The Need for Weapons Detection in Healthcare and Campus Environments

By Dylan Hayes, CHPA, CPP

As an experienced physical security professional and industry contributor, I chose to write this article because I'm extremely passionate about developing safe and secure healthcare, education and workplace environments.  More and more weapons detection screening systems are being deployed in to campus, organizations and businesses with good intent but poor execution and limited results.

Detecting some weapons creates a false sense of program effectiveness when 95% of weapons are being undetected. Keeping weapons outside buildings or off property can have a dramatic impact in the reduction of weapon violence, however, I notice consistent, significant, gaps and failures in weapons detection screening programs everywhere I visit. In my experience, weapons detection at non-government facilities is failing drastically at most organizations today. 

Is this effort a smoke and mirrors approach to look like an organization cares about creating a safety culture and simply change the perspective of security for a campus or business or it to actually achieve the goal of detecting weapons to reduce threats and keep dangerous objects out of the environment.  It is an extreme liability for an organization to implement weapons detection poorly and give a false sense of security.  I have walked through many facilities and found that very few actually perform weapons detection screening that would receive an A+ rating. In fact many receive an F. Is the approach that "we are doing something" good enough? Is the money to deploy and support these operations creating consistent and effective outcomes? The answer for the industry is No. This article is based on my personal experience, knowledge and research of the industry and my collaboration with colleagues.  

Hospitals implement weapons detection screening at emergency departments and other critical entrances for one key reason: violence in healthcare is rising faster than in almost any other industry. Hospitals, mental health/psychiatric units and emergency rooms are high-stress, emotionally charged environments where patients arrive in crisis, families are overwhelmed, and behavioral health challenges are common. Staff are assaulted, threatened, and verbally abused daily. Hospitals turn to weapons screening systems—like Evolv, Metrasens and Athena—not because it’s a nice-to-have, but because EDs are the most vulnerable portals to the entire hospital ecosystem.

Behavioral health patients, drug-seeking individuals, gang-related incidents, domestic disputes, and escalating wait-time frustration all contribute to an environment where weapons—knives, guns, metal tools, and makeshift objects—are a real risk. Screening is supposed to reduce this danger. Yet across the country, hospital leaders are unaware that their weapons detection systems are not delivering the safety outcomes they are expecting.  Weapons detection must begin with risk relevance and clarity.  Organizational leaders and security personnel must be clear about the outcomes desired and the capabilities and limitations of the technology, personnel and processes that perform this critical screening.

• Full divesting and removal of objects just like going through TSA or accessing a courthouse may be unrealistic and not the desired experience in healthcare.  Is everyone from the top down 100% clear which weapons are expected to be undetected when conducting a weapons screening? 

• Is it acceptable for smaller guns, knives, razor blades and needles to enter the perimeter of the facility?

• Is it acceptable for hidden razor blades and metal objects to enter the ED, Mental Health/Psychiatric Units or the MRI area?  Is the risk acceptance clear?

• How often is the screening process being audited to ensure flawless execution without gaps? 

  
  

Why? The failures usually fall into three categories: People, Process, and Technology.

Below is a breakdown of why your program may be underperforming—and the framework hospitals should adopt to fix it.

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The Most Common and Overlooked Point of Failure - People

Technology doesn’t run itself—people do. And when your frontline staff aren’t focused or diligently following procedure, even the most advanced weapons detectors will fall short.

A. Inadequate Training

Many hospitals install a system and provide an initial training overview. That’s not training—that’s exposure. ED entrance staff need repeated:

• Scenario-based practice (high-volume rushes, agitated patients, behavioral emergencies).

• Step-by-step drills on alarm response.

• Understanding of the system’s detection logic (what alerts, what doesn’t, what produces nuisance alarms).

• The ability to differentiate patient belongings from true threat items.

• Crisis de-escalation and communication skills.

  
  

Without this, staff will either underperform (not follow the basic screening procedures such as searching a bag or person) or underreact (ignoring alarms to keep the line moving).

B. Poor Staffing Levels

If one person is expected to manage a busy environment that includes:

• Bag checks

• Alarm responses

• Directing patients

• Operating the system

• Addressing or securing identified weapons

• De-escalation

• Throughput coordination

…that system will fail.

Weapons detection screening in busy environments is only effective when at least two trained personnel are present—one managing the line and questions and another managing alarms. Many hospitals staff only one entry monitor, leading to missed threats or unsafe interactions. Consider the presence of a weapon or escalated individual. Wouldn’t additional staff support be required to assist in that moment?

C. Misaligned Roles, Skills and Responsibilities

Some hospitals assign screening to:

• Security staff who rotate posts frequently

• Environmental services employees

• Patient access staff with no security background

• Contract security services with reduced experience, limited professional security experience and inattention to detail

  
  

While these teams are excellent at their primary roles, they may not have the security mindset needed to manage a weapons-screening environment. Successful programs designate a consistent, trained, and ongoing tested, team with clear authority and expectations.  The weakest and most common failure points I have personally come across is contract staff not following procedure and not appearing to care about conducting quality screenings.  All the cost of the technology and staffing, all the procedures, all the expectations from leadership FAIL when an individual fails.

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When Your Workflow Undermines Your Security - Process

Hospitals assume their tech is failing when the real issue is workflow design. A weapons detection system is only as strong as the processes wrapped around it.

A. Unclear Screening Policy

Many hospitals never formally define:

• What items are prohibited

• What happens when a weapon is detected

• Whether staff must confiscate or require the visitor to store items in their vehicle

• How to manage patients arriving by ambulance with possessions

• How to manage patients and visitors with wheelchairs, walkers and strollers

• Exceptions for law enforcement officers

• Rules for vendors, contractors, and couriers

  
  

Without a clear policy, staff improvise—and inconsistency is the fastest path to system failure.

B. Ineffective Triage and Throughput Management

The ED can fill up fast. When the waiting room spills into the hallway, staff often:

• Turn off screening temporarily

• May be distracted and wave people through without responding to alarms

• Allow groups to pass all at once

• Let bags go uninspected to “keep the line moving”

Throughput pressure can destroy the integrity of a screening program. Screening must be non-negotiable, even during peak volume.

C. Lack of a Standardized Alarm-Response Procedure

If an alert occurs, do staff:

• Ask the person to step aside?

• Physically check belongings?

• Use secondary screening tools?

• Call security?

• Allow the person to refuse?

  
  

A vague or inconsistent response leads to:

• Missed weapons

• Staff discomfort or fear

• Patients becoming frustrated or aggressive

  
  

A scripted, repeatable, documented response, backed by operations and legal leadership is essential.

D. No Continuous Improvement Loop

Hospitals often install a system and never:

• Audit alarm outcomes

• Track what items are most commonly stopped

• Review videos of failed detections

• Adjust placement, staffing, or signage

• Update training based on incident trends

  
  

Without data-driven improvement and audits, systems degrade quickly—especially with high staff turnover.

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When the System Is Not Configured for Healthcare Realities - Technology

While people and process issues are more common, technology can fail as well—especially when vendors oversimplify how “automatic” weapons detection really is.

A. Improper Placement

Weapons detection systems need:

• Straight walking paths

• Adequate distance from metal infrastructure

• Minimal ferromagnetic interference (wheelchairs, carts, stretchers)

• A controlled entry lane

  
  

Emergency departments, however, often place systems:

• In cramped vestibules

• Near security desks

• Next to metal-framed doors

• In traffic pinch points

  
  

Misplacement contributes to false alarms, blind spots, and inaccurate detection.

B. Miscalibrated Sensitivity Settings or Wrong Technology Selected

Many systems use machine learning models that weigh:

• Object signature

• Density

• Metal composition

• Threat likelihood

  
  

Hospitals sometimes:

• Turn sensitivity down to reduce nuisance alarms and allow more throughput

• Turn it up to “be extra safe,” causing throughput problems

• Apply the wrong threat profiles and tool for the wrong location

• Break-down or move equipment without recalibrating with each set up

• Use ineffective technology that does not detect small items like razor blades and needles. Hand wands depend on the skill of the operator and often cannot detect small blades or hidden objects even when used properly.  Today there are more reliable tools that do not heavily depend on skilled use of wands or technology.

  
  

The result? Either dangerous items pass through—or the system constantly alerts on harmless objects.

C. Over-Reliance on AI

AI-based systems are helpful, but not magic. They are not 100% reliable, nor do they replace staff vigilance. Weapons detection still requires:

• Human judgment

• Bag reviews

• Trained observation

• Secondary screenings

  
  

Hospitals that assume the tech will “just work” inevitably experience failures.

D. Lack of Integration With Other Security Systems

Screening is most effective when combined with “hard-wired” interfaced tools, technology and processes (meaning forced processes that eliminate inconsistency) such as:

• Video analytics

• Visitor management

• Panic buttons

• Radio communication

• Access control

• Incident reporting systems

  
  

Running screening in isolation limits the ability to respond effectively when a threat is detected.

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A Framework for Successful Weapons Detection Screening in Healthcare

To create a high-reliability program, hospitals need an integrated approach that balances people, process, and technology.

Below is a proven framework:

1. People Framework

• Create a dedicated, trained screening team (security + patient access).

• Train quarterly on:

  • Alarm response

  • De-escalation

  • High-stress scenario simulations

  • Behavioral threat recognition

• Ensure minimum two-person staffing per screening point.

• Assign clear authority for when to escalate and when to deny entry.

  
  

2. Process Framework

• Develop comprehensive weapons screening policies: prohibited items, steps after detection, storage/return protocols, and exceptions.

• Implement a standardized alarm-response script to improve consistency and reduce confrontation.

• Create a throughput management plan for peak-volume hours.

• Conduct monthly audits of performance, alarm data, and incident trends.

  
  

3. Technology Framework

• Ensure systems are properly placed, tested, and adjusted for your environment.

• Use correct threat profiles calibrated for healthcare realities.

• Integrate with video, incident reporting, and communication systems.

• Monitor and deploy technology firmware and software updates on a consistent schedule.

• Test technology performance using a testing kit at the beginning of each shift and any time technology is unplugged, moved or network communication or power has been lost.

  
  

Conclusion

Weapons detection screening in healthcare is not failing because the technology is flawed. It’s failing because hospitals often underestimate the complexity of creating a high-reliability screening ecosystem in the fast-paced, high-risk environment of an emergency department or the challenging environment with mental health and psychiatric patients.

When people are trained, processes are clear, and technology is optimized, screening can significantly reduce weapons entering your facility—protecting staff, patients, and the entire hospital community.

Dylan Hayes is a 25-year physical security technology expert and previously acted as the physical security program leader for Seattle Children’s Hospital and Research Institute. He managed teams, operations, and technology that transformed the culture of safety and experience for staff, visitors, and patients. Currently he is Security Solutions NW Healthcare Consultant.

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