Safety: Be Prepared for an Active Shooter

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Response training increases the chance of survival during attacks.


The news cycle is filled with troubling reports of gun violence. Recently, in the span of just three weeks, mass shootings occurred at a supermarket in Buffalo, an elementary school in Uvalde and an orthopedic clinic in Tulsa. Innocent people food shopping, children attending classes and healthcare workers serving their communities have become vulnerable targets for determined shooters. Unfortunately, you can’t ignore the danger your staff faces in the midst of the nation’s gun violence epidemic.

Empowered to take action

Protecting your staff from the possibility of facing an active shooter situation requires a comprehensive approach, which includes assessing risk, developing prevention frameworks and providing response training. ALICE Training empowers everyday people to stay safe and survive these violent incidents through a blended learning model involving an asynchronous online course curriculum that lays a foundation of knowledge followed by synchronous in-person training. The program’s skills training provides individuals with knowledge about what they need to know and consider to best prepare for an active shooter event, and how best to prepare themselves for when a shooting incident does occur.

ALICE Training can help answer the following questions: What should a healthcare facility do when so many people cannot evacuate? There is no way to “lockdown” every room, so how can healthcare workers secure in place? How do small facilities with limited staff protect themselves until help arrives?

One weakness of locking down in place when an active shooter is nearby is that it does not account for the variety of scenarios that can occur during the violent event. It also doesn’t empower individuals to take control of their own survival when locking down is not an option. This is particularly important in a healthcare setting due to the unique challenges providers face. They might have to decide about what to do with patients and visitors. Patients or staff might not be able to evacuate the area due to age, injury, illness or a medical procedure in progress. There is no single method to respond to an active shooter event, but prior planning and ALICE Training allows healthcare professionals to choose the best option with the goal of maximizing lives saved.

If an active shooter incident occurs, healthcare facilities must balance the need for safety and security with continuing to provide necessary care. This might mean assessing the risks associated with stopping a surgery in the middle of the case versus continuing to operate under the stress of knowing that an active shooter has not been neutralized. Unlike shootings in schools or office complexes, which often involve lockdown and evacuation, healthcare professionals in some instances must continue to deliver care and ensure patient safety. Perhaps a surgery doesn’t have to be stopped, which would put the patient in jeopardy, if an active shooter is located on another floor or wing of a hospital.

Constant vigilance

It’s important to note that training for an active shooter situation is not a one-and-done effort. Training needs to be ongoing with reminders or evaluations conducted every 90 days. Additionally, realistic drills are key to increasing employees’ knowledge of how to respond to a violent event because they help prepare individuals to respond quickly, calmly, confidently and safely should an actual critical incident take place. Announce drills with open communication throughout the entire process and conduct them in real time, if possible.

Preparedness and training are vital in helping individuals respond to an act of violence with confidence and increase their survivability. When cultures of safety are prioritized, communities can thrive. OSM

Follow These Life-Saving Steps to the Letter
A-L-I-C-E
BARRIER PROTECTION When evacuation is impossible, shelter in place and secure the area by whatever means necessary.  |  Navigate360

Close to 1,500 healthcare facilities across the U.S. have used ALICE Training to prepare for an active shooter situation. The training provides individuals with the skills to respond with confidence and increase their survivability. Here are the key steps to the response protocols in an easy-to-remember acronym:

Alert: This is your first notification of danger, which requires a speedy response. Seconds count. The sooner you understand you’re in danger, the sooner you can save yourself.
Lockdown: If evacuation is not a safe option, barricade entry points into the room you’re in to create a semi-secure location.
Inform: Communicate the violent intruder’s location and direction in real time if it is safe to do so. Information should always be clear, direct and in plain language, not in code.
Counter: Create noise, movement, distance and distraction with the intent of reducing the shooter’s ability to shoot accurately. This is a strategy of last resort intended to provide the seconds you need to evacuate the area.
Evacuate: When it is safe to do so, remove yourself from the danger zone.

Healthcare leaders need to review their Emergency Operations Plan (EOP) and tell employees what is expected of them during an active shooter event. They should also conduct unbiased risk assessments that go beyond the basic requirements of accrediting agencies or local departments of health. These regular assessments are foundational to ongoing safety and security efforts.

JP Guilbault

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