CHICAGO—As a Level I Trauma Center on Chicago's West Side, caregivers at Mount Sinai Hospital know just how bad the city's gun violence problem can get from the injuries they treat.
But earlier this month, that problem became even more real as it made its way to the hospital's front doors when an individual opened fire in a drive-by shooting on a group of people gathered just outside.
The group was less than half the distance of a football field from the emergency room doors, awaiting news of a loved one who had been shot a day earlier. “The vehicle pulled up and fired shots into the crowd, hitting three people,” said Ray Martinez, the health system's head of security.
Family members rushed the wounded inside and security immediately began locking down the emergency department and, later, the main entrance to the hospital, he said.
Hospital staff, unfortunately, knew exactly what to do.
It was one of the most violent weeks in Chicago's history. Nine people were murdered and 76 people were shot over the span of seven days, the Chicago Tribune reported. It's part of ongoing gun violence in the city with police reporting a total of 36 people shot this Memorial Day weekend, which is actually a reduction from previous years.
It was also the second shooting on hospital grounds in less than a year.
(Mount Sinai Hospital)
Lessons learned
The first shooting at the 319-bed hospital happened last July during another violent weekend in the city. Thirty people were shot and three people died of their injuries across Chicago over the span of 18 hours, the Tribune reported.
A woman had been brought in with a gunshot wound and, as commonly happens, a crowd began to gather outside. Tensions flared. Security locked down the emergency department. Moments later, a man was shot right outside.
It began a year of hard work and soul searching for Sinai Health System officials.
"We were highly emotional. We had not had this happen. I’ve worked in trauma for 25 years and never had an incident happen so close," said Chief Nursing Officer Michele Mazurek, who has spent her career at Mount Sinai. "Hospitals are called safe zones, especially with gang members, and any gang member you talk to you know you do not hurt a hospital. You do not touch nurses. Those are neutral territories. Those are the places you go to get fixed and healed and taken care of. It was quite shocking."
Hospital officials immediately convened a group including security personnel and administrators, as well as leadership in the emergency room and front-line staff to discuss what could have been done to prevent the incident from occurring on hospital grounds and how to assure caregivers and community members of their safety going forward.
They said they brought their ideas to Chicago police and fire officials before making any decisions, a move which turned into regular lunch meetings and direct communication between the hospital administration and first responders that continues to this day, Mazurek said.
Among the first ideas to bubble up was the need for improved communication, officials said. For instance, EMS officials indicated they wanted to improve coordination with police and hospital security.
"You can imagine, they’re going out into these locations where there are known shootings and picking patients up. Then, as soon as they pick a patient up, the neighborhood, the friends, the family, begin to follow that ambulance into the hospital," Mazurek said. "Their fear is when they come to the hospital, who is protecting the rig when they are bringing the patient in for their own safety?"
The solutions
Mount Sinai Hospital's safety strategies following a 2017 shooting outside its doors included:
Installed safety barrier outside emergency department doors
Installed metal detector and upgraded wanding system at ED entrance
Created space for police substation to encourage stronger police presence
Replaced front desk employees in lobby entrance with security staff trained in customer service
Trained all nurses and security in de-escalation techniques
Began hosting regular meetings between hospital administration and police/fire/EMS leadership
Began hosting community policing meetings at hospital
Improved internal communication plan with inpatient floors
Improve communication and coordination between hospital, EMS rigs and police when there is a known security risk
Within the next year, the hospital plans to install fencing all around its ED drive
