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VA Veterans Affairs

Inmate Patient Takes Sheriff’s Deputy’s Gun, Shoots Deputy and Kills Himself

Prisoner Grabs Deputy’s Gun at a West Union, Iowa Hospital,  Shoots Deputy & Turns Firearm on Himself.

At Palmer Lutheran Health Center, a full service hospital in West Union, Iowa, an inmate who was brought from Fayette County Jail on Saturday morning, August 23, at 8:30 am, grabbed the County Sheriff Deputy’s gun and demanded he be released, the deputy used a non-lethal device on the inmate, who then shot the deputy at close range.  The inmate then killed himself with the handgun.

The deputy, who was wearing a bulletproof vest, was shot in the stomach, but was treated and released at the site of the incident.  The inmate, still unidentified, grabbed the gun when one of his hands was released for his medical treatment.

West Union Shooting

LESSONS  LEARNED:

1.   Forensic patients (prisoners) know it’s easier to escape
from the hospital
room, or hospital bed,  than it is to
escape from the County Jail!  Security should be
present to support law enforcement.  One deputy is
a minimum.  Deputy with security officer present is
better.

 

2.   Wearing a bulletproof vest saved the deputy’s life during the incident.  Security officers should
consider having bulletproof vests available when dealing with this type of patient.

According to research in the Journal of Injury Prevention,  “Shootings in U.S. Hospitals 2000 – 2011,
in 23% of shootings within hospital emergency departments, the weapon was a security officer’s gun taken by the perpetrator. https://www.llis.dhs.gov/sites/default/files/FA-gdkelen.pdf

IAHSS (International Association of Hospital Safety and Security),  has policy guidelines for security departments that deal with forensic (inmate) patients.  IAHSS members can access the Healthcare Security: Basic Industry Guidelines at www.iahss.org.

Security managers and hospital management need to make sure that All Hospital Staff including Clinical Staff
Are Warned to Use Extreme Caution When Working with or Near Forensic Patients!


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Copyright, 2014-2015 – Risk & Security LLC   



How Risk-Based Security Can Reduce Violence in Healthcare

reprinted with permission from www.securityinfowatch.com

Using Risk-Based Security to Stem the Tide of Violence
in Hospitals and Healthcare


Created by:   Caroline Ramsey Hamilton

Date: May 22, 2014

Hospital and healthcare security is experiencing a major increase in violence,
instigated by patients, patient families and even healthcare staff.  Just last year,
there was an active shooter incident in Reno, Nev., in which two physicians were
shot, and in Houma, La., 
a hospital administrator was shot to death by a terminated
nurse. As recently as Easter Sunday in California, two nurses were stabbed at the
hospitals, where they worked.  One was stabbed in both the upper and lower torso
and is in critical condition. These two incidents add to the more than 100 
violent
incidents in 2013 and the first half of 2014.

Since 2010, violence in healthcare has skyrocketed. As a result, the Joint Commission has
issued a “Sentinel Event Alert” on the issue and contributed to numerous articles on shootings
in U.S. hospitals. The Department of Homeland Security and a consortium of state and local
hospitals recently released 
a standard for active shooters in healthcare. These all point to the
conclusion that the current law enforcement-based hospital security model is not working.

Changes in Healthcare
The changes in healthcare, including the increase in insured Medicaid patients and increased
traffic to emergency departments, highlights the fact that very well-intentioned people are
working with an outdated security model that hasn’t evolved to address a changing healthcare
environment. The change in billing and reimbursements for healthcare organizations, such as
tracking of readmission rates, has squeezed hospital profits causing reductions in funding in many
security departments at a time when violent events are steadily increasing.

A new risk-based model for hospital security is emerging that is less linear and more cyclical.
It uses technology to a greater extent, employs forecasting and statistical models to predict the
likelihood of future incidents, and is proactive instead of reactive, focusing money and energy on
preventing events instead of simply responding to them. This model also uses risk assessment
formulas to quickly assess the current security profile of a hospital, clinic, hospice, or behavioral
health facility, factoring in heightened threat-risk environment, not only for the facility in question,
but also adding in the wealth of healthcare data that’s now available.

Risk –Based Security Focuses on Continual Assessment
A major focus of this model is the continual assessment and evaluation of preventive security
controls, which are reviewed quarterly, semi-annually, or annually to discover gaps in controls,
and to fix gaps as soon as they are identified. This dovetails nicely into the assessment models
already required by the Joint Commission, OSHA and new CMS standards.

Looking at recent high-profile security events that took in place in hospitals shows that incidents
happen because of exploited gaps in the existing security of the healthcare facility. In the past,
security officers successfully worked hard to reduce response time so that often officers could
arrive in under two minutes, but it’s still too long.  In the Reno shooting, response time was under
two minutes, but that was long enough to kill two doctors.

Focusing on prevention makes sense for healthcare, much in the way the Joint Commission
focuses on patient safety, by continually assessing controls, reducing discovered gaps in controls,
and mitigating gaps by reassessing and tightening security, which creates a cycle of continual
improvement in the healthcare security environment.

Taking Advantage of Technology
The healthcare risk-based security model takes advantage of technology. Instead of waiting
for manual recording of security incidents every day, software programs allow hospital security
officers to enter data at the end of each shift, and that means security directors can map what’s
happening in the hospital or facility on a daily, weekly, monthly and yearly basis.  This can go a long
way to identifying trends early and help facilities make appropriate changes in controls so that
negative trends can be reversed 
quickly and both patient and staff security is increased.

In addition to automating incident collection and analysis, the healthcare security risk assessments
must be automated too.  Risk assessments are too time-consuming and labor intensive to be done
annually.   
By the time the risk assessment is over, the environment has changed again.  By
automating the risk assessments, including environment of care and hazard vulnerability,
it produces data that can be used instantly to analyze and recommend the most cost-effective
controls, and rank them by their return-on-investment (ROI).

The role of security in hospital and healthcare organizations is changing too. Security organizations
should no longer be isolated without intensive interaction with others in the organization, including
the human resources department, the facilities managers, safety managers, and the emergency
management staff.

New DHS Guidelines for Active Shooters in Healthcare
With DHS issuing new guidelines for active shooters in healthcare, hospital emergency managers
are now required to prepare for active shooter incidents, as well as storms, hurricanes, tornadoes,
power interruptions and other events related to natural or man-made disasters.  This creates a
natural partnership between the emergency management staff and the security program,
because the skills of both functions are needed to properly prepare an organization for any disaster.

Instead of existing in a vacuum, healthcare security directors and managers should cheer at
this development because it expands the importance of security inside the hospital or healthcare
facility, and underscores its value in protecting the organizational assets –  the physical facility,
patients, visitors and staff –  to proprietary information, including the HIPAA mandated PHI
(Protected Health Information), vehicles, security systems, high-value healthcare equipment
and the healthcare provider’s reputation.

Security budgets have always suffered because security costs are seen as operating
expenses, not an income source, but by tying the security expenses more closely to loss
prevention and protection of the organization, it creates a cost justification for hospital and
healthcare security.

Risk-Based Security Links to Hospital Compliance Standards
A risk-based security model also links security to myriad compliance standards that affect healthcare
and this also supports and justifies the costs related to security. For example, hospitals are required
to have a variety of security controls in place related to tagging of newborns, posting of no-weapons
signs, and environment of care issues. Any healthcare organization accepting funds from Medicare
or Medicaid must comply with the new mandate for annual security risk assessments. 

OSHA 3148 also requires hospitals and healthcare organizations to do annual workplace violence
assessments, and more than 33 states also require enhanced protection of hospital and healthcare staff.

As security incidents continue to increase and violence in healthcare escalates, making the
switch to a risk-based security program will provide better protection for hospitals and healthcare
organizations, making more effective use of existing security personnel, as well as justifying and
expanding healthcare security budgets.

 

For more information:  contactCaroline Ramsey-Hamilton at caroline@riskandsecurityllc.com

 



RISKAlert – May 2014 Shooting at VA Medical Center, Dayton, Ohio

RiskAlert         INCIDENT REPORT 552 – HOSPITAL SHOOTER

Terminated Employee Shoots Staff Member during Card Game
at Veterans Affairs Medical Center in Dayton, Ohio

Allowing terminated employees to have access to a hospital or facility where they
worked before is a questionable decision, because not only anger at the organization,
but also a
nger at individuals and former co-workers may turn into an incident as this report
explains.

In early May, a terminated housekeeper at the Veterans Affairs Medical Center in Dayton, Ohio came back to the hospital to play cards in a hospital break room with a group of current VA staff.   The perpetrator, Neil Moore, had also brought a handgun to the hospital.  Neil was upset because he thought another VA staff member was having a relationship with his wife, so he pulled out the gun, and as a result, one person was shot in the ankle.

It was not a typical active shooter scenario, but it does point outVAMC-DaytonOH
the access control problem in hospitals, and also questions the
ability for anyone to walk into a hospital with a loaded gun
.

LESSONS LEARNED:

 1.  Access to former employees should be prohibited or at
least limited on a case by case basis.

 2.  Visitors should not be allowed to bring guns into a hospital.
      Metal detectors should be used to screen for weapons.

 

Moore, a former employee at the Veterans Affairs hospital, told police that he was going to a regular card game with
his former co-workers.  He said he went to the hospital Monday intending to brandish the handgun to intimidate two former co-workers he believed were involved in relationships with his wife and daughter, both of whom reportedly work at the hospital.  Moore planned to “hold the ex-co-workers at gunpoint while he punched them with his right hand,” according to court documents.

The hospital complex has beds for about 450 people and provides veterans with medical, mental health and nursing home care. It doesn’t have metal detectors at its entrances, but it does have its own security force.

VA spokesman Ted Froats said the force conducts active shooter training four times a year and showed outstanding response Monday. He said in a statement Tuesday that the hospital will consider additional steps to ensure safety, while making sure that any new measures won’t impede the hospital from providing care to veterans as quickly as possible.

RISKAlert®  is a publication of Risk & Security LLC at www.riskandsecurity.com




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