Friday, September 28, 2012

Excellent Piece of Hospital Violence Research

Marred by whining...

In September 2010 there was a high profile multiple victim shooting incident at Johns Hopkins Hospital in Baltimore, MD.  

"A 50-year-old man who became distraught after hearing about the unfavorable prognosis following surgery on his elderly terminally ill mother drew a concealed handgun and fired on his mother’s surgeon in the hallway of hospital ward. The shooter barricaded himself and his mother in her hospital room, where he fatally shot his mother and then committed suicide. The surgeon survived."

As an element of their multifaceted, interdisciplinary response to the incident Johns Hopkins took it upon themselves to conduct a study of shootings in hospitals.  The resulting paper, prosaically titled Hospital-Based Shootings in the United States: 2000 to 2011,
is a thought-provoking piece of research and analysis.  It observes that hospital shootings are not as common as some believe, offers an interesting analysis of the demographics of perpetrators and victims, and points out several trouble spots requiring additional attention.

Depending on motive and shooting location at or within the hospital the researchers determined that magnetometers are no panacea.  Counter-intuitively they suggest that for locations within the hospital (as opposed to incidents that occur on the grounds) metal detectors seem to be of the least possible value in the emergency department.  Most interestingly, they discerned that weapons taken away from law enforcement, corrections, and security personnel were used in as many as half the shootings in the emergency department. 

Their ideas as to solutions to this complex reality are uneven.  They lightly touch on the idea of excluding all firearms from the ED, but as quickly point out that cops and corrections officers are loathe to go about unarmed.  They suggest that biometric safety locks on firearms would help, but did not bother to determine whether or not such technology is available (it isn't).  They did not examine the idea of making certain that all armed private security personnel working in Emergency Departments receive at least as much advanced weapon retention training as police and use only high security firearms holsters issued to public law enforcement personnel.

Alas, no good deed goes unpunished.   

SecurityInfoWatch tells us the International Association for Healthcare Security & Safety (IAHSS), penned a press release complaining that the paper was incomplete:

"...hospitals should seek out the consultation of a certified healthcare security expert to assist in the development of a healthcare security program -- something not specified in the study.

Although the report shed some light on the issues of violence in hospitals covering the 40 states considered in their research, the study stops short of addressing some of the critical issues facing hospital administrators on a daily basis: How to operate a facility with a well-trained, professional security team, which functions under a well-conceived security plan, and is prepared to handle any crisis situation that may arise."

Where I come from a statistically robust research paper written by physicians and copiously referenced in the academic style, that outlines several areas upon which to focus limited security resources is something security leadership professionals would regard as manna from heaven.  The IAHSS might have aligned itself with the Hopkins study to leverage it for all it's worth to advance the interests of safety in the healthcare workplace.  Instead, they chose to complain that they were not mentioned.

The IAHSS missed the boat on this one.  For me, I'm bringing MDs, epidemiologists, MPHs, and medical statisticians to all my healthcare violence debates from now onIt's a fine paper.  Be sure to read it if WPV is your thing.

No Business Is Immune To Tragedy

Not even in Minneapolis...

While my client was hosting its annual employee recognition reception Thursday afternoon just three miles away in Minneapolis police were responding to a mass killing at Accent Signage Systems, a small company located in the pleasant Bryn Mawr neighborhood.  According to news reports the alleged killer was apparently an employee who had been terminated that day.  Three employees (including the owner) and a UPS driver were killed, four more were wounded (three critically), and the shooter (a terminated employee) took his own life.  Gratefully this sort of thing doesn't happen often, but no business is immune to such tragedy.  We will learn more about precisely what happened, what was done to prevent it, and what else might have been tried.  In the mean time care for yourselves, each other, and your family members; support your fellow employees; insist on a bully-free workplace and humane management; and report any threatening comments or other behaviors that concern you.  We can all work together to create a safe and secure workplace for ourselves, our teams, and our community.

Photo credit: bjmacke via flickr