GNYHA hosted a symposium last week on preparedness for and response to an active shooter in a hospital setting. As mass shootings become more prevalent, hospitals across the nation are developing and continuously improving plans, protocols, and training efforts to keep staff, patients, and visitors safe and allow the facility to maintain operations.

The symposium featured Alexander Eastman, MD, MPH, FACS, FAEMS, the US Department of Homeland Security’s Senior Medical Officer-Operations. Dr. Eastman is a former a trauma surgeon at Parkland Memorial Hospital in Dallas, Texas, and a member of the Dallas Police Department’s SWAT Team. He co-authored Active Shooter Response in a Healthcare Facility, a 2018 paper that offers an alternative to the traditional “Run-Hide-Fight” model. Dr. Eastman’s “Secure-Preserve-Fight” model was designed for areas of a hospital that house vulnerable, non-ambulatory patients. He discussed the complexities of responding to active shooter events and offered practical approaches to implementing the “Secure-Preserve-Fight” model and training staff to use it.

Dr. Shapiro speaks on the symposium panel

A panel featured Montefiore Health System’s Jared Shapiro, DrPH, System Senior Director, Environmental Health and Safety; Joseph D’Amico, a former New York Police Department (NYPD) Chief, Superintendent of the New York State Police, and now a Consultant in the Office of the President at Montefiore; and NYPD Deputy Chief Scott Shanley, Commanding Officer, Critical Response Command. They discussed Montefiore’s overall approach to active shooter prevention and mitigation, including efforts to educate and coordinate with first responder agencies, through joint meetings, walk-throughs, and the creation of first-responder access kits that contain all-access key cards, radios, and blueprints.

A second panel featured Northwell Health’s Mark Jarrett, MD, Senior Vice President, Chief Quality Officer, and Associate Chief Medical Officer; Mary Mahoney, Vice President, Emergency Management and Clinical Preparedness; and Angelo Conetta, Investigator, Corporate Security. They detailed the health system’s training approach, which includes general online training and unit-specific efforts that incorporate the “Secure-Preserve-Fight” model on units that care for vulnerable patients. They also described the feedback loop between frontline staff training and training and exercises conducted with system leadership, which enabled their policies and protocols to evolve over time to directly address staff concerns.

Key themes that emerged included the importance of educating and empowering staff to act, accepting that the first few minutes of an incident will be extremely chaotic, and understanding the pressing need to quickly shift to recovery and business continuity operations once the perpetrator(s) have been neutralized or apprehended.

The symposium was part of GNYHA’s yearlong Workplace Violence Prevention Learning Series, which explores the many aspects of this complex topic. To access materials from all programs in the series, please visit the program page.