Shooting in hospitals prompted a review of the system of security measures

Shooting drills are common in hospitals, especially academic medical centers, according to industry observers and associations. But hospitals have a lot of leeway in deciding which types of hazards are most important to their facilities, experts say.

“In principle, hospitals should consider the “active shooter” as one of the relevant hazards that needs to be planned and trained in preparation for “all hazards.” But in practice, hospitals have broad powers,” Glen Mays, professor of health management. and politics at the University of Colorado Anschutz, the email said. “Academic medical centers are particularly exposed to the risks of active shooters due to their educational mission along with their mission to provide medical care.”

There are two national requirements for hospital emergency preparedness: the CMS federal emergency preparedness rule and the Joint Commission accreditation mandate. Both require hospitals to have all hazard response plans and train staff at least once a year. The Joint Commission indicated active marksmanship training as a requirement in its June 2021 update.

Typically, staff review active shooting response protocols for hospital security personnel, involving law enforcement, evacuation, shelter in place, and clinical guidelines for mass casualty event response. Training typically includes active shooting drills and exercises with law enforcement officers.

Northwell, for example, reviewed the Tulsa case with its employees, analyzing what prevention protocols it has in place, what needs to be adjusted, and how they would respond.

At least once a year, the health system conducts active shooting exercises. It offers training to each of Northwell’s 80,000 employees in active shooting situations, de-escalation, and “bleed-stop” processes. Armed police and security guards are on duty at Northwell hospitals, Strauss said.

Northwell has created a “Safe Place Initiative Group” that brings together members of the Legal, Quality, Patient Experience and others departments to discuss how they can improve staff safety and patient care. The company has implemented a more thorough visitor access control system to better screen visitors and is considering implementing a covert weapon detection system, Strauss said.

“Here at Northwell, we are very lucky to have top management upholding the security protocol,” he said. “If you don’t have top management support, you have nothing.”

The 21-hospital Cleveland Clinic hosts several active shooter training programs throughout the year, a spokesman said.

The active readiness of the shooter depends on the hospital. Some hospitals have armed guards and weapons detection systems. The level of preparedness of health systems for emergencies has remained relatively unchanged in recent years as they have been focused on the COVID-19 pandemic.

According to National Health Security Preparedness Index. At the current pace, it will take eight years for most states to reach the levels of health security currently seen in the most prepared states.

According to the report, which analyzes dozens of different metrics, such as the number of paramedics and medical volunteers available, the degree of community engagement, the level of information management, communities with stronger preparedness measures had a significantly lower risk of mortality associated with the COVID-19 pandemic. and infrastructure stability.

Several proposed bills and litigation seek to strengthen health systems security protocols and curb gun trafficking.

“As we have said repeatedly since gun violence was declared a public health crisis in 2016, gun violence in the United States is out of control, and without real, common-sense federal action, it will not will subside,” Dr. Gerald. This was stated by the President of the American Medical Association Harmon.

The US House of Representatives recently passed a bill that would require healthcare employers to implement workplace violence prevention plans that will protect workers and other personnel from shootings and other events.

The House Judiciary Committee recently introduced the Protect Our Children Act. Among other things, it will ban the sale of semi-automatic weapons to persons under the age of 21.

“The terror in Tulsa on Wednesday should remind us all of both the increasing incidence of violence in healthcare facilities and the urgency of legislative action to protect our caregivers, other healthcare personnel, and every patient or family member in these facilities,” Jean Ross, President, General This is stated in the statement of the organization National Nurses United.

But it’s not clear whether Congress or state legislators will pass the relevant laws or whether the lawsuits against health care systems will stand in court.

The widow of a nurse’s assistant who was shot dead at Thomas Jefferson University Hospital last year is suing Jefferson Health for allegedly lax security, according to a lawsuit filed Tuesday in Philadelphia General Court. Jefferson Health declined to comment.

In another case, a woman was shot three times in a Florida hospital and sued the facility for alleged security breaches. Court rules that under the hospital’s contract with the security company, the security only required the protection of the hospital and its employees.

Workplace safety and compliance standards are relatively subjective and are case- and site-specific, said Mark Silberman, chairman of the White Collar, Government Investigations and Compliance Group at law firm Benesch.

“Unless we are willing to address the bigger problems that are allowing these things to happen, we cannot place all responsibility on medical institutions without fundamentally changing the role they are supposed to play for us,” he said.

Marie Devereaux contributed to this report.

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