Yesterday, a Houston man shot himself to death in his wife’s hospital room hours after she had given birth to their baby.  Family members said he had been distraught recently.  The mother was unharmed and the baby wasn’t in the room.  But events like this stay with you – daily reminders that hospitals confront relatively higher rates of workplace violence than do other work settings and environments.

I believe, however – and I’ve seen this over and over – that with awareness of these risks comes change: positive, prevention-oriented programs that help save lives. We are currently authoring a comprehensive Active Shooter Plan for a major regional healthcare center.  In the process of updating relevant metrics and baselines drawn from our client’s specific industry, our research team uncovered a very well-written report that helps quantify the true extent of active shooter incidents in a healthcare setting.  One report in particular stands out – a scientifically researched and documented review conducted by a group of doctors in 2011 that took a look at hospital-based active shooter incidents over a 12-year period.[1] Here are some highlights that drew my attention.  Over this period:

  • There were 154 hospital shootings in 148 hospitals, with 235 victims
  • 3% of U.S. hospitals experienced a shooting event with a victim
  • 59% (91) of the shooting events took place inside the hospital, while 41% (63) took place on hospital grounds
  • For every 10,000 workplace violence assaults, eight were committed against healthcare workers, compared to two out of 10,000 for other private sector industries
  • Only an estimated 30% to 36% of the hospital-based shootings could have been prevented by a magnetometer screening process at a point of entry
  • Only 4% of the hospital-based shootings involved mentally unstable patients, while 11% involved an escape attempt/event by a patient in police custody at the hospital

What can we learn from this data? What are the best practices hospitals and health care facilities like our clients should be adopting? Too many to cover well in a short blog. But here are a few: Conduct a careful needs assessment first. Avoid stand-alone plans based on templates. Understand the common drivers behind many acts of targeted violence – and make sure your plan reflects these insights. What else can be done? Since active shooter incidents vary widely and often involve an extensive range of potential scenarios that can change on a minute-to-minute basis, integrate the Active Shooter Plan with the hospital’s broader Emergency Management Plan. And place an emphasis on training exercises that involve both facility security and your local police department. But most importantly, get an Active Shooter Plan in place without delay. You’ll save lives.


[1]  Gabor D. Kelen, MD; Christina L. Catlett, MD; Joshua G. Kubit, MD; and Yu-Hsiang Hsieh, PhD; “Hospital-Based Shootings in the United States: 2000 to 2011, Annals of Emergency Medicine.
An active shooter attack is over in five minutes or less. Would your team be prepared?