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
The R3 Report provides the rationale and references that The Joint Commission employs in the development of new requirements for workplace violence prevention standards
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.
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.
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.
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.
This article offers strategies to guide hospital emergency managers and other healthcare personnel to combat active-shooter situations effectively.
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.
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.
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.
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
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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
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.
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.
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.
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.
This training video was created for central Indiana healthcare workers on how to respond if an active shooter enters their workplace.