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Healthcare Settings

A selection of references, training, and videos have been compiled below to assist personnel in healthcare environments with understanding how to prevent, prepare for, and respond to an active assailant incident.  Those affiliated with healthcare settings are encouraged to utilize these resources for educational, informational, and planning purposes.

 

General Preparedness

R3 Report (Requirement, Rationale, Reference)
https://www.jointcommission.org/-/media/tjc/documents/standards/r3-reports/wpvp-r3_20210618.pdf
The R3 Report provides the rationale and references that The Joint Commission employs in the development of new requirements for workplace violence prevention standards
ASPR TRACIE – Mass Violence

https://asprtracie.hhs.gov/mass-violence

The United States Department of Health and Human Services Administration for Strategic Preparedness and Response’s Technical Resources, Assistance Center, and Information Exchange-developed resources can help our stakeholders prepare for, respond to, and help their communities recover from mass violence events.  The page includes Mass Violence/Active Shooter Incident Tip Sheets and additional mass violence resources.

Healthcare and Public Health Sector Coordinating Council: Active Shooter Planning and Response in a Healthcare Setting

https://www.jointcommission.org/resources/patient-safety-topics/workplace-violence-prevention/healthcare-and-public-health-sector-coordinating-council/

Comprehensive guidance from the Joint Commission written for healthcare facilities to prevent, respond to, and recover from an active shooter event. The document includes law enforcement tactics and integrated medical and mental health response.

Joint Commission – Workplace Violence Prevention Resources

https://www.jointcommission.org/resources/patient-safety-topics/workplace-violence-prevention

This website provides a number of valuable sources of information from the Joint Commission enterprise and other organizations related to the topic of workplace violence in healthcare.  The page includes resources from The Joint Commission, Federal Resources, State Resources, Professional Associations, and Other Resources.

Quick Safety 4: Preparing for Active Shooter Situations

https://www.jointcommission.org/resources/news-and-multimedia/newsletters/newsletters/quick-safety/quick-safety–issue-4-preparing-for-active-shooter-situations/preparing-for-active-shooter-situations-addendum-february-2017/#.Ypom4qgpCUm

This report from The Joint Commission reviews reports from its accredited organizations of 39 shootings that resulted in 39 deaths from 2010-2020.  The page provides safety actions for health care organizations to consider and strategies that organizations can use to help be prepared for active shooter events.

Active-Shooter Incidents: Basic Strategies for Hospitals

https://www.hmpgloballearningnetwork.com/site/emsworld/article/1225574/active-shooter-incidents-basic-strategies-hospitals

This article offers strategies to guide hospital emergency managers and other healthcare personnel to combat active-shooter situations effectively.

Topic Collection: Active Shooter and Explosives

https://asprtracie.hhs.gov/technical-resources/30/active-shooter-and-explosives/0

ASPR TRACIE updated this Topic Collection in October 2021 to include recently released resources on lessons learned from actual incidents, guidance documents, research, and links to curriculum. These resources can help emergency medical professionals plan for and respond to the changing nature of mass shootings or explosive incidents.

OSHA Workplace Violence Guidelines for Healthcare and Social Services

https://www.osha.gov/sites/default/files/publications/osha3148.pdf

This guidance document provides an overview of workers’ rights under OSHA for healthcare workers, including inpatient and outpatient settings, and social services workers assisting with patients.

InfraGard – Partnership for Protection

https://www.infragard.org/

The InfraGard is a partnership between the FBI and members of the private sector. The program provides a vehicle for seamless public-private collaboration with government that expedites the timely exchange of information and promotes mutual learning opportunities relevant to the protection of critical infrastructure.

Active Attack Preparedness and Response Resources and Links: Northwest Healthcare Response Network

https://nwhrn.org/active-attack-preparedness-and-response-resources-and-links/

A variety of preparedness, response, and recovery resources compiled by the Northwest Healthcare Response Network (Washington State) targeted specifically for healthcare audiences.

 

Planning Guidance & Best Practices

Mass Casualty Incident Response Toolkit

https://www.gnyha.org/wp-content/uploads/2019/04/MCI_Toolkit_digital.pdf


The Greater New York Hospital Association create guidance for hospitals to help them prepare and train for mass casualty incidents.  This toolkit details emerging best practices from intentional attacks that occurred in the United States and internationally. The toolkit includes suggested preparedness and response actions for the many clinical and non-clinical departments that would be involved in an MCI response.

On-Campus Healthcare Facility Armed Assailant Planning Considerations

https://files.asprtracie.hhs.gov/documents/on-campus-hospital-armed-assailant-planning-considerations.pdf

The checklist from Administration for Strategic Preparedness and Response’s Technical Resources, Assistance Center, and Information Exchange helps healthcare planners prepare their facilities to mitigate, respond to, and recover from an active shooter or armed assailant situation on campus.

Active Shooter Planning and Response: Learn How to Survive a Shooting Event in a Healthcare Setting

https://www.jointcommission.org/-/media/tjc/documents/resources/workplace-violence/2017_active_shooter_planning_response_healthcare_settingpdf.pdf

Developed by the Healthcare & Public Health Sector Coordinating Council, this is an in-depth look at the four (4) phases of emergency management: mitigation, preparedness, response, and recovery. This document offers step-by-step guidance to assist healthcare facilities in active shooter planning and response.

Incorporating Shooter Incident Planning into Health Care Facility Emergency Operations Plans

http://www.phe.gov/preparedness/planning/Documents/active-shooter-planning-eop2014.pdf

This document is primarily designed to encourage facilities to consider how to better prepare for an active shooter incident. Though hospitals and many other Health Care Facilities (HCFs) have emergency operations plans (EOPs), this document provides emergency planners, disaster committees, executive leadership, and others involved in emergency operations planning with detailed discussions of unique issues faced in an HCF.

The Active Shooter in a Healthcare Facility

https://files.asprtracie.hhs.gov/documents/25-active-shooter-template-2014-508.pdf

This template for response procedures was created by the DC Emergency Healthcare Coalition and is intended as guidance for healthcare facilities to consider in emergency preparedness.  The first section of this document presents several preparedness considerations that the organization may wish to include when developing and implementing its plans. The second, lengthier section provides a template structure for documenting response procedures.

Active Shooter Planning and Response in a Healthcare Setting

https://www.fbi.gov/file-repository/active_shooter_planning_and_response_in_a_healthcare_setting.pdf/view

This document from the Federal Bureau of Investigation expands upon the “Active Shooter Planning and Response in a Healthcare Setting” document to include law enforcement tactics and integrated medical and mental health response.

Security Awareness for Soft Targets and Crowded Places

https://www.cisa.gov/sites/default/files/publications/19_0515_cisa_action-guide-hospitals-and-healthcare.pdf

This action guide provides mitigation strategies and protective measures as well as potential indicators that hospitals and healthcare facilities should be aware of as soft targets that can be crowded places.

Incorporating Active Shooter Incident Planning Into Health Care Facility Emergency Operations Plans

https://www.phe.gov/Preparedness/planning/Documents/active-shooter-planning-eop2014.pdf

This document is primarily designed to encourage facilities to consider how to better prepare for an active shooter incident. Though hospitals and many other HCFs have emergency operations plans (EOPs), this document provides emergency planners, disaster committees, executive leadership, and others involved in emergency operations planning with detailed discussions of unique issues faced in an HCF. This document also includes discussions on related topics, including information sharing, psychological first aid (PFA), and law enforcement/security.

Health and Medical Response to Active Shooter and Bombing Events

https://nam.edu/health-and-medical-response-to-active-shooter-and-bombing-events/

This discussion paper reviews the health and medical respond to active shooter and bombing events including preparation considerations.

Planning for Mass Casualty Incidents: Emergency Treatment and Privacy Considerations

https://www.americanbar.org/groups/health_law/publications/aba_health_esource/2019-2020/october-2019/mass-casualty/

This document is by the American Bar Association and provides an overview of legalities that could be involved with a Mass Casualty Incident (MCI). It also includes several links to other resource sites on varying topics associated with MCIs.

Security in Healthcare Toolkit

https://lhatrustfunds.com/toolkits/security-in-healthcare-toolkit

The security in healthcare toolkit from the LHA Trust Funds provides best practices, all-hazards risk assessments, sample policies and other resources that provide guidance for organizations planning effective security programs.

 

Training & Exercises

FEMA Center for Domestic Preparedness – Training Resources

https://cdp.dhs.gov/

The FEMA Center for Domestic Preparedness (CDP) provides in-person and web-based training courses relevant to the response and management of mass casualty incidents.  The CDP has trained over 1.3 million emergency responders over the past two decades.  The training calendar for both in-person and virtual instruction will be updated regularly.

Civilian Response to Active Shooter Events (CRASE) Train the Trainer

https://alerrt.org/CivilianResponse

The Civilian Response to Active Shooter Events (CRASE) course, designed and built on the Avoid, Deny, Defend (ADD) strategy developed by ALERRT in 2004, provides strategies, guidance, and a proven plan for surviving an active shooter event.

Active Shooter/Active Threat Resources For Healthcare Facilities

https://www.ahepp.org/page/ActiveShooterHealthcare

The Association of Healthcare Emergency Preparedness Professionals’ Active Shooter Resource Hub provides open-source training videos and resources share by healthcare emergency preparedness professionals.

Planning for Active Shooter Incidents

https://www.calhospitalprepare.org/active-shooter

This resource from the California Hospital Association provides active shooter preparation and training for hospitals.  The active shooter training within hospital settings will assist leadership and educators in establishing protocols, training strategies, community assessment of coverage, and developing a recovery response plan.

MESH Coalition Responding to an Active Shooter in a Healthcare Setting

https://vimeo.com/112455575

This training video was created for central Indiana healthcare workers on how to respond if an active shooter enters their workplace.