Helping harden medical facilities against active shooter attacks

Law enforcement and hospitals need to work together on planning for violent scenarios

Increasingly, law enforcement agencies must be furnished with the most advanced training possible to be able to respond to a wide array of active shooter events. The Navy Yard attack and the Sandy Hook school shooting are just two recent events that point to the fact that such events happen in a wide range of places.

Hospitals are also vulnerable targets — in the past 10 years, violence in health care settings has increased — and they present critical challenges to the law enforcement community in terms of strategic response.

Violent incidents have come to medical facilities, too. In Long Beach, California, a pharmacy technician shot the pharmacy’s executive director and a supervisor and killed himself;  the shooter apparently feared he was going to lose his job. In Baltimore, Maryland, on learning of an unfavorable prognosis for his mother, a distraught man shot his mother’s surgeon in the hallway of the hospital. In Rockdale, Texas, a 77-year-old man went to the room of his bedridden wife, who suffered from dementia. He shot her in the head and killed himself.

Most shootings that occur in hospitals are due to domestic violence. In addition, it is not uncommon for human resource and financial personnel to be primary targets, as well as professionals in the patient relations department who are tasked with resolving patient complaints.

Hardening Our Hospitals 
It’s important for law enforcement and hospitals to engage in partnerships, working together to be prepared for violent scenarios. Though hospitals in various localities have been proactive, there are others that fail to address the issue because they won’t admit that bad things could happen in their facilities.

“Hospitals have a responsibility to say this could happen,” said Paul Ford, director of safety, security and transportation for Tampa General Hospital. Ford holds a PhD from the University of South Florida in Violence in Health Care and is well versed on safety issues and active shooter situations.

The proactive efforts conducted at Tampa General Hospital serve as an exemplary model of the interagency cooperation and collaboration. Ford works closely with the Tampa Police Department and the Florida Department of Law Enforcement.

“Police departments are a blessing to hospitals and should be sought after,” Ford said.

In addition to a substantial security force — some of whom carry guns and some who carry TASERs — the hospital has a Tampa Police officer employed on the campus 24/7. Though it may be costly to employ a police officer on site at all times, Ford feels it is well worth the cost.

“I can have a full response in two minutes,” Ford said.

Conducting Risk Assessments
Some estimates indicate that 90 percent of hospitals do not have armed security guards in their facilities. All major city hospitals need to carefully look at their environments and conduct a risk assessment for violence. 

“A dialogue needs to exist between first responders and our critical infrastructure partners. Partnering with law enforcement to perform a well-documented threat, risk, and vulnerability assessment is the first step a hospital administration should take to forge this relationship. An assessment will form the foundation from which to build a more secure facility by clearly identifying the gaps that need to be addressed,” said Garry Lisiewski, homeland security grant supervisor/coordinator for the Tampa Police Department.

Lisiewski pointed out that many of the recommendations from such an assessment will be low-cost solutions such as procedural changes. Local law enforcement can provide hospital security personnel with active shooter training so that they can be better prepared to respond until help arrives.

“Engaging the law enforcement community to perform a facility assessment will also provide the necessary justification for target-hardening equipment such as improved locks, lighting bollards, alarms, and cameras,” Lisiewski added. “Establishing these relationships before the need exists will not only ease the post-disaster response and recovery but, in most instances, save lives.”

Walking Through a Response
Law enforcement agencies need to know, in advance, the layout of the facility and have access to floor plans, diagrams, and exit locations. They also need to be aware of internal communication codes. Police need to be able to test their communication equipment, in advance, to see whether it works in labs, elevators, X-ray rooms, and other locations.

Law enforcement personnel need facility maps, keys, card access, entry options and the location of the hospital command center. Police and hospital leadership should also coordinate how public information officers will handle active shooter and other violent events.

Hospital staff must be provided intensive training and be given options on what to do in an emergency situation.

“Staff are not robots. You can’t dictate a person’s actions when a gun is pointed at them. You have to allow professional people to use their best judgment at the time that occurs,” Ford said.

“Training, observant employees, security layers, and the concept of run-hide-fight works and, in today’s world, we all need to be prepared anytime or any place,” concluded Arlington County (Va.) Police Chief, Doug Scott.

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