Workplace violence is on the rise, and unfortunately, hospitals are no exception. When employees must make life or death decisions in a matter of seconds, training can make all the difference.
We recently sat down with Christopher Sonne, HSS’s Director of Emergency Management, and Senior Tactical Instructor Billy Castellano to talk about the Hospital Active Shooter Program.
Jeff Metherd: Tell us a little bit about your backgrounds.
Christopher Sonne: Sure. I'm the director of emergency management at HSS. I've been with the company for over four years, and I've been involved in emergency management for over 15.
Billy Castellano: I'm the senior tactical instructor with HSS, and I'm a former law enforcement officer from the Chicagoland area.
Jeff Metherd: How did you get into the profession?
Christopher S: I worked in the emergency department at Advocate Lutheran General Hospital for many years, and I was drawn to emergency management, preparedness and safety.
Jeff Metherd: What about you, Billy?
Billy C: I left law enforcement to work overseas with the US Department of State. While I was overseas, I was contacted by a Level One Trauma Center that wanted to develop an internal response for an active shooter situation.
Jeff Metherd: What makes you passionate about what you do?
Christopher S: We're trying to help people manage a terrible scenario, when they're in a situation where a quick decision could save lives. In an active shooting scenario, our clients will be better able to protect themselves, their colleagues, and their families.
Billy C: If workers are trained to respond to a workplace shooting, their chances of survival increase greatly. We offer the best advice and training available today.
Jeff Metherd: Workplace violence is a sensitive topic. Do people sometimes want to pretend the danger doesn’t exist?
Christopher S: People always think, "it's not going to happen here." But attacks like the ones in Orlando and San Bernardino show us that an active shooting event can happen anywhere. We have to be prepared. We have to be knowledgeable. We have to be able to take care of ourselves and others during these incidents.
Jeff Metherd: How do you define an active shooter incident?
Billy C: An active shooter is an armed individual that's threatening lives in a populated and confined area. Usually there's no method to their selection of victims.
Jeff Metherd: How does that differ from say, a hostage situation?
Billy C: A hostage situation is an armed individual that's holding people against their will until specific demands are met. On their face, these events look very similar.
Christopher S: But a hostage situation is a relatively stable situation. Organizations should develop a separate plan for active shooter and hostage situations, because they require very different responses.
Billy C: In an active shooter situation, the law enforcement response would be immediate, with the first responding police officers making entry. But in a hostage situation, the first police officers on the scene may set up a perimeter.
Jeff Metherd: How do you get organizations to take active shooter preparedness seriously?
Christopher S: We've had great partners in the insurance and underwriting industries who have helped us design our training programs and exercises to mitigate risk.
Billy C: Our data-driven approach is the most effective way to help clients prepare.
Jeff Metherd: What are some of the trends or statistics about active shooter incidents people should be aware of?
Billy C: Nearly three-quarters of active shooter events are five minutes or less in duration. The average law enforcement response time varies between 10 and 15 minutes.
Employees need to learn to protect themselves, because waiting for law enforcement might not be their best option.
Christopher S: We’ve also seen these incidents becoming more frequent. The environment is becoming more dangerous.
Jeff Metherd: What are the root causes and issues behind the rise in active shooter incidents?
Billy C: These incidents are difficult to profile, but we do see some common themes. Frequently, the shooter will be seeking revenge, trying to correct a perceived wrong. Other shooters are terrorists, with no relationship to their victims.
Most assaults are planned in advance. In hindsight, we often learn that a shooter’s colleagues or friends saw warning signs. Our training helps clients understand the warning signs and identify potential threats.
Jeff Metherd: Do active shooters share particular personality traits?
Billy C: It’s tough to profile individuals, but perpetrators often have a history of behavioral health issues. 98% of shooters are single males. We're seeing multiple firearms used more frequently, and we're also seeing improvised explosive devices more often. Most shooters aren't concerned with their personal safety. Many have already written a suicide note. They may wear body armor to prolong the event.
Jeff Metherd: What type of successes and failures have you seen with organizations that have attempted to develop active shooter programs?
Christopher S: The best practice is to develop a comprehensive program that combines regular exercises, employee training, and a contingency plan. A response and mitigation plan can be used to develop the specific employee training program.
Practical exercises can help staff develop their situational awareness and response techniques. One of the biggest mistakes we see are people trying to go too big, too fast. The first step should be to focus on your own team and build up from there.
Billy C: Sometimes an organization wants to have a big showy exercise, but shock and awe training won’t work if the staff isn’t fully prepared.
Jeff Metherd: Are there any types of exercise you discourage?
Christopher S: We see no benefit in unannounced exercises. The key to a successful exercise is communication. Long before we conduct on-site training, we're communicating with the staff about what they should expect.