Hopkins shootings are a reminder to revisit response plans

How times have changed. Once upon a time, hospitals were safe havens. No one violated these spaces with violence or mayhem.  Yesterday’s shootings at Johns Hopkins are yet another reminder of the world we live in now. Whether it's a high school, a place of worship or a university campus, no place seems off limits.

Hospital security directors across the country work hard every day behind the scenes to ensure their healthcare environments remain open, welcoming centers of healing. And while it's impossible to predict or prevent every possible incident, the Hopkins nightmare is a harsh example of the importance of regularly reviewing your emergency response procedures with stakeholders in every area of your organization.

Unfortunately, just what can be done to boost security in hospitals isn’t all that clear. Harry Koffenberger, vice president of security for Johns Hopkins Medicine, told Associated Press  that Hopkins uses handheld metal detectors to screen high-risk patients and visitors. But with 80 entrances and 80,000 visitors a week, it is not realistic to blanket a healthcare setting with metal detectors and guards, he said.

Hospital security is an oxymoron, because it links two seemingly mutually incompatible concepts -- open access and security, Elliot Boxerbaum, a healthcare security expert, tells FierceHealthcare. “It’s a very delicate balance,” says Boxerbaum, president and CEO of Columbus, Ohio-based Security Risk Management Consultants, which specializes in security assessments for universities and hospitals.  

Dan Finger, who has 27 years of experience as a security director in hospitals, explains further. When you have multiple hospitals in a city trying to compete for business, no hospital wants to look like a fortress. They all want to show they’re open and there to help you. “They try to be more personable, but that leaves them more vulnerable,” Finger says.

“You just don’t know who is going to do what. That’s the hard part,” says Finger. “You want to present a comfortable presence at your work location. But at the same time, your biggest asset is your employees and you have to protect them.”

One thing you can do is plan how to respond, he says. But just how prepared are hospitals to respond? That varies.  Mock drills might help your emergency preparedness director determine whether everyone knows what to do if they hear a gun shot. 

Does everyone know which rooms lock from the inside? Do your employees know that a gunman could potentially pull the fire alarm to flush people out to serve as targets? Staff at one Massachusetts hospital are instructed not to evacuate if a "Code Silver" is announced during a fire alarm. 

This is a good time to pull out your plans and try to understand whether what happened at Hopkins could happen at your facility, Boxerbaum says. "Violence can occur anywhere anytime," he says. Security is not all about metal detectors and barriers to entry. It also hinges on organizational culture and training.

While we don’t know the details of what the Hopkins doctor and shooter said to each other, maybe it’s time everyone who works in a hospital gets training on how to talk someone down off a figurative ledge. What does it take to de-escalate a situation with words? Wouldn’t that be worth teaching anyone who might come into contact with patients or irate family members or friends? If it saves lives or prevents someone from getting shot, those skills might save a life. - Sandra