A 2003 Pontiac Montana mini-van parked outside Rouge Valley Health System in Scarborough has RVHS vanity plates. It’s the Centenary hospital site’s lone patrol vehicle. The only reason the security department even has the van is because the hospital’s manager of security and parking, Martin Green, struck a deal with a local car dealership to donate it. He got someone else to donate the light bar on the top of the vehicle, and ongoing donations he solicits from the community are used to maintain the vehicle for the department. Last year, he also picked up some slightly-used DVRs when another colleague in the public sector was upgrading equipment.

It’s another example of how Green has become savvy in the ways of managing on a limited budget. Even though Rouge Valley Health System (RVHS) — which consists of Centenary Hospital in Scarborough and Ajax-Pickering in Durham Region — is experiencing some facility renewal, the security department continues to have limited resources so he finds way to keep his aging security system running and provides coverage the best way he knows how. The hospital is the only one in the GTA that doesn’t have a dedicated security officer permanently stationed in the ER. It also has aging camera infrastructure and is running a $78-million deficit.

Rouge Valley consists of several sites, including two community hospital campuses located 22 km part: Rouge Valley Centenary in east Toronto and Rouge Valley Ajax and Pickering in west Durham. Together they employ a team of 224 general practitioners, 325 specialists and 1,000 nurses.

The hospitals span one million square feet. Each hospital site sees 50,000 emergency room visits a year. RVHS is an acute care community hospital with programs including round-the-clock emergency support, cardiac care and mental health.

It’s a hospital group in the middle of several redevelopment projects. Centenary’s facilities are in three buildings — the oldest built in 1967 is not fully outfitted with a sprinkler system. A Birthing and Newborn Centre at Centenary opened on Dec. 10, 2008. This all-new addition to the Rouge Valley Centenary hospital campus (located at the corner of Ellesmere and Neilson Roads) is state-of-the-art with a Hugs infant protection system.

The Ajax-Pickering site’s new construction is scheduled to open this summer with a new ER, diagnostic imaging, lab services, complex continuing care and 30-bed continuing care unit.

About 20 mental health unit beds were also transferred to the Centenary site from Ajax in the fall of 2008 making Centenary the largest in-patient mental health unit in the GTA with a total of 60 beds. However, no additional resources came with that transfer for the security department and its role in assisting staff with those patients.

Green grumbles here and there about the financing of security in health care, and while he’s usually able to adapt, sometimes unfortunate incidents prove that his call for additional resources was appropriate.

Until a tragic event last April in which a man tried to stab himself to death, there was no means for the staff area of the ER to be locked down in an emergency — even though ER doctors had been asking for it for almost 10 years.

It took a $25,000 fix for mag locks to be put in place in the staff area because the doors were fire exits. Until that man attempted to take his own life, it wasn’t a priority item.

Another example was during the SARS crisis of 2003. The province eventually provided the funding to help the hospital ensure the emergency ward could be locked down electronically, but as with so many things in security, it took a tragic incident before action was taken.

 “It’s not that they didn’t want to do it, but other things compete for priority,” says Green who is also chairperson of the International Association for Healthcare Security and Safety representing Eastern Canada.

“If it comes down to me getting a lock on a door versus someone getting an IV at a bedside, the IV is always going to win. Sure, I’d like to have IP cameras, video analytics and all these cool toys, but when you’re faced with budgets that are so small and you’re competing with requests for new IV pumps, which way do you think it’s going to go? I managed to get new DVRs from a colleague at another public facility who was upgrading to IP.”