Learn how Huntington Hospital, along with law enforcement and
fire department partners, quickly and effectively planned not
one, but four active shooter training exercises within our
facility in just 4 months. Our education department filmed the
sessions and interviewed staff to create a training video for
those unable to attend, which will be shown during the
presentation. We will share lessons learned and highlight how
hospital leadership and our planning team worked together to
ensure this training was successful for our employees while
minimizing impact on hospital operations.
Presenters:
Jennifer Waldron, MBA-HCM, BSN, RN,
Disaster Program Manager, Huntington Hospital
Darren Morgan,
Director-Security/Disaster Services, Huntington Hospital
Oct 3, 2023 | Disaster Planning for
California Hospitals
Overview:
Health care workers are particularly at risk of experiencing
workplace violence. The range of potential violence is broad and
can include simple acts of aggression to significant acts of
physical violence. As organizations work to better understand the
dynamics of workplace violence, additional attention needs to be
paid to the effect acts of workplace violence have on our
employees and organizations.
K9s represent an effective way to prevent and reduce hospital
violence and increase safety for patients, staff and visitors.
This panel discussion explores the pros and cons of using
protection dogs in hospitals and/or hospital emergency rooms.
Presenters currently work in hospitals using protection dogs or
with security companies providing canines for hospital security.
Presenters:
Mark Bosque, Founder & CEO, K9
X-Factor
Marcus Brown, K9 Security Officer,
Pomona Valley Hospital Medical Center
Mike Dunning, Principal Consultant,
The Healthcare Security Consulting Group, LLC
Michael Vestino, Dr, PH, MHA, EML,
FACHE, Vice President of Support Services, Pomona Valley
Hospital Medical Center
An active shooter event is likely one of the worst events that
can happen within a medical facility due to trauma, loss of
potential life, and the continued need for patient care. The
active shooter training within hospital settings will assist
leadership and educators in establishing protocols, training
strategies, community assessment of coverage, and developing a
recovery response plan.
Presenters:
Angela Warneke, Hospital
Administrator, County of San Diego
Michael Pacheco, Detective, San Diego
County Sheriff Department
Active shooter events are on the rise, and emergency management
and security officials are increasingly tasked with ways to
effectively and safely train hospital workers on how to respond.
Ms. Walsh will discuss new methodology of how to tackle the
crucial task of training each hospital staff member and
department, based on their unique functions within the hospital,
as well as with their specific locations on any hospital campus.
Presenter:
Michelle Walsh, Security Manager, Pomona
Valley Hospital Medical Center
The law requires all licensed general acute-care hospitals, acute
psychiatric hospitals and specialty hospitals to conduct a
security and safety assessment at least annually. The law also
requires hospitals to use the assessment to develop a security
plan with measures to protect personnel, patients and visitors
from aggressive or violent behavior. The security and safety
assessment must examine trends of aggressive or violent behavior
at the facility. Hospitals must track incidents of aggressive or
violent behavior as part of the quality assessment and
improvement program, and for the purposes of developing a
security plan to deter and manage further aggressive or violent
acts of a similar nature. The plan may include, but must not be
limited to, security considerations relating to all of the
following:
Physical layout
Staffing
Security personnel availability
Policy and training related to appropriate responses to
violent acts
Efforts to cooperate with local law enforcement regarding
violent acts in the facility
In developing this plan, hospitals are required to consider
guidelines or standards on violence in health care facilities
issued by the California Department of Public Health, the
Division of Occupational Safety and Health, and the federal
Occupational Safety and Health Administration. As part of the
security plan, hospitals are required to adopt security policies
including, but not limited to, personnel training policies
designed to protect personnel, patients and visitors from
aggressive or violent behavior. In developing the plan and
assessment, hospitals are required to consult with affected
employees, including the recognized collective bargaining agent
or agents, if any, and members of the hospital medical staff.
This consultation may occur through hospital committees. The
hospital committee responsible for developing the security plan
is required to be familiar with all of the following:
Role of security in hospital operations.
Hospital organization.
Protective measures, including alarms and access
control.
Handling of disturbed patients, visitors and employees.
Identification of aggressive and violent predicting
factors.
Hospital safety and emergency preparedness.
Rudiments of documenting and reporting crimes, including, by
way of example, not disturbing a crime scene.
Hospitals are required to have sufficient personnel to provide
security pursuant to the security plan developed. Persons
regularly assigned to provide security in a hospital setting are
required to be trained regarding the role of security in hospital
operations, including the identification of aggressive and
violent predicting factors and management of violent
disturbances.
Any act of assault, which results in injury or involves the use
of a firearm or other dangerous weapon, against any on-duty
hospital personnel are required to be reported to the local law
enforcement agency within 72 hours of the incident (defined in
Section 240 of the Penal Code, or battery, as defined in Section
242 of the Penal Code). Any other act of assault, against any
on-duty hospital personnel, may be reported to the local law
enforcement agency within 72 hours of the incident. No health
facility or employee of a health facility who reports a known or
suspected instance of assault or battery pursuant to this section
shall be civilly or criminally liable for any report required by
this section (as defined in Section 240 of the Penal Code, or
battery, as defined in Section 242 of the Penal Code). Any
individual knowingly interfering with or obstructing the lawful
reporting process may be guilty of a misdemeanor.
All hospital employees, as well as other health care workers such
as physicians and nurse practitioners, regularly assigned to the
emergency department are required to receive education as
provided for in the security plan developed relating to the
following topics:
General safety measures.
Personal safety measures.
Assault cycle.
Aggression and violence predicting factors.
Obtaining patient history from a patient with violent
behavior.
Characteristics of aggressive and violent patients and
victims.
Verbal and physical maneuvers to diffuse and avoid violent
behavior.
Strategies to avoid physical harm.
Restraining techniques.
Appropriate use of medications as chemical restraints.
Any resources available to employees for coping with
incidents of violence, including, by way of example, critical
incident stress debriefing or employee assistance programs.
Temporary personnel are also required to be oriented to the
security plan.
Hospitals are encouraged to review Health and Safety Code
Sections 1257.7 and 1257.8 to ensure compliance with this
mandate.
The California State Threat Assessment System is an all hazards
Information Sharing partnership of Federal, State and Local law
enforcement agencies throughout California. The System connects
Suspicious Activity Reporting and incidents that may have a
possible Terrorism or Homeland Security nexus with law
enforcement statewide through a network of interconnected
Regional Threat Assessment Centers (RTACs) in San Diego, Los
Angeles, San Francisco, and Sacramento.
These Regional Centers are directly connected to the FBI and the
U.S. Department of Homeland Security, and provide regional
analysis and assessment of events, including patterns and trends,
to deter, detect and prevent terrorism in California.
Additionally, the State Threat Assessment Center (STAC), also in
Sacramento, is a partnership of the California Highway Patrol and
the Governor’s Office of Homeland Security, whose focus is
statewide analysis of incidents, trends and patterns to help
identify larger threats and protect key and critical
infrastructure.
Suspicious Activity Reporting (SAR) programs such as “If You See
Something, Say Something” are active across the country and help
communities deter crime, violent incidents, and in some cases
prevent terrorism. The idea is simple, but for first
responders/receivers there are particular activities to look for
depending on your sector.
The Nationwide SAR Initiative (NSI) recently released the new
online training module “Public
Health and Health Care Partners,” developed to teach workers
to recognize suspicious behavior associated with pre-incident
terrorist activities. The training also discusses civil rights,
privacy, and how and when to report suspicious activity. NSI also
offers a two-page resource,
Suspicious Activity Reporting Indicators and Behaviors.
This training module can easily be added to any in-house training
for new employees or yearly refresher training for established
personnel. The new training
module joins others disciplines such as public safety
telecommunications, fire/EMS, emergency management, maritime, and
more. Those completing the training successfully can print a
certificate.
All hospitals should know what suspicious activity is and how it
should be reported. All hospitals should also know which threat
assessment center they fall under and maintain contact
information.
Active shooter events in a healthcare setting present unique
challenges: a potentially large vulnerable patient population,
hazardous materials (including infectious disease), locked units,
special challenges (such as weapons and Magnetic Resonance
Imaging (MRI) machines (these machines contain large magnets
which can cause issues with firearms, or remove it from the hands
of law enforcement), as well as caregivers who can respond to
treat victims.
There is no single method to respond to an incident, but prior
planning will allow you and your staff to choose the best option
during an active shooter situation, with the goal of maximizing
lives saved. For hospitals and healthcare care systems, the HSCC
has provided the updated guidance document “Active Shooter
Planning and Response in a Healthcare Setting.”
The Security and Safety Active Shooter Drill Tool Kit was
developed to create greater awareness of workplace violence among
hospitals and health care facilities, and to provide the
tools necessary for each facility to develop a plan that leads to
a safer, more prepared environment.
Based on an active shooter drill held at LAC + USC Medical Center
in March 2013, the materials feature templates, checklists,
industry guidelines, scenarios, safety rules, participant
releases and staffing suggestions for planning a similar event.
This video also provides a firsthand account of the HASC drill
with scenes from the simulated attack in clinical and office
settings.
This instructive video demonstrates possible actions to
take if confronted with an active shooter scenario. The video
reviews the choices of evacuating, hiding, or, as an option of
last resort, challenging the shooter. The video also shows how to
assist authorities once law enforcement enters the scene.
Terrorist attacks have a profound emotional and physical effect
on a community. While preventing these attacks would
be preferred, agencies must work swiftly and cohesively to
improve patient outcome when an attack does occur.
Read full discussion paper.
In the wake of the Newtown, Connecticut shooting, the
Hospital Code Silver Activation Active Shooter Planning Checklist
was released. The checklist supports hospital efforts to
review and develop active shooter response plans. The tool was
developed with key advisement from agencies including FEMA, the
Department of Homeland Security and the International Association
for Healthcare Security and Safety.
The City of Houston, Texas, has produced a six-minute, graphic
video on what to do when encountering an active shooter. The
video is entitled “Run-Hide-Fight: Surviving an Active Shooter
Event” and was produced with a $200,000 grant from the U.S.
Department of Homeland Security.
This 90-minute webinar can help private and public sector
personnel understand the importance of developing an emergency
response plan and the need to train employees on how to respond
if confronted with an active shooter.
The presentation describes the three types of active
shooters–workplace/school, criminal, and ideological–and how
their planning cycles and behaviors differ.
All employees can help prevent and prepare for potential active
shooter situations. This course provides guidance to individuals,
including managers and employees, so that they can prepare to
respond to an active shooter situation.
This course was written for non-law enforcement personnel. The
material may provide law enforcement officers information on
recommended actions for non-law enforcement employees to take
should they be confronted with an active shooter
situation. Upon completing this course, the participant will
be able to:
Describe actions to take when confronted with an active
shooter and responding law enforcement officials.
Lieutenant Stephen Redfearn, one of the first responders in the
Aurora shooting reviews lessons learned from the Aurora Movie
Theater Shooting. He served Aurora PD since 1999, and currently
oversees and supervises the major investigation section.
Lieutenant Redfearn recounts the incident and its timelines, as
well as the successes, challenges, and lessons learned.
This sample plan is provided courtesy of Victor Valley Global
Medical Center. The document outlines an emergency response
plan to alert hospital staff that an active shooter appears to be
actively engaged in killing or attempting to kill people in
the hospital or on the campus.
This sample plan provides guidance in the event an
individual is actively shooting persons in the hospital or on the
campus. This emergency response plan was developed to alert
hospital staff that an active shooter appears to be actively
engaged in killing or attempting to kill people in the hospital
or on the hospital campus.