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 on.  It'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 http://www.flickr.com/photos/bjmacke/2644522865/

Good News From The BLS CFOI

Workplace homicide continues to decline...

The Bureau of Labor Statistics (BLS) has published its preliminary Census of Fatal Occupational Injuries (CFOI) numbers for 2011. Good news; last year the workplace was slightly less lethal overall.  There were 4690 fatal injuries at work in 2010 and 4609 in 2011.  Violent deaths at work declined from 832 to 780.

The BLS has changed its coding for 2011; “Assaults and violent acts” is now “Violence and other injuries by persons or animals.”

• Violence and other injuries by persons or animals – 780
• Homicides – 458
• Suicide – 242
• Animal and insect related – 37

There is another new category in the preliminary data this year. “Injury by person – unintentional or intent unknown,” currently accounts for 43 deaths.  Of those 17 deaths were the result of unintentional shootings, presumably negligent discharges.

Of perennial interest to me and my peers in the security trade, workplace homicides continue to decline; 458 murders is the lowest in the series started in 1992.  There were also fewer suicides this year than last – down from 270 to 242, reversing a troubling upward trend over the past couple years.

"Animal and insect related" deaths are divided between stings and venomous bites and being gored, kicked, or trampled by cattle and horses.  Ouch.

These numbers are subject to revision - and usually increase - before the final statistics are published in a few months.

A question to be resolved is whether these lower numbers are driven by our current Great Recession or by effective crime prevention and incident management efforts.  One would hope to demonstrate it's the latter while we fear we are enjoying only a temporary respite brought on by the former.  Only time will tell.

Literary Oversight Corrected

Orson Scott Card's Ender's Game has aged well...

I read Orson Scott Card's original short story in Analog when it was first published in 1977 and it has stuck with me all these years.  Why I have not read his fine novel until now baffles me; just another example of a misspent adulthood I guess.  In any case I'm glad - very glad - to have corrected my oversight.  Ender's Game is excellent science fiction and a strong piece of storytelling.  It has so much to say about the nature of leadership that anyone with personal or professional responsibility for others who has not read it should.  There is no reason to wait like I did.  Try to get around to reading it before half a lifetime passes you by.

What's in a Word?

Principles of Neurotheology overreaches...

Over the past few years I've deeply enjoyed several of the books written by Andrew Newberg, especially those penned with his late collaborator Eugene d'Aquili.  Newberg's latest, Principles of Neurotheology, which he describes as a "principia" for this nascent field which he has done much to advance, left me cold for most of its 266 pages (it felt like many more before I checked).  Newberg casts such a broad net that neurotheology might become all things to all its proponents. A cynic might wonder if the field he is mapping isn't the perfect vehicle with which to scoop up Templeton Foundation grants. A more charitable soul might surmise that Newberg either become (or admitted to himself that he is) a deeply religious person and is bending over backwards to leave his spiritual impulse some wiggle room.  Things did pick up a bit in chapters 8-10, when it felt like Newberg was returning to his roots as a scientific researcher, but throughout Principles of Neurotheology he rarely describes any aspect of the field that wouldn't be better addressed by neurology or theology/philosophy alone.  Predictably, some religious reviewers find his latest book too secular while some skeptics find it too religious.  Offending both extremes sometimes means you are hewing a middle path, but science is about truth not balance.   If you have not read on this topic, or on Newberg and d'Aquili's contributions to the field, I strongly recommend you start with The Mystical Mind: Probing the Biology of Religious Experience or Why God Won't Go Away: Brain Science and the Biology of Belief.

Samsara, Take Two

For those who insist, here are some details...

Samsara is the ancient Pali or Sanskrit word applied to the Vedic concept of perpetual life, death, and rebirth.

Samsara, the movie, examines humanity in its many manifestations and its search for spiritual truth as we live out our lives on an ever turning wheel of existence.  Samsara is without dialogue; it tells its story with majestic images and a compelling sound track.  Many scenes of nature and the human environment are stunning.  As it is in life, not every human experience portrayed is pleasant.  Samsara features images of discord, inequity, and objectification.  While much of the movie is writ large it takes time to look deeply into the eyes of the people whose lives it captures, young, old, familiar, different, energized, tired, content, and put upon.  As they engage us from the screen are eyes expressing a question or making an accusation?

Samsara evokes memories of the ground-breaking 1982 Koyaanisqatsi: Life Out of Balance (The first film in Godfrey Reggio's Qatsi trilogy, which also included Powaqqatsi and Naqoyqatsi.), the 1985 Chronos, and the 1992 film Baraka, and for good reason.  Director Ron Fricke applied his prodigious talents to all of them. 

Samsara's producer Mark Magidson worked with Fricke on Chronos and Baraka (the home video release of which was described by Roger Ebert as "sufficient reason to acquire a Blu-ray player").  In their latest collaboration they are making use of the finest cinema technologies available.  It is simply an awesome experience!

Cassie and I saw Samsara at the Edina Cinema, which converted to DLP Digital projection and sound just last month.  The experience could only be more real if you visited the 25 countries where the film was shot over the last five years.  There was a time when serious cinephiles sought out movies of this quality early in their run, before the prints began to show their age due to scratches and repaired breaks.  Now it seems films preserved in the digital format will not age.  See Samsara on the largest and very best screen you can find.  

Just go see it.

You can thank me later.

Samsara

Is the finest cinema experience you are likely to have at a motion picture theater this year...

Just go see it.

You can thank me later.

Fizzle Yield

A very loose collection of ideas - some of them clever - trying to achieve critical mass...

It arrived without any fanfare (rarely a good sign) or advance screenings for the critics (never a good sign) but the movie Branded nonetheless caught my eye and a couple hours of my time this week.  It features actors Max von Sydow, Leelee Sobieski, and Jeffrey Tambor.  Set and filmed in post-Soviet Russia this 2012 film is nominally a fantasy science-fiction story.  

Nominally.

In practice it's some sort of post-Communist allegorical - and phantasmagorical - screed aimed at the excesses of modern marketing, capitalism, corporate amorality, materialism, personal excess, and consumerism.  There are American spies using USAID as a front (like that would ever happen), Lenin as the inventor of scientific marketing, a gullible populace whose easily manipulated opinions are transmitted to them via reality programs and TV commercials (Pshaw!), traffic jams that transform Moscow streets into parking lots - and bedrooms (did I mention Leelee Sobieski?), a plan that turns "thin is in" inside out, a ritual sacrifice of the red heifer performed in the traditional Hebrew style, and an ambivalent marketing whiz who can perceive the spiritual manifestations of his own and his competitors' campaigns.  It was probably a brilliant short story.  As a movie Branded is a goofy, stylish, kinetic mess.

Memorial Bowties?

Really, that's the best you can do to perpetuate the horror?

I thought we Americans would eventually get over the nasty sucker punch we took on September 11th, 2001.  Instead we've made 9/11 a national holiday and ground zero into a police state theme park.    

This week, on the occasion of the 11th anniversary of Osama bin Laden's terror attacks, Slate has an excellent essay online this week.  Written by a very talented Mark Vanhoenacker and titled Do You Have a Photo ID, Young Man?, it questions the excessive security in place at the National September 11 Memorial & Museum (& Gift Shop).  Bruce Schneier was interviewed for this edgy piece and he does not fail to deliver.

Schneier responded to a description of the memorial’s visible security with a pointed question: Is the memorial to the victims—or to our collective stupidity?   The tactics, Schneier said, “assume we can guess the plot. But as long as the terrorists can avoid them by making a minor change in their tactics or target, they're wastes of money.”

 

In one of many pointed paragraphs from this excellent essay:

In terms of balancing America’s most cherished values, no other American memorial marking a terrorist act has struck anything like the “balance” New York has. The Oklahoma City memorial, the Flight 93 memorial, even the Sept.11 memorial at the Pentagon: None require advance names, photo ID, or airport-style security, let alone all three ... Abroad, access to highly urban memorials in freedom-loving countries better acquainted with terrorism - Spain, the United Kingdom - is unfettered. Neither the memorial to the London July 7, 2005, attacks nor the Madrid station bombing memorial require preregistration, ID, or security checks.

I remember the horrible morning of 11 September 2001, but a decade and a year later I choose not to be crippled by fear, or to let my judgement be clouded by anger. But neither will I celebrate it.  The USA and its coalition members have killed tens of thousands of Iraqis, Afghanis, Pakistanis, and Yemenis  in reprisal for Al Qaeda's dastardly attacks.  Perhaps it's time to share some of our national outrage with those who have cynically guided, leveraged, perpetuated, and profited from our reflexive and jingoistic response to the original offense. 

We have sacrificed the lives of more than 6,000 military personnel and maimed tens of of thousands, spent two trillion dollars and have not stopped counting, cheered while the alphabet agencies told the Congress precisely where to gut-rip our Constitution, and now stand patiently in cattle chutes while the TSA gropes our grandmothers and looks at naked pictures of our children.

All that's left is to send Al Qaeda GeeDubya's "Mission Accomplished!" banner.

And when you're done refreshing your dread at ground zero don't forget to visit the Gift Shop where you can purchase four dollar rubber bands, co-branded NYPD ball caps ($18.00) and NYFD T-shirts ($22.00), and memorial bowties ($57.00?!!).

How About You?

What books have you read more than once? 

An interesting quote of the day from GoodReads has got me thinking.

“If you would tell me the heart of a man, tell me not what he reads, but what he rereads.” - François Mauriac

According to my best recollections at my GoodReads account I've read something like a thousand books.  Among them I've read the following more than once:

• African Rifles and Cartridges, by John "Pondoro" Taylor
• The AK47 Story: Evolution of the Kalashnikov Weapons, by Edward Clinton Ezell
• American Hunting Rifles: Their Application in the Field for Practical Shooting, by Craig Boddington
• The Andromeda Strain, by Michael Crichton [The first novel I ever owned]  
  
• Anvil of Stars, by Greg Bear
• Beyond Fair Chase: The Ethic and Tradition of Hunting, by Jim Posewitz
• The Body, by Stephen King
• The Book of the Garand, by Julian S. Hatcher
• Combat Shotgun And Submachine Gun: A Special Weapons Analysis, by Chuck Taylor
• The Complete Book of Combat Handgunning, by Chuck Taylor   
• The Complete Walker III, by Colin Fletcher
• Cooper on Handguns, by Jeff Cooper  
• Dune, by Frank Herbert
• Dune Messiah, Frank Herbert 
• Endymion, by Dan Simmons
• The Fall of Hyperion, by Dan Simmons
• The Fighting Rifle, by Chuck Taylor 
• Fireworks, by Jeff Cooper 
• The Forge of God, by Greg Bear
• Goodnight Moon*, by Margaret Wise Brown
• Guns, Germs, and Steel: The Fates of Human Societies, by Jared Diamond
• Hyperion, by Dan Simmons 
• The Illiad, by Homer (Fagle translation)
• Longbow: A Social and Military History, by Robert Hardy
• Lucifer's Hammer, by Larry Niven and Jerry Pournelle
• The Man in the High Castle, by Philip K. Dick
• The New Testament, by multiple authors 
• The Odyssey, by Homer (Fagle translation) 
• Of Arms and Men: A History of War, Weapons, and Aggression, by Robert L. O'Connell 
• On Killing: The Psychological Cost of Learning to Kill in War and Society, by Dave Grossman
• Plagues and Peoples, by William H. McNeill
• The Polar Express*, by Chris Van Allsberg
• Ringworld, by Larry Niven
• The Rise of Endymion, by Dan Simmons
• The Runaway Bunny*, by Margaret Wise Brown
• Safari Rifles: Doubles, Magazine Rifles, and Cartridges for African Hunting, by Craig Boddington
• Shots at Big Game, by Craig Boddington 
• Slaughterhouse Five, by Kurt Vonnegut 
• The Snowy Day*, by Ezra Jack Keats
• Stalking & Still-Hunting (The Ground Hunter's Bible), by G. Fred Asbell 
• The Stand, by Stephen King 
• Starship Troopers, by Robert Heinlein
• Startide Rising, by David Brin
• Sundiver, by David Brin 
• Where the Wild Things Are*, by Maurice Sendak
• Why God Won't Go Away: Brain Science and the Biology of Belief, by Andrew Newberg, Eugene D'Aquili and Vince Rause

* Okay, the books we read the kids may be a cheat, but these are among the better ones and we read them many, many times.

There are probably a couple others; I'll think on it. 

How about you?