Security lessons learned from Colorado Springs

Hospital Safety Insider, March 3, 2016

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An active shooter incident is one of those things that healthcare clinic staff know could happen to them at any time, yet it's something that's never expected. As it turns out, security improvements can makea difference.

Planned Parenthood facilities have always attracted threats, especially from protesters who don't believe in the services they provide, but one of the most recent major incidents occurred on November 27, 2015, in Colorado Springs. In that case, Robert Lewis Dear, Jr., a 57-year old man from Charleston, South Carolina, targeted the Planned Parenthood clinic there based on his religious and political views on abortion. Dear entered the facility after firing several shots outside, according to published reports, and took several staff members and clients hostage during a five-hour standoff with police. At the end of the incident, SWAT teams stormed the clinic, resulting in Dear's arrest, but not before one police officer and two civilians were killed. As awful as the outcome was, there were many things that worked well that day to keep more people from being harmed. Take some of the lessons learned and apply them to your own clinic's violence prevention plan.

Know your regulars, and share that information. In almost every incidence of violence against healthcare facilities, the assailant is known to the targeted victims. Whether it's a disgruntled family member, someone upset about a large bill, or an estranged spouse looking for revenge, violence against a healthcare provider is almost never random. Colorado Springs was no exception; in fact, Dear reportedly asked at least one person for directions to the facility before the attack. While it's unclear whether that information could have stopped the shooting, many security experts recommend forming threat assessment teams that can share information about people who may be a threat. By doing this, facilities can restrict entry privileges, contact law enforcement, and take other precautions when dealing with these individuals.

Practice your procedures. Don't wait until the moment that shots ring out to practice your facility's emergency response plan for the first time. Your staff's role and actions need to be second nature at that point to avoid them freezing in panic. As soon as staff at the Colorado Springs clinic heard gunshots, they moved patients out of the waiting room and into a locked security room. That move probably not only saved lives, but also took away the intruder's ability to negotiate by directly threatening the lives of hostages. Staff members and patients were herded into rooms that had locks and turned their phones to silent to avoid drawing attention to themselves.

Let your local police come in and drill. Most hospitals have at least a casual relationship with the local police department as well as fire and other emergency response officials. It's good to have those contacts; fire officials can come in to check out fire hazards and perhaps run your staff through an impromptu lesson on how to use a fire extinguisher, while police officials can give a quick (and free) primer on security techniques and self-defense tactics. If you decide to do a security drill, most departments will help you plan and execute the exercise. It's beneficial for both sides: Your staff get to practice, and so do the police. The time law enforcement officers spend getting to know the layout, exits, security features, and floor plans of your facility gives them the upper hand when responding to an emergency. In the case of Colorado Springs, knowing the floor plan helped the police department determine what side of the building had rooms that staff members would be likely to hide in, and they were able to isolate the shooter in another section.

Physical barriers work. Walk into almost any medical clinic and you'll likely find a receptionist sitting at a desk with hardly any protection. OSHA and many security experts are now recommending physical security barriers such as bulletproof glass, or at least a desk that is difficult to hop over, to help give staff a chance to react to violence. Other recommendations include doors that latch behind them when closed and panic buttons that can used to alert staff in the back of the facility. 

Put intruders on TV. Police were able to monitor the intruder's actions during the Colorado Springs incident by way of a closed-circuit security camera system that had been installed, along with an external feed to law enforcement. This allowed the staff to protect themselves by knowing where the shooter was, and also allowed police to coordinate and plan how best to eventually storm the clinic and end the standoff. By knowing where the shooter was (and where he was not), police were able to draw a diagram of the building with marks of where he was. Eventually, police used this information to plan a rescue: They rammed a door of the building with an armored vehicle close to where hostages were to allow them to escape, while at the same time removing any route of escape for the shooter.

This is an excerpt from the monthly healthcare safety resource Medical Environment Update. Subscribers can read the rest of the article here. Non-subscribers can find out more about the journal, its benefits, and how to subscribe by clicking here.


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