived to offer greater security because staff place greater emphasis on the recorded images, regarding these as more accurate than their own recollection. Viewing recordings became the first thing to do when investigating & evaluating incidents in the wards. It was also found that there was no improvement in real-time response in preventing violent incidents even when security guards were monitoring the cameras continuously. By the time help arrived, the incident had already occurred.

 

Thus, the reality of using CCTV cameras as a deterrent does not necessarily lead to a violence-free environment, as the camera needs an operator to make professional judgements. The presence of CCTV cameras will not stop violent incidents from occurring. For some patients who experience paranoid symptoms, CCTV cameras have the potential to increase aggressive & violent behaviour.

 

Note – IP video technology provides hospitals with added flexibility in video surveillance installation, while offering benefits such as remote video monitoring & more effective storage capabilities. Having N+1 disaster tolerance mechanism, distributed & centralized storage strategies avoid data loss & makes the system much safer & more reliable.