Healthcare News & Insights

Feds give guidance for handling shooters in hospitals

It’s the worse-case scenario for your hospital: There’s an active shooter in your facility.

465163643An angry patient in your hospital’s emergency department turns violent – and the person has a gun.

From there, chaos ensues. Patients and clinical staff are caught in the crosshairs as there’s a mad scramble to subdue the shooter.

With countless stories of tragic gun violence in hospitals making the news, it’s key to have a solid plan in place to mitigate any negative outcomes from a similar situation.

That’s why the Department of Health & Human Services (HHS) has just released a new report outlining what hospital staff should do if an active shooter is present in the facility.

Keys for your plan

The report lays out how hospitals should structure their response to a shooter, from the initial alert process to the moment when the shooter is subdued.

Rather than rely on vague alert language, such as “code silver,” the HHS report stresses that hospitals should use clear, easily identifiable terms when dealing with an active shooter. Reason: While staff may hear the alert and know to how to react, patients and visitors won’t understand its meaning. That confusion may put them in even more danger once they realize what’s going on.

Per the HHS report, being prepared for the threat of a shooting is a team effort. Each person on your hospital’s staff, regardless of their role, has three crucial responsibilities to keep your facility safe in the face of an active shooting situation:

  1. Learn the signs of a potentially volatile incident and how to prevent it from escalating
  2. Learn how to increase the chances that both the person and others survive a shooting incident, and
  3. Be ready to work with law enforcement during the incident to bring about the best possible outcome.

Assessing threats

As a way to prevent violent attacks before they happen at your hospital, the report suggests putting together a threat assessment team. The team should be made up of representatives from multiple departments, including executives, clinicians, HR and security staff. There should also be involvement from law enforcement and mental health professionals.

The team’s goal should be to identify behaviors from patients, or current and former staffers, that may be indicators of future violent activity in the hospital, and to keep these actions from escalating into violence.

Once the team discovers a threat, members come together to plan an interdisciplinary course of action, taking each individual’s department or area of expertise into account when crafting a plan.

If a shooter enters

Although being proactive by creating a threat assessment team can help prevent some incidents, the strategy isn’t foolproof. So if your hospital finds itself dealing with an active shooter, staff members should remember the three options they have to keep themselves and patients safe:

  • Run. In cases where danger is imminent and it’s safe to do so, running may be the best response. They should run as far as possible until they’ve reached a safe place.
  • Hide. Running may not be practical in every case – especially if the shooter is very close, or if there are patients with mobility issues who need to be protected. So the next best option is to hide in a place that’s not immediately visible to the shooter. Doors and entrances should be locked and barricaded, and blinds should be drawn on windows. Lights should be turned off and cell phones should be silenced. Staffers and patients in hiding should remain where they are until police give the OK to leave the premises.
  • Fight. While this may be the most frightening option, it’s actually very effective. In many cases, when active shooters were confronted by multiple people, they managed to incapacitate the shooter and stop the violent rampage. This shouldn’t be presented as a requirement, but rather an option if staff feel comfortable doing so with the resources at their disposal.

And, just as hospitals have routine fire drills, there should be an occasional “drill” to prepare for an active shooter as well. That way staff will have an idea of what to expect should the situation arise and can apply these three principles to their response.

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