Active shooter preparedness resources
Healthcare active shooter preparedness requires balancing patient safety and care in the complex healthcare setting. A proactive plan incorporating security, compassionate care, and crisis management is needed to reduce patient harm and medical operations.
Vizient Medical Executive Network leaders polled healthcare institutions regarding active shooter response. Several organizational tactics were found to be lacking or inconsistent. The Vizient Medical Executive Network issued a call to action to address these vulnerabilities. Forty people from twenty-seven Vizient member organizations developed Recommendations and Rationales to help hospitals mitigate common risks, identify national guidelines, and prepare for such situations.
Learn more: Vizient Report - Assessing Active Shooter Preparedness in U.S. Hospital Systems
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In the US, from 2018 – 2023, there has been a consistent rise in active shooter events (injuries and casualties) to over 300 in 2023.
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Recommendations and Rationales
During an active shooter event, effective communication is the cornerstone between chaos and potential safety
The healthcare organization should consider whether plain language or code language is to be used during the initiation of an active shooter situation. Evidence supports using plain language.
The healthcare organization should consider several rapid communication platforms such as overhead pages, text messages and emails. Consideration should be given to content and frequency of messaging with clear and concise instructions. While there is no specific evidence that supports one type of rapid communication over the other, experience shows that direct, quick communication has the potential to mitigate the situation.
The healthcare organization should have a crisis communication plan in place to manage initial communication decisions before a crisis happens. When available, the healthcare organization should partner with Law Enforcement Public Information Officers. In rural communities, when law enforcement resources are scarce or not immediately available, the healthcare organization should have bullet point communication prepared in advance for concise information to be shared.
Consideration should be given to partnering with emergency services and law enforcement agencies in advance of any emergency to ensure a well-coordinated, efficient, and safe response to a potential or real Active Shooter threat.
In an active shooter situation, physical security measures serve as the first line of defense and a crucial component in safeguarding lives
Utilize an evidence-based approach to designing or renovating healthcare organization facilities to increase safety and prevent vulnerabilities that may be further exposed during a crisis. Conduct security vulnerability assessments yearly to identify gaps and areas of improvement.
Implement an access control plan that provides protection against an external threat, establishes reasonable security controls and mitigates risks as identified in the healthcare organizations security management risk assessment.
The use of physical security safeguards plays a critical role in active shooter mitigation strategies. Have the integration of multiple physical facility options and technologies creates expanded and enhanced opportunities for early detection of threats, expedited response times and more robust forensic evidence.
In active shooter situations, every second is critical. Safe rooms enable occupants to seek immediate protection rather than evacuating the premises, which may expose them to danger. It is recommended, staff should be trained and have the ability during a crisis event to identify a safe room or area to hide, barricade and lockdown.
In the face of an active shooter event, having a comprehensive and well-rehearsed plan of action, coupled with a swift and coordinated response, stands as the key to minimizing casualties and ensuring the safety of individuals
Develop and implement comprehensive an active shooter incident response plan and procedures within healthcare organizations to mitigate risks, minimize harm and ensure critical business operations and patient care can be maintained.
Include and train staff on options and criteria for active shooter incident responses in the Active Shooter Response Plan.
Develop and implement a plan which includes training and applicable supplies for providing hemorrhage control capabilities during an active shooter event. Deploy hemorrhage control kits to points of entry and other areas within the healthcare organization. Hemorrhage control kits contain essential supplies to control severe bleeding and are vital for immediate first aid response.
Practicing drills and simulations for an active shooter event isn't just about going through the motions — it's a vital rehearsal that can make a life-saving difference in a crisis
Development of an active shooter response plan, with a robust drills and simulation process is an imperative step in safeguarding the well-being of the patients, families, staff and visitors present in your healthcare organization’s facilities.
Simulating an active shooter drill or simulation in a secure environment in conjunction with law enforcement is the best practice. As close to a real-life scenario or series of scenarios without creating security risks or staff/community trauma is the goal. Leaders and staff must be trained in their respective roles and responsibilities but also in the roles and responsibilities of others, such as how and when law enforcement will respond. The desired outcome is to create perspective on how all roles impact each other to contribute to the success of the overall response is by drilling.
After an active shooter exercise/drill has been concluded, consideration should be made to (1) conduct a debrief of the drill, (2) offer support resources to staff as needed, (3) conduct a survey for the drill and (4) develop an after-action report.