5 Steps to Help Stop Gun Violence at Your Hospital

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Random gun violence plaguing the country can happen anywhere, and the shooting death in January of Dr. Michael J. Davidson, a Boston cardiothoracic surgeon at work on the premises of Brigham and Women’s Hospital, means hospitals are not immune.
In fact, health care facilities have seen a dramatic rise in violent shooter incidents. Recent research from the Journal of the American Medical Association indicates these shootings are becoming increasingly prevalent: “Active shooter incidents” at health care facilities have gone from nine per year from 2000 to 2005, to an average of 16.7 per year from 2006 to 2011.   
A recent article in Dotmed daily news presents a five-step strategic plan that health care facilities can use to limit the likelihood of active shooter incidents and mitigate potential damage that might occur. The five-step plan is part of a recommendation made by the US Department of Health and Human Services late in 2014, encouraging health care facilities to incorporate active shooter incident planning into their emergency operations plan.
1. Prevention
A critical first step is the performance of a Security Risk Assessment by a qualified professional. They can help facilities determine how well staff are following protocols already in place, and assess regional and social conditions, as well as offer specific action steps for facilities based on factors such as mental and behavioral health services provided.
2. Protection
Technological measures like metal detectors and cameras can help a facility respond to a violent shooter incident more readily, but well-trained staff who are alert and non-complacent can be the most crucial safeguard.
A recent CPI podcast interview with Dr. Sally Gillam, the Chief Nursing Officer at a large Texas hospital, underscores the importance of training and the possible effect of complacency on staff. Dr. Gillam conducted a peer-reviewed scientific study that indicated crisis intervention training had a proven effect at limiting violent situations but that the benefit of the training eroded significantly after 180 days. The erosion of benefit at that time may signal the limits of retention and the reintroduction of staff complacency.
3. Mitigation
Training staff in the techniques of de-escalation and crisis prevention can mitigate the risk of violence by using techniques that improve Therapeutic Rapport and quell anxiety while respecting personal space. 
Dr. Gillam’s study, referenced above, had in its findings a 23% reduction of violent incidents in a year’s time at a 75,000-patient-per-year emergency department pursuant to staff receiving Nonviolent Crisis Intervention® training.
4. Response
When an active shooter incident appears likely to occur, the FBI Critical Incident Response Group offers a training video that outlines three options: run, hide, fight. If possible, escaping the area and phoning authorities is best practice.
5. Recovery
In the wake of an active shooter incident, it’s important that health care facilities have a crisis communication plan that includes patients, staff, visitors, and appropriate media channels.
Health care facilities that neglect taking the appropriate action can find themselves legally liable should an incident occur.
A review of your facility’s readiness for an active shooter incident through the five steps listed above will ensure you are best able to prevent, protect, and respond for the maximum safety of all involved.
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