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.

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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.

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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.

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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.

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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.

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Annual Security and Safety Assessments
Under California law, all licensed general acute-care hospitals, acute psychiatric hospitals, and specialty hospitals are mandated to conduct an annual security and safety assessment. This assessment is crucial for developing a security plan aimed at safeguarding personnel, patients, and visitors against aggressive or violent behavior.

Key Elements of the Security Plan

The security plan must address the following elements:

• Physical Layout: The arrangement of the hospital space to enhance security
• Staffing: Allocation of staff to maintain a secure environment
• Security Personnel: Availability of trained security staff
• Policies and Training: Implementation of policies and training for responding to violent incidents
• Local Law Enforcement Cooperation: Collaboration with local authorities to handle violent acts within the facility

Guidelines and Standards

In formulating the security plan, hospitals must consider violence-related guidelines issued by:

• California Department of Public Health
• Division of Occupational Safety and Health
• Federal Occupational Safety and Health Administration

Security Policies and Personnel Training

The security plan should incorporate policies for:

• Personnel training to prevent and manage violent behavior
• Consulting with affected employees, bargaining agents, and medical staff through hospital committees

Committee Responsibilities

The committee tasked with developing the security plan should be knowledgeable about:

• The role of security in hospital operations
• Hospital organization and safety measures
• Crime documentation and reporting protocols

Reporting Requirements

Incidents of assault resulting in injury or involving weapons must be reported to local law enforcement within 72 hours. Reporting parties are protected from civil or criminal liability, and interference with the reporting process is punishable by law.

Education for Emergency Department Staff

Hospital employees and health care workers in the emergency department must receive training on:

• Safety measures and aggression management
• Techniques to de-escalate violent behavior
• Use of restraints and chemical interventions
• Support resources for post-incident coping

Compliance with Health and Safety Codes

Hospitals should review Sections 1257.7 and 1257.8 of the Health and Safety Code to ensure adherence to these mandates.

CHA Memo on Safety and Security Assessment, Planning and Training Requirements

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.

• Nationwide SAR Initiative (NSI)
• Cal OES State Threat Assessment Center, with links to Regional Threat Assessment Centers
• View California State Threat Assessment map 

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.”

• Active Shooter Planning and Response in a Health Care Setting Guidance
• Incorporating Active Shooter Incident Planning into Health Care Facility Emergency Operations Plans

Department of Homeland Security

• DHS Active Shooter Preparedness Program
• Active Shooter: How to Respond
• Active Shooter Pocket Card
• Hometown Security Fact Sheet
• Security Assistance Fact Sheet
• Connect/Plan/Train/Report
• DHS Active Shooter Pamphlet Quick Reference Guide
• Active Shooter Response Poster
• Planning and Response to Active Shooter
• National Terrorism Advisory System Bulletin

Active Shooter ResourcesHospital Association of Southern California (HASC)

The Security and Safety Active Shooter Drill Tool Kit was developed by Hospital Association of Southern California (HASC) 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, 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.

• Active Shooter Drill Tool Kit
• Active Shooter Drill video

Huntington Hospital

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.

• Presentation