Are your employees trained for the unthinkable?
“Shooter on the premises!” If you think it can’t happen at your care organization, think again.
Long-term and post-acute care (LTPAC) settings must be prepared to respond to sudden acts of violence, such as spill-over domestic violence that follows employees to work or resident suicide pacts, however remote the possibility may seem. At least 27 percent of fatalities in healthcare and social services settings are the result of violence, according to the Bureau of Labor Statistics. Employers and employees need deep training in how to respond before, during and after an active shooter event to ensure everyone’s safety.
The Centers for Medicare and Medicaid Services (CMS) has created recommendations for dealing with an active shooter in LTPAC setting. The Federal Emergency Management Agency, in its FEMA IS-907 document, also has explored the planning, training and exercise challenges associated with preparing to respond for active shooter events within LTPAC communities.
“In most cases, active shooters use ﬁrearms and have no pattern or method to selecting victims,” notes Steve Wilder, CHSP, STS, CEO and President of Sorensen Wilder & Associates, a safety and security consultancy, in a blog. “Contrary to what we’d like to believe, the reality of an armed intruder or active shooter coming into your facility is all too real.”
While the traditional “run, hide, fight” approach is solid advice, LTPAC providers face unique challenges. Many residents have mobility challenges and cognitive impairment and need staff assistance to shelter in place, let alone evacuate. Clear policies and procedures ensure that staff members will react with confidence at the first sign of a threat.
The primary response is to lockdown the facility. Wilder describes three types of lockdown: The first keeps the shooter out, the second keeps people securely in the building and the third type is a total lockdown that prevents entry or egress.
To strike a balance between resident and employee safety, Wilder recommends revising the “run, hide, fight” doctrine to:
- Get Out: If possible, evacuate the building quickly and call 911 from a safe area.
- Hide Out: Move to an inconspicuous area. The shooter doesn’t have time to search.
- Keep Out: Barricade your safe area.
- Take Out: This is the action of last resort when the first three actions are ineffective.
The all-employee, cross-team approach to training is key in LTPAC settings. For example, once maintenance or security employees ensure that entries are secure and police are en route, they should be trained in how to assist the nursing staff with moving or sheltering residents. Likewise, cross-team training ensures that caregivers who “float” between departments or care roles will know what to do in each location of the building.
A comprehensive active intruder plan is essential, but hands-on training and mock drills are equally important, Wilder says. Reinforcing procedures with practice on a regular basis will help employees act with confidence and calmness in the face of a threat.
All new employees should receive training in the organization’s emergency procedures. In-services and training drills for all employees should be scheduled every six months at minimum, Wilder suggests. It’s a small investment in time to prepare employees, and proper training can save lives.
Visit your associations for advice and templates for creating or revising your security action plan. Keep staff in the loop by issuing a reminder pocket card available from Homeland Security. Take advantage of every resource—from webinars, videos and more.
The chances of an active shooter event might seem remote but planning and preparation will ensure that your community is ready to face the challenge. As LTPAC providers you have the duty—and privilege—of keeping those in your care and in your service safe.