health care leadership certification

What to Delegate First When Your Practice Is Growing

Posted on by Joseph Gerard

A young doctor is sitting in the clinic and talking on telephone and doing paperwork that should be done by an an admin assistantWritten by Ashleigh Atuahene,

Before I, Ashleigh, co-founded Ataraxis, I spent years working inside the kind of practices I now help other people staff. I started on the administrative side, spending a few years in a physician’s office doing patient intake, scheduling, insurance verification, and prior authorization. Later I took a role providing one-on-one ABA therapy under a licensed therapist, and once that clinic realized I already had an admin and insurance background, the same kind of work found its way on my desk there too. Over time I handled intake, scheduling, chart QA, prior auths, and insurance verification across pediatric, internal medicine, and behavioral health. So when I talk about what to delegate first, I am not repeating something I read in an operations handbook. I watched practices get this right, and I watched practices get it wrong, sometimes from inside the same building.

Here is the question I hear most often from growing practices: what should I hand off first? Most owners assume the answer is “someone to answer the phones.” Sometimes it is. But the real answer depends on one thing, and that is how your practice gets paid.

Start With How You Get Paid

If you accept insurance, delegate billing and coding first. Not the phones, not the calendar. Billing. This is the part owners resist, because the phone is loud and the billing is quiet. The phone interrupts you all day, so it feels like an emergency. Billing sits in a queue and does not shout, so it feels like it can wait. It cannot. Every claim that goes out late, coded wrong, or missing a prior authorization is money you earned and may never collect. In behavioral health especially, where claims are denied more often than in general medicine, the person who owns your billing is the person who owns your cash flow. Hand that off to someone who does it well, and do it early.

If your practice is out-of-pocket or cash-pay, the situation flips. When there are no claims to chase, your bottleneck is not billing, it is access. In that case, delegate everything that touches the patient but does not generate a billable hour: new patient intake, new patient questions, taking messages, routing questions meant for the provider, screening the sales reps who want “just five minutes” with the office, and, yes, the scheduling everyone expects. The clinical hour is the product. Anything that pulls the provider out of that hour without adding revenue should be delegated, and a good virtual medical receptionist can absorb most of it.

Reducing Friction

When a practice grows, the growth is not invisible to your patients. They feel it. Scheduling gets harder to manage. Reaching the provider takes longer. Those small frictions are the first thing a patient notices, and they are the first thing that makes a patient wonder whether they should look elsewhere.

The goal of your first hire is to keep the patient from feeling the growth at all. Ideally, a practice at forty patients should feel as easy to work with as it did at ten. That does not happen by accident. It happens because someone whose whole job is responsiveness is standing between your expanding schedule and the person trying to book into it. 

The Cost of a Missed Moment

The larger a practice gets, the more opportunities start to fall through the cracks. Imagine a solo provider with a handful of patients. It is simple to manage the schedule, move an appointment, stay on top of notes, and answer a quick question between sessions. Now picture that same provider booked back to back all day. The moment their calendar fills up, they lose the ability to manage those small functions effectively.

Here is a real-life example I saw over and over. Your one o’clock is running late and calls to reschedule. If you have a light day, you see the message and move them in two minutes. If you are in back-to-back sessions with no admin, you will not even see that message until it is already one o’clock. That patient could have been rescheduled and the slot backfilled. Instead you have an empty hour, a frustrated patient, and a note you still have to write. Multiply that by a full calendar and you can see how a growing practice starts leaving money and goodwill on the table, not because demand dropped, but because no one was available to catch the moment.

Money Is to the Business What Gas Is to the Car

No one understands the value of the clinical hour better than the provider delivering it. You are paid on billable hours. Accumulate them and the practice runs. Let them drop and you cannot cover overhead, and you certainly cannot pay yourself without dipping into reserves. Money is to the business what gas is to the car. The good news about growth is that it brings more billable hours. The hard news is that it also brings a flood of administrative work, and that work does not bill.

In a landmark time-and-motion study, physicians spent close to two hours on documentation and desk work for every single hour of direct patient care (Sinsky et al., 2016). Behavioral health is often heavier still: a fifty-minute session usually generates another twenty-plus minutes of notes, before you consider billing, intake, or authorizations. And prior authorization deserves its own line. The American Medical Association found that physicians and their staff spend an average of thirteen hours per week, per physician, completing prior authorizations, working through roughly thirty-nine requests each week (American Medical Association, 2025). That is more than a full workday, every week, spent on paperwork where the rules keep changing.

So the math is simple, even if the decision feels hard. Your time is finite, and growth makes that scarcity impossible to ignore. Every hour you spend on a task someone else could do is an hour you are not billing. Why waste billable hours when you can pay someone twelve dollars an hour overseas, or thirty dollars an hour locally before benefits, to do well, when that same hour of your time is worth hundreds? Hiring is not the cost. Doing your own admin is the cost. It just does not show up on an invoice.

When You Get the Order Wrong

Delegating well is not only about what you hand off. It is about the order you do it in, and about being honest with yourself when something is not working. The practices I have been part of taught me this in different ways.

Hiring Too Late

At a small ABA practice, there was one admin who handled the phones, the schedule, and parent questions. She was capable, but she had little experience with insurance verification or prior auths and no time to learn them. I came in as an ABA therapist, and once they learned about my earlier admin experience, insurance work for three providers got delegated to me, the family therapist, the speech-language pathologist, and the ABA side. By the time I took it over, the practice was already swimming in denials and patching broken workflows. We got it back on track, but you cannot fully recover the time and income lost to mistakes made months earlier. Billing delegated late is more expensive than billing delegated early, because the denials compound while you wait.

Too Slow to Change

I also worked with a solo speech-language pathologist who did one thing right and one thing wrong. She hired an admin first, then brought on a billing specialist through an agency later, which is a reasonable order. Her mistake was not listening. When the billing specialist told her the claims were not collectible as submitted and the system was fighting them, she kept pushing to make it work instead of finding someone more adept. Even if a stronger specialist had cost more, she would have come out ahead. Delegation only works if you trust the person you delegated to, or replace them, rather than overriding the expertise you hired.

Getting the First Hire Right

More recently, I watched these same principles play out from the other side of the table as my team worked closely to help staff a small group therapy practice in San Jose with three clinicians. They were making their very first hire. The founder was not in crisis mode, which is exactly the point. She was still seeing her own clients while personally carrying the billing, the session submissions, and the scheduling, and what wore her down was the constant switching between being a clinician and being an administrator. In her words, she needed another brain.

What made this one go right came down to two decisions. First, she hired before the wheels came off, while she still had the bandwidth to onboard someone properly instead of handing over a mess. Second, she was honest about what mattered most. Her practice is bilingual, and an assistant who also spoke Mandarin would have been a nice bonus, but when it came down to it she chose deep behavioral health experience and a strong command of HIPAA and her EHR over the language skill. 

The person she brought on had a psychology background and already knew the systems her practice ran on, and she took over the session submissions, the billing, the out-of-network claims, and the scheduling at about twenty hours a week. That was enough to hand the founder her clinical focus back. The last thing she did right is the piece most first-time hirers skip: she wrote down her processes before the start date, so her new assistant was working from clear documentation instead of guessing. Get the right person and the right instructions in place, and the handoff is usually simple.

Where to Start This Week

If you take one thing from my experience, let it be this. Decide how you get paid, and delegate that pressure point first: billing if you bill insurance, patient-facing overhead if you are cash-pay. Delegate early rather than at the point of pain, because the mistakes made while you wait are the expensive ones. Trust the specialists you bring in, or move on quickly if they do not perform, but do not spend your own high-value hours overriding them. Growth is a good problem. It only becomes a bad one when the administrative load grows faster than your willingness to hand it off.

 

Ashleigh headshotAuthor’s Bio:

Ashleigh Atuahene is co-founder of Ataraxis. Before building the company, she provided one-on-one ABA therapy under a licensed therapist and spent years in healthcare administration, handling patient intake, scheduling, prior authorization, insurance, and documentation across pediatric, internal medicine, and behavioral health practices.

 

References

American Medical Association. (2025). 2024 AMA prior authorization physician survey. American Medical Association.

Sinsky, C., Colligan, L., Li, L., Prgomet, M., Reynolds, S., Goeders, L., Westbrook, J., Tutty, M., & Blike, G. (2016). Allocation of physician time in ambulatory practice: A time and motion study in 4 specialties. Annals of Internal Medicine, 165(11), 753–760.

 

 

 

Please also review AIHCP’s Managed Health Care Certification program and CE courses see if it meets your academic and professional goals.  These programs are online and independent study and open to qualified professionals seeking a four year certification

Why Every Healthcare Leader Should Understand Building Safety

Posted on by Joseph Gerard

A icon of a hospital building with a red cross on a blue background

Written by Lucy Peters,

When was the last time you walked into a hospital and thought about the roof? The answer is probably never, and that’s a good thing. If the lights turned on, and the elevators were running, and nothing seemed out of place, the building had already done exactly what it was supposed to do, which is to disappear into the background. Building safety is not typically discussed by anyone involved in the healthcare of a patient. We notice hospitals for the people inside them, which is usually the nurses moving quickly between patient rooms, and the physicians making difficult decisions.

But what happens when that infrastructure stops doing its job? For all the focus healthcare receives on issues of patient safety, as well as on infection prevention, on the number of medication errors and on quality improvement, too little attention is given to the physical environment in which all this is going on. So even though the healthcare setting is where all this care is given, that description of healthcare misses the fact that the building itself is what actively supports the work being done.

The systems no one notices 

Even for a senior healthcare leader, it would be very unusual to have to check the roof  membrane for damage, find the cause for a flickering light, or describe how air is kept moving safely through an Operating Theatre by means of an HVAC system. That’s the expertise of engineers, contractors, and facilities teams. But understanding why those systems matter, and what happens when they don’t work as they should, is an entirely different story. The building that delivers healthcare could easily be reduced to the four walls of the hospital, yet the structure around the activity delivers healthcare constantly and usually unnoticed on a daily basis. In a moment when the power fails for example the electrical failure will reveal itself to be a potentially disastrous problem for the scheduled surgery. Similarly, an unreliable ventilation system isn’t merely a maintenance headache, as it can actually affect infection control, patient comfort, and the environments where some of the most complex care is delivered.

The patient never sees the machinery

Most patients will never give a second thought to a hospital’s ventilation system, its backup generators, or the network of electrical and mechanical systems working quietly behind the walls. Nor should they have to. They arrive expecting those things to work, just as they expect the lights to come on when they flip a switch or the water to run when they turn on a tap. This type of confidence is part of what healthcare organizations spend years earning, even if patients rarely think about it in those terms. The moment those systems stop doing what they’re supposed to do, however, the experience of care changes. A procedure delayed because of a facilities issue feels very different from one delayed for a clinical reason. A broken elevator for instance, can create an enormous amount of hardship for patients with disabilities during what should be a routine appointment. In addition, patients can be affected by uncomfortable room temperatures and leaks in the waiting room, which can lead them to wonder whether the environment around them is being cared for as expected.

None of these situations say anything about the skill or dedication of the clinicians providing care, but the thing is, they inevitably shape how an organization is perceived. Patients rarely separate the quality of the healthcare they receive from the condition of the place where they receive it, because to them, it’s all part of the same experience. Perhaps that’s why building safety deserves to be thought of as more than an operational responsibility. Every functioning elevator, every reliable power supply, every well-maintained patient room contributes to something that is difficult to measure but incredibly easy to lose, which is confidence.

 

The workplace shapes the work

The same principle applies to the people providing care. Healthcare workers often spend more time inside these buildings than almost anywhere else. From nurses moving between patient rooms to technicians operating complex equipment and environmental services teams keeping spaces safe and functional, thousands of people depend on the facility around them every day. When the building works well, it becomes almost invisible, and that’s exactly how it should be.

But anyone who has worked in healthcare knows how quickly small building issues become everyone’s problem. An elevator that’s constantly breaking down. A clinical area that’s too hot. Repairs that are postponed again and again. On paper, these can sound like relatively minor inconveniences, but in practice, they become one more obstacle in professions that already operate under extraordinary pressure. Individually, they’re frustrating, and collectively, they add unnecessary friction to a working day that leaves very little room for it. And there’s another message hidden in a well-maintained facility, too. It tells employees that leadership values the place where they spend their days. Investing in the building is, in many ways, an investment in the people who make healthcare possible.

Look up

Perhaps no part of a healthcare building illustrates this better than the roof. The roof is easy to forget about until there is a problem, and yet it is a critical component of a hospital. The roof protects valuable healthcare assets including patient rooms, surgical suites, imaging equipment (many of which have very high value), IT infrastructure, pharmaceuticals, and most importantly patients and their families 24/7. When it comes to hospitals in tornado-prone regions, that responsibility becomes even greater. Communities across parts of Texas, Oklahoma, Kansas, Nebraska, and surrounding states face weather conditions that demand more than routine maintenance. Strong winds, flying debris, and increasingly unpredictable storms mean roof replacement can’t simply restore what was there before, but should also improve resilience for the future. Instead of rebuilding a healthcare facility for yesterday’s weather, we need to prepare for tomorrow’s weather. That’s not a question of building, but of providing continuity of care. A strong roof is important not only in case of rain but also to ensure patients can still receive treatment, staff can continue working safely, and communities have access to healthcare precisely when they need it most.

 

So, What Does Understanding All of This Actually Mean for Healthcare Leaders? 

It means they get to ask the right questions, stay curious, and recognize that a small issue now can become a much bigger problem, sometimes, in just a matter of hours. Is the emergency generator ready if the power fails? Are the people in charge of maintenance actually taking care of recurring concerns about the hospital? Are the people planning renovations for the hospital thinking about risks to the hospital instead of just looking at what happened in the past? Whilst not the most exciting of questions in the boardroom, these are of critical importance to enable an organization to respond when something unexpected happens. A hospital is not just four walls, a roof, and a place where doctors and nurses work. The building itself helps make healthcare possible, and when the systems behind the scenes are reliable, everyone inside can focus on what matters most, which is taking care of patients.

Author bio

Lucy is a freelance writer who enjoys contributing to a range of publications, both in print and online. She spent almost a decade working in the care sector with vulnerable people before taking a step back to start a family and now focuses on her first love of writing.

 

 

 

Please also review AIHCP’s Health Care leadership Certification program and CE courses see if it meets your academic and professional goals.  These programs are online and independent study and open to qualified professionals seeking a four year certification

How Small Clinics Streamline Vendor Payments

Posted on by Joseph Gerard

Please also review AIHCP's Healthcare Case Management Certification and see if it meets your academic and professional goals

Written by Sarah Jenkins,

In the intensity of small clinic operations, it’s typical to see focus placed on providing the best outcome for service users, which inevitably means making compromises in other areas due to a lack of adequate people power. Such a strategy might make sense from moment to moment, but the big-picture perspective provides clear evidence that if important pieces of admin are sidelined, the knock-on effects can be catastrophic. Imperfect vendor payment management is a prime example, as missteps here can leave dents in your medical supplies and even have a deleterious impact on facility upkeep.

All of this sounds daunting. But the reality is that making the most of modern tools and tactics can iron out all manner of issues with paying vendors promptly.

If you’re still on the fence about whether it’s actually necessary to take action, consider the fact that processing an automated invoice takes 3.3 days, compared to 2 weeks for manual systems, according to the CAQH Index Report. Such a dramatic reduction in time, as well as the shift away from manual processes which would otherwise monopolize the working day of at least one team member, allows office managers to focus on patient coordination rather than tracking down lost paper trails or managing disgruntled contractors waiting on late payments.

Building The Foundation Of A Reliable Intake System

The efficiency of a vendor payment workflow is like medical billing, in that it’s determined early on, long before a check is cut or an ACH transfer is initiated. It begins during the vendor onboarding phase, where legal and financial expectations are set. Many clinics fail because they treat onboarding as an afterthought, leading to frantic requests for W-9 forms during tax season or payment delays when insurance certificates expire.

Standardizing the intake process ensures that every service provider, whether they are a recurring medical waste disposal company or a one-time flooring contractor, meets the clinic’s compliance standards. Collecting a Form W-9 before the first invoice is processed is a non-negotiable step that prevents backup withholding penalties from the IRS. Without this document, the clinic remains at risk for significant fines during an audit.

For specialized facility repairs, such as HVAC or plumbing, the documentation becomes even more granular. Administrators need to verify that contractors carry the appropriate liability insurance and workers’ compensation coverage to protect the practice from litigation. A centralized digital repository for these documents ensures that payments are never issued to non-compliant vendors, creating a natural gatekeeper for the clinic’s funds.

Small clinics often find success by adopting digital tools that mimic the transparency found in professional service industries. When a clinic works with tradespeople, they often encounter a contractor estimate app like Joist which provides clear, professional breakdowns of labor and materials. This level of detail helps administrators understand exactly what they are paying for, allowing for faster internal approvals and reducing the back-and-forth communication that typically slows down the accounts payable cycle.

Establishing clear communication regarding payment terms is the final piece of the intake puzzle. Most vendors default to Net 30 terms, but clinics can often negotiate better rates or prioritized service by offering shorter windows, such as Net 15, in exchange for a small early payment discount.

Streamlining Approval Tiers And Purchase Orders

Once a vendor is onboarded, daily invoice management requires a structured hierarchy to prevent unauthorized spending and ensure accuracy. The use of Purchase Orders (POs) is a gold standard in healthcare because it creates a pre-approved spending limit for specific services. When an invoice arrives, it is matched against the PO and the packing slip, a process known as three-way matching.

Approval tiers add a necessary layer of security, especially in clinics with multiple departments or locations. For example, a department head might have the authority to approve medical supply orders up to $500, while any facility repair exceeding $2,000 might require the signature of the practice manager or the physician-owner. This prevents “maverick spending” and ensures that the clinic stays within its monthly operational budget.

To maintain a smooth workflow, clinics should follow these specific steps:

  • Digital capture of all incoming invoices through a dedicated email address
  • Automatic routing to the designated department head for initial verification
  • Final authorization by the practice manager before the payment is queued

Moving away from physical sign-offs is essential for clinics that want to remain agile. Paper-based approvals are notorious for getting buried under patient charts or lost in inter-office mail. A digital approval workflow provides a time-stamped audit trail that shows exactly who approved a payment and when, which is invaluable during year-end financial reviews.

Emergency repairs often bypass the standard PO process, leading to chaos in the general ledger. To mitigate this, clinics should establish “emergency spending caps” for trusted vendors. If an HVAC unit fails during a summer heatwave, the facility manager should have pre-authorized approval to approve the repair up to a certain dollar amount without waiting for a board meeting.

Transitioning To Secure Digital Payment Methods

The final stage of the workflow is the actual disbursement of funds. While paper checks were once the backbone of small business commerce, they are increasingly viewed as a liability in 2026. Data shows that paper checks remain the primary target for fraud, accounting for 63% of payment security breaches.

ACH transfers and virtual cards have emerged as the superior alternatives for small clinics. ACH is cost-effective and integrates directly with most accounting platforms, reducing the manual labor required for reconciliation.

Virtual cards go a step further by offering “single-use” credit card numbers for specific transactions. This is particularly useful for one-time vendors or emergency contractors, as it allows the clinic to set a strict limit on the card that expires immediately after use.

Virtual cards also provide automated reconciliation. Because each card is tied to a specific vendor or project, the accounting software can automatically categorize the expense, saving the bookkeeper hours of manual data entry. This level of precision ensures that the clinic’s financial statements are always up to date and accurate.

Managing change orders in construction or facility maintenance is another area where digital payments shine. When a roofing contractor discovers unforeseen damage during a repair, the budget can shift instantly. Having a digital system that allows immediate adjustment of a virtual card limit or rapid approval of a revised estimate prevents project delays and keeps the vendor-client relationship healthy.

Ensuring Audit Ready Records And Compliance

The ultimate goal of a streamlined vendor payment process is to produce records that can withstand the scrutiny of an audit. Whether it is a routine tax audit or a more rigorous healthcare compliance review, the clinic must be able to prove that every dollar spent was authorized, documented, and paid to a legitimate entity.

A centralized document management system links the original estimate, the approved PO, the final invoice, and the payment confirmation. This “golden thread” of information prevents double payments or fraudulent invoices from slipping through the cracks. In a high-stakes environment like healthcare, this transparency is the best defense against financial mismanagement.

Standardizing these processes also simplifies the transition in the event of turnover among administrative staff. When the workflow is documented and digital, a new office manager can quickly understand the status of every pending invoice without having to dig through filing cabinets. It creates institutional knowledge that protects the clinic’s operational continuity.

For more insights on optimizing the administrative side of your healthcare practice, we recommend exploring our internal blog resources on medical billing efficiency and practice management strategies.

Integrating Service Professionals For Smooth Facility Management

Facility maintenance often presents the most volatile variable in a clinic’s budget due to the unpredictable nature of structural repairs. The majority of plumbing calls qualify as emergency dispatches, meaning a clinic’s payment workflow must be agile enough to handle immediate billing without compromising oversight. When a pipe bursts or the HVAC fails, the administrative team cannot afford to spend three days debating internal approvals while the lobby floods.

Modern medical administrators are increasingly looking toward the service industry for cues on how to handle these rapid-fire transactions. Many elite tradespeople provide transparent, line-item quotes that can be approved via a smartphone in seconds. By demanding this level of professional digital documentation from your HVAC or electrical partners, you eliminate the guesswork from facility overhead.

The goal is to create a symbiotic relationship in which the vendor is paid instantly for their expertise, and the clinic retains a clean, audit-ready record of the work performed. This prevents the common trap of verbal agreements that lead to billing disputes six months later during a financial review. A structured payment path for these external pros ensures the physical environment remains as healthy as the patients being treated inside it.

Modernizing The Clinical Back Office

Implementing these changes requires an initial investment of time and a shift in mindset, but the long-term rewards are undeniable. By moving toward a digital-first approach to vendor payments, small clinics can reduce their overhead costs, strengthen their relationships with essential service providers, and protect themselves from the growing threat of financial fraud.

The transition from manual chaos to automated precision allows the clinic’s leadership to focus on what matters most: providing exceptional patient care. When the lights stay on, the supplies are stocked, and the contractors are paid on time, the entire ecosystem functions at its highest potential.

Author Biography

Sarah Jenkins, MHA

Sarah is a veteran practice management consultant with over 15 years of experience helping small and mid-sized healthcare facilities optimize their operational workflows. She holds a Master of Health Administration and is a certified Healthcare Financial Professional. Sarah specializes in the intersection of clinical excellence and administrative efficiency, focusing on how digital transformation can reduce burnout in the medical office.

 

References

Internal Revenue Service. (2025). About Form W-9, Request for Taxpayer Identification Number and Certification. https://www.irs.gov/forms-pubs/about-form-w-9

AFP. (2025). 2025 AFP Payments Fraud and Control Survey. https://www.financialprofessionals.org/training-resources/resources/articles/Details/companies-stick-with-check-payments-despite-fraud-risk

CAQH. (2025). The 2025 CAQH Index 

https://www.caqh.org/insights/index-report

 

 

 

Please also review AIHCP’s Health Care Leadership Certification program and CE courses see if it meets your academic and professional goals.  These programs are online and independent study and open to qualified professionals seeking a four year certification

Hospital Consumables and Clinical Outcomes: What Procurement Choices Mean at the Bedside

Posted on by Joseph Gerard

Doctors wearing gloves giving a thumbs upWritten by Kelton Lewis & editorial team at MAP Medical,

Gloves, IV bags, and administration sets sit in every supply room, but their specifications shape infection rates, medication errors, and nurse workload in ways that purchase orders rarely reflect. Barrier failures, incompatible tubing, and inconsistent sizing show up first at the bedside, not in procurement dashboards. Facilities that source wholesale hospital supplies from distributors with documented quality controls give clinical teams something most contracting conversations overlook: consistency from one lot to the next.

Supply variation is not neutral. When a unit’s glove brand changes mid-week, nurses relearn tactile feedback, donning friction shifts, and occupational allergen profiles can move. When IV sets change manufacturers, Y-site port spacing, roller-clamp resistance, and drop factors may differ in ways that raise the cognitive load of high-acuity care. These small mismatches accumulate, which is precisely why value analysis committees staffed by clinicians, rather than contracting staff alone, should drive catalog decisions.

Gloves are the highest-volume consumable in any healthcare facility and a useful case study for these decisions. When a nurse or infection preventionist evaluates medical supplies gloves for formulary inclusion, four characteristics matter more than unit price: barrier integrity under use conditions, allergen profile, chemical resistance for expected tasks, and donning ergonomics. The regulatory baseline for these products is also specific enough to shape contract language.

The regulatory floor for medical gloves

Medical gloves function as primary barriers under OSHA’s Bloodborne Pathogens Standard, 29 CFR 1910.1030, which requires employers to provide appropriate PPE wherever occupational exposure to blood or other potentially infectious materials is reasonably anticipated (Occupational Safety and Health Administration, 1991). Every medical glove sold in the United States is a Class I reserved medical device that requires 510(k) premarket notification. Under 21 CFR 800.20, the Food and Drug Administration applies a minimum acceptable quality level (AQL) of 1.5 to surgical gloves and 2.5 to patient examination gloves, using the ISO 2859 sampling plan and a water-leak test method (U.S. Food and Drug Administration, 2024). A 2.5 AQL means that, statistically, up to 2.5 percent of gloves in a batch may contain pinhole defects and still pass inspection. Many health systems now specify 1.5 or lower for all exam gloves, particularly in oncology, emergency, and critical care units, where barrier reliability is non-negotiable.

Since January 18, 2017, powdered surgeon’s gloves, powdered patient examination gloves, and absorbable powder for lubricating a surgeon’s glove have been banned under the FDA’s final rule published at 81 FR 91722. The agency found these products to present an unreasonable and substantial risk of severe airway inflammation, hypersensitivity, and peritoneal adhesions, and determined that labeling changes could not mitigate these risks (U.S. Food and Drug Administration, 2016). Procurement specifications should still explicitly require powder-free product, because the ban does not apply to powdered radiographic protection gloves, and cross-border sourcing of non-compliant stock remains a risk.

Material selection in practice

Nitrile

Nitrile has become the clinical default for non-surgical use across most U.S. health systems. It is latex-free, has strong puncture resistance, and performs reliably against common disinfectants. For oncology and pharmacy personnel handling antineoplastic agents, United States Pharmacopeia General Chapter 800 requires gloves tested under ASTM D6978 for chemotherapy drug permeation, along with double-gloving during compounding and administration (United States Pharmacopeial Convention, 2019). Facilities should stock these chemotherapy-rated gloves as a separate line item from standard exam inventory, and pair them with compliant gowns and engineering controls.

Latex

Natural rubber latex still offers the most refined tactile feedback, which is why many surgeons continue to prefer it for procedures that require fine motor control. Its drawback is well documented: occupational IgE-mediated sensitization in healthcare workers, with reported worldwide prevalence averaging around 9.7 percent and rising higher in populations with intense latex exposure prior to the shift toward powder-free and synthetic alternatives (Wu et al., 2016). Facilities that stock latex for surgery should maintain synthetic alternatives for latex-sensitive staff and patients, and a latex-safe protocol for known allergies.

Vinyl

Vinyl gloves are suitable for brief, low-risk tasks such as environmental services, food handling, and certain non-sterile support functions. They are a poor choice for sustained patient contact, venipuncture, or any scenario where barrier integrity must hold under stretch.

IV administration sets and medication safety

Infusion-related errors remain among the most frequent preventable harms in acute care. The 2024 INS Infusion Therapy Standards of Practice, now in its ninth edition and published as a supplement to the Journal of Infusion Nursing, establishes evidence-based expectations for device selection, care, and evaluation across the infusion pathway (Nickel et al., 2024). Several design elements deserve specific attention during procurement.

Free-flow protection

An administration set without integrated anti-free-flow protection can deliver an uncontrolled gravity bolus when tubing is removed from a pump. Free-flow protection should be a baseline specification for any set used with electronic infusion devices, and the clinical team should confirm that the mechanism engages automatically, rather than requiring a separate step by staff.

DEHP-plasticized tubing

Di(2-ethylhexyl) phthalate is a plasticizer historically used in PVC tubing. It can leach from tubing into infusates, with leaching rates highest in lipid-containing solutions. In its 2002 public health notification, the FDA identified male neonates, pregnant women carrying male fetuses, and peripubertal males as populations of concern, particularly during total parenteral nutrition, ECMO, and multi-device procedures in the NICU (U.S. Food and Drug Administration, 2002). DEHP-free tubing is now standard in NICU, PICU, and oncology settings in most U.S. health systems, and should be specified explicitly in purchase contracts for those units.

Drop-factor standardization

Macro-drip sets (typically 10, 15, or 20 gtt/mL) and micro-drip sets (60 gtt/mL) serve different clinical purposes. Mixing drop factors on a single unit invites calculation errors when staff revert to manual rate verification during pump downtime. Facility-wide standardization, supported by written policy and clear labeling, reduces this risk.

Supply chain resilience after 2020

The COVID-19 pandemic exposed the fragility of single-source consumable procurement. Glove shortages, IV fluid allocations, and PPE rationing forced many U.S. hospitals to rebuild sourcing strategies. Dual-source agreements, real-time PAR-level dashboards, and formal substitutability testing for backup SKUs have become the new baseline. Nurses, who see empty bins before they appear in a report, are the most reliable early signal in this process and should be invited into sourcing reviews rather than informed of their outcomes.

The clinical voice in value analysis

Clinical staff surface evidence that contract bids cannot: tear rates on 12-hour shifts, skin reactions that emerge over weeks, tubing kinks in crowded corridors, pump alarms that correlate with a specific set design. Formalizing nurse participation on value analysis committees consistently produces better formulary decisions and stronger staff engagement with supply protocols. The financial case is also direct: a product that reduces one medication error or one catheter-related bloodstream infection pays for significant price differences many times over.

Choosing a wholesale partner

A supplier’s role is not limited to fulfillment. Clinical teams benefit from partners that can produce FDA 510(k) documentation, ASTM test reports, and lot-level quality data on request. MAP Medical is a distributor of medical products for clinics, hospitals, and surgical centers, carrying gloves, IV bags, IV sets, and other daily consumables supplied under the quality standards outlined here.

About the authors

This article was prepared by the editorial team at MAP Medical, a U.S. distributor of medical consumables to clinics, hospitals, and surgical centers, together with Kelton Lewis, Managing Manager. The team draws on direct experience supporting procurement, infection prevention, and nursing leadership across acute-care facilities.

References

Nickel, B., Gorski, L., Kleidon, T., Kyes, A., DeVries, M., Keogh, S., Meyer, B., Sarver, M. J., Crickman, R., Ong, J., Clare, S., & Hagle, M. E. (2024). Infusion therapy standards of practice (9th ed.). Journal of Infusion Nursing, 47(1S Suppl. 1), S1-S285.

Occupational Safety and Health Administration. (1991). Bloodborne pathogens standard, 29 CFR 1910.1030. U.S. Department of Labor.

United States Pharmacopeial Convention. (2019). USP general chapter <800>: Hazardous drugs-handling in healthcare settings. USP Compounding Compendium.

U.S. Food and Drug Administration. (2002). Public health notification: PVC devices containing the plasticizer DEHP. Center for Devices and Radiological Health.

U.S. Food and Drug Administration. (2016). Banned devices: powdered surgeon’s gloves, powdered patient examination gloves, and absorbable powder for lubricating a surgeon’s glove. Federal Register, 81(243), 91722-91731.

U.S. Food and Drug Administration. (2024). Patient examination gloves and surgeons’ gloves; sample plans and test method for leakage defects; adulteration, 21 CFR 800.20. Code of Federal Regulations.

Wu, M., McIntosh, J., & Liu, J. (2016). Current prevalence rate of latex allergy: Why it remains a problem? Journal of Occupational Health, 58(2), 138-144.

 

Please also review AIHCP’s Health Care Management Certification program and CE Courses see if it meets your academic and professional goals.  These programs are online and independent study and open to qualified professionals seeking a four year certification

Healthcare Facility Security: Why It Matters

Posted on by Joseph Gerard

A stethoscope over computer keyboard Written by Marchelle Abrahams,

One of the biggest challenges facing healthcare facilities these days is the rising number of security threats. Hospitals all over the world deal with physical threats, the risk of cyberattacks, and even problems with internal safety daily. In fact, the healthcare sector has quietly become one of the most targeted in the world.

The numbers tell the story. In 2024 alone, more than 250 million Americans had their health records compromised. As if that wasn’t bad enough, many nurses have said that they have experienced at least one incident of workplace violence in the past few months.

The message couldn’t be clearer: security is no longer a nice-to-have for healthcare facilities. It’s fundamental. If your facility isn’t protected, everything else is at risk. Patient trust. Staff morale. Daily operations. All of it.

So what does healthcare facility security look like in real life, and more importantly, how can you get it right? Let’s discuss.

What Security Means in Healthcare

When you hear “healthcare security”, you probably picture a guard at the front desk checking IDs. That’s a part of it, but it’s not all there is to it.

True healthcare facility security is multi-layered. As you already know, there will be a physical security guard at the front desk checking for IDs and watching out for trouble. You also have cameras, badge readers, and other forms of biometric security so that only authorized people can access certain areas. 

Then there’s occupational health and safety. This involves providing healthcare personnel with PPE, ventilation systems, as well as your protocols for handling biohazards.

Facilities also need safeguards for patient records, billing systems, and even medical devices. Why? Because a successful breach can cost facilities up to $7.42 million, according to the HIPAA Journal. Healthcare cybersecurity is non-negotiable.

If your facility is located in a rough neighborhood, healthcare safety means having the right legal safeguards and response plans in place.

Bottom line? Healthcare security isn’t just stopping threats. It’s keeping the entire system stable, safe, and running without a hitch.

Key Areas of Protection in Healthcare Facilities

So, what are the key security or protective measures that should be put in place? We already mentioned them briefly earlier. Let’s now go in-depth.

Physical Security

It starts with the physical security. This covers trained security personnel who check IDs and do bag checks. It also involves access control systems and CCTV surveillance that covers high-risk areas like ICUs, operating rooms, and drug storage facilities. 

The idea is that not everyone can go everywhere within the facility. But facilities are also moving beyond traditional bag checks and manual screening. 

Hospitals are now installing metal detectors like those used in airports. This trend has become even more popular since the Carilion Roanoke Memorial Hospital attack. On Christmas Day 2024, a man walked into the hospital’s trauma center with a hatchet and attacked a physician. 

He was able to carry out the attack because there was no system in place to detect the weapon. That’s changing. Systems like the CEIA OPENGATE detector allow people to walk through without stopping or removing personal items, while still detecting weapons like knives or firearms. 

According to GXC Inc., these detectors are fast, reliable, and less intrusive. And honestly, more practical in high-traffic environments.

Occupational Health and Safety

Your staff faces risks that go beyond angry patients. They also deal with exposure to biological hazards, chemicals, and infectious diseases. The COVID-19 pandemic was a real eye-opener. It showed just how vulnerable healthcare workers can be in these environments. 

That’s why healthcare security should also cover protection against these threats.

Let’s also not forget physical injuries from patient handling, as well as ergonomic strain from repetitive tasks. Hospital nurses are the most affected, with one source reporting that up to 83.9% of nurses experience symptoms of musculoskeletal disorders.

As a hospital admin, it’s on you to put clear policies in place. Not just on paper, but in practice. Proper lifting techniques, better equipment, and realistic shift structures can go a long way in reducing these risks.

Data and Asset Protection

We’ve already touched on the cost of healthcare data breaches. But honestly, the financial loss is just one part of the story. Think about the loss of reputation, as well as the legal consequences that will follow when patients’ personal information is stolen. And worse, sold on the black market.

This is a real and growing threat, and healthcare facilities need to take it seriously. At the very least, this means strong EHR security, firewalls, and encryption, and providing regular staff training on cybersecurity. These are non-negotiable basics. 

You may also want to consider taking on a cybersecurity expert. That could be an in-house role or an outsourced partner, depending on what makes sense for your setup. 

The goal is to ensure that patients’ information is safe within your system.

Protection in Conflict Zones

For facilities operating in rough neighborhoods or conflict zones, the stakes are even higher. 

In conflict zones, hospitals and medical facilities might have some leverage, but only just. And that wiggle room can be found in the Geneva Convention, which states that healthcare facilities are not to be attacked as long as they are fulfilling a medical function. 

But the truth is a lot different.

There are always attacks on healthcare facilities in these areas. In fact, health facility attacks intensified in the past couple of years, with more than 900 health workers killed in 2024 alone. 2025 was even worse.

Knowing that there’s a law somewhere protecting your facility is one thing, and it may not be enough. You need to have an actual security plan that reflects the risk to your facility.

The same thing applies if your facility is located in a rough neighborhood.

Why Security Is Critical in Healthcare

Maybe your healthcare facility has been enjoying people and tranquility, and now you’re wondering, “Why bother?” Here are three reasons to care.

  1. Patient and Staff Safety. First, it keeps people alive. Your patients and your staff. A secure facility has fewer injuries, fewer infections, and fewer incidents. People trust you more when they feel safe.
  2. Operational Continuity. Next, it keeps your doors open. A data breach can shut down your facility for weeks. A violent incident? It can also shut you down for weeks while the authorities investigate. Bottom line? Security failures cost money.
  3. Financial and Legal Exposure. According to the American Hospital Association, violence can cost healthcare facilities an estimated $18.27 billion. It might not be that much for your facility, but you get the picture. Without a proper security posture, you’re exposed both financially and legally.
  4. Reputation. Finally, it protects your reputation. It takes little to damage the reputation you’ve spent years building. One bad breach. One viral video of a fight in your waiting room. Suddenly, nobody trusts you anymore. Hospitals run on credibility. Lose that, and you lose everything.

Is Your Healthcare Facility Secure Enough?

Now that you know why security is important in healthcare facilities, ask yourself, is your security system secure enough?

The truth is that when your doctors and nurses feel safe, they provide better care. When patients feel secure, they heal faster. And of course, better patient outcomes speak well for your hospital.

So, investing in hospital security isn’t just an item in your budget. It’s an investment in your people, your patients, and your community.

Just like you wouldn’t run a hospital without electricity, don’t run one without real protection either.

Author Bio:
Marchelle Abrahams

Writer by day, dream catcher by night. Marchelle Abrahams cut her teeth during the infancy of the internet when the dial sound of the modem was more than a soundbite at a rave. Not a Millennial and not a Boomer, Marchelle is an in-betweener, making her a special breed of human. As a qualified journalist, Marchelle believes her superpower is stringing a few words together and people reading them. That, and the ability to take her kids on with her unique brand of gnarly comebacks

 

 

Please also review AIHCP’s Health Care Leadership Certification program and CE courses see if it meets your academic and professional goals.  These programs are online and independent study and open to qualified professionals seeking a four year certification