Transforming Access Control Across a Complex Healthcare System

A large, multi-hospital healthcare system experienced a deadly workplace violence incident that prompted leadership to re-examine how people, vehicles, and assets moved across its campuses. With more than 40 hospitals and over 600 medical facilities, the organization recognized that access control practices varied significantly by location and that existing approaches were not scalable, consistently governed, or defensible at the enterprise level.

The organization identified a need for an in-depth, data-driven review of access control for patients, visitors, vendors, staff, and vehicles. The goal was to improve safety and security while preserving the open, patient-centered environment essential to healthcare delivery.

Our Approach

Campus Observations and Data Collection

CSA worked with the client to identify four large hospitals that were representative of the system’s broader campus population. Across these sites, CSA observed approximately 175 unique building entrances, along with dozens of parking lots and garage access points.

Observations were conducted during daytime, overnight, and weekend periods to understand how traffic flowed on and within each campus, who was accessing facilities, and where controls were effective or lacking.

Interviews and Stakeholder Engagement

CSA conducted interviews with hospital leadership, security leadership, and frontline security personnel at each location. Discussions also included law enforcement partners and staff working across multiple shifts.

These conversations provided insight into both the actual and perceived security environment at each hospital, highlighting operational challenges, inconsistencies, and risk tolerance differences across sites.

Security Assessment

Using observation data, interviews, and CSA’s healthcare benchmarking experience, the team identified key findings related to primary and secondary building entrances, parking and garage access, wayfinding and signage, technology and system integration and general access control and security concerns.

CSA evaluated how existing controls supported or undermined safety, efficiency, and user experience, and where gaps created risk exposure or operational friction.

Presentation of Potential Solutions

CSA developed industry-aligned, best-practice recommendations focused on improving access control in a way that was both scalable and sustainable. Solutions addressed: wayfinding and signage improvements, lockdown procedures, weapon detection strategies, security patrol models, medical record flagging protocols, door alarms and monitoring, visitor management systems and panic alarm deployment.

CSA presented these findings and recommendations to project stakeholders and executive leadership, building alignment around a cohesive access control strategy.

Impact

Following leadership alignment, CSA supported the client in presenting the strategy to the Board. The organization was able to clearly articulate the risks of inaction, the operational and safety benefits of the proposed approach, and the long-term value of a governed access control program.

The Board approved a multi-year, eight-figure Security Access Control initiative to execute the recommendations across the healthcare system. The program was designed to improve patient and staff safety while enhancing the overall campus experience and ensuring long-term operational sustainability.

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