Facility Dude

Healthcare facilities should prepare for new types of violent threats

By Wendy Mallon
Apr 27, 2015

Healthcare, Safety and Risk Management

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Incident mgmt Those who work in healthcare facilities aren't strangers to emergency situations. In fact, most hospitals and long-term care facilities mandate extensive response procedures to deal with possible contagion outbreaks and similar potential threats to public health. But certain news events in recent years have caused healthcare administrators to focus on preparing for another possible threat - an active shooter.

Preparing for a threat of this kind involves new ways of thinking for healthcare professionals and other facility staff. Fortunately, the Department of Homeland Security issued an online guide designed to walk these facilities through the process of creating and educating staff on a response plan for such a contingency.

The evolution of preparedness

All public facilities must maintain crisis response plans in order to comply with the U.S. government’s regulations dictating preparedness levels at public facilities. As the DHS report noted, these guidelines changed in 2011 to include a new class of disaster which includes terrorism and active shooter threats. The report outlined a five-step process around which individual programs should be designed:

  • Prevention
  • Protection
  • Mitigation
  • Response
  • Recovery

These guidelines, referred to as PPMRR, offer an overview of things facilities should be taking into account, in roughly chronological order.

Key points to consider

While each situation is going to be unique, the DHS endeavored to create as general an outline as possible. Some of the points healthcare facilities were recommended to consider were employee training designed to help staff members identify and, if possible, preemptively stop a violent person. Barring the success of preventive measures, the guide focuses on the importance of communication with other staff members and authorities outside, providing adequate evacuation routes and post-incident recovery.

As this McKnight's article pointed out, one of the main recommendations of the report was for facility managers and administrators to understand that there will be no such thing as a "perfect" plan. Rather, professionals should instead focus on keeping as many occupants as possible safe, by encouraging a hierarchy of run, hide and fight.

Facility and safety managers play a significant role

The facility manager and safety manager should be included in the formulation of a response plan to this type of threat. As with any such contingency, the effectiveness of the response in the event of a real-life crisis situation relies heavily on both a facility's current resource limitations and the state of its building maintenance. These individuals are uniquely equipped to have in-depth knowledge of what resources are available, and where shortfalls may occur. The information gathered and maintained in the facility's CMMS can also help plan the most effective evacuation routes.

Moving into recovery

Aside from the material and personnel concerns involved in responding to an active shooter, the DHS report focuses on additional psychological factors that may be involved in the recovery process. Damage to the building itself or any infrastructure is fairly simple to measure and respond to, especially if FMs have been maintaining up-to-date information on maintenance statuses and life cycle information. But the importance of helping staff members themselves recover shouldn't be overlooked either. McKnight's suggested that, as part of the response plan, facility administrators integrate the potential to offer psychological first-aid training to those who wish to help in that regard.

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