Shattuck Hospital was not designed as a correctional institution but has been used increasingly by the corrections department for major surgery and specialized medical care. The number of inpatients treated as outpatients increased from 1,537 to 2,156. Inmates needing treatment must be escorted through the general hospital area to the security ward. This situation complicates security management and places heavy burdens on the staff. A review of the security ward indicated that the initial security measures had already been accomplished but that mental patients housed in the same area should be moved to a different location to enable the staff to devote their attention to the inmates. Outpatient procedures and inpatient scheduling had several security weaknesses that would allow prisoners to plan an escape. Improved transportation and communications arrangements were recommended, and the study suggested that these procedures ultimately be automated to avoid unnecessary telephone calls. Vulnerabilities discovered in the outpatient holding area included insecure corridors, poor observation points, and unguarded bathrooms. An electronic locking system, a sallyport security door, convex mirrors, and closed circuit television were among the suggested remedies. The evaluation recommended the installation of more duress alarms, improvements to window security, and modifications to the nurses' station. The costs of the recommended equipment are listed and then categorized according to priority. The appendixes contain blueprints of the hospital and information materials on the security equipment.