Nancy Newell RN, CHEC
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1 ACTIVE SHOOTER CODE GRAY THIS IS NOT A DRILL Nancy Newell RN, CHEC
2 OBJECTIVE Identify escalation Workplace Violence within the National Healthcare System since 2000 Discuss Real-world event at Las Vegas Hospital Identify Lessons Learned from event Discuss unique challenges Discuss Operation Wilcox - Full Scale Exercise with Las Vegas Metro (MACTAC) Introduce L.I.V.E. Project Q & A
3 VIOLENCE UNITED STATES NEWTOWN LAX BOSTON
4 NOT BREAKING NEWS Work School Shop Eat Entertainment
5 HOSPITAL-BASED SHOOTINGS IN THE UNITED STATES John Hopkins Office of Critical Event Preparedness & Response Dr. Kelen Dr.Catlett Dr. Kubit Dr. Hsieh Published Annals of Emergency Medicine March 2012
6 154 Hospital Shootings with 235 Victims 3% Hospital s Active Shooter involved a Victim 59% took place inside the Hospital 41% took place on Hospital grounds 30-36% shootings could have been prevented 4% shootings involved mentally ill 11% shootings involved escape attempt/event
7 NUMBERS ARE CHANGING.
8 TAKE A LOOK BACK TO 2011
9 READY OR NOT!!!!!!! CHH (Centennial Hills Hospital) 2011 HVA revealed importance taking hard look at preparedness and response for an Active Shooter Event Recommendation to train and exercise was denied based on history of previous years events within healthcare community Research: What is the problem?
10 DISCOVERY: Early 2010 unannounced exercise in Las Vegas Hospital Off-duty Police Officer causes panic & fear Negative Media attention Loss of jobs Litigation
11 THE PROBLEM Obstacles had been set in stone across the Valley in Healthcare environment due to poor outcome of an Active Shooter Exercise
12 The Cruise Effect To go or move along, especially in an unhurried or unconcerned fashion Ships typically have both a top speed and a service speed. A number of factors contribute to the average cruising speed Routes are a major variable that impacts speed Cruise ships travel at a speed that comfortably takes them to their destination and back. A captain may choose not to proceed at top speed in order to conserve fuel and pace the voyage. not going to happen here not going to talk about it
13 STEPPED INTO THE OCTAGON in for a fight NOT GIVING UP IT S A MATTER OF TIME
14 THIS IS NOT A DRILL January 30, 2012
15 JANUARY 30, 2012 LAS VEGAS, NV. 4 Perpetrators commit armed robbery in local Pawn Shop
16 REFUGE LOCKDOWN Code Silver Code Lockdown
17 WE ARE NOT READY!!!! Security receives call from Metro Perpetrators on property, enter facility Perpetrators move thru the facility - freely Hospital on Lockdown for 6 hours Las Vegas Metro Police/SWAT/MACTAC converge on facility
18 LESSONS LEARNED Communication Breakdown Internally Externally Inability to Effectively Lockdown facility Security Video Footage Review Code Pink Metro Response
19 LESSONS LEARNED Media Staff Response Visitors Recovery
20 GUESS WHAT? You ve got to be kidding
21 GOING TO TEACH YOU A LESSON January 30, 2012 could have been a very different day We were fortunate, out of 4 perpetrators none of them thought to bring a weapon into the facility The automatic weapons and handguns stolen from the Pawn Shop were left in the trunk of the car parked in front of the Hospital Wake-up Call
22 CHALLENGES After Action Report identified critical internal & external issues Highest priority Call to Action Communication Look at the Video footage. Realistic Security Assessment What does Lockdown mean? How do we effectively lockdown large facility; safely?
23 CHALLENGES Education to all staff, to include C-Suites Code Pink Code Gray Code Lockdown Engagement and collaboration with Metro First time for everything, we were not ready for this
24 HOSPITAL STAFF INTERVIEWED I have patients to take care of I cannot run I didn t know what to do I called the operator and she told me that she needed to talk to security first I called a Code Pink after the Code Lockdown was called because I was worried about the babies Nobody bothered to talk to us after, we were all scared
25 nothing happened we are fine DIGGING IN
26 CHANGE OF THE GUARD Regulatory Requirements Upcoming TJC Survey AAR identified opportunities Agreement for TTX Exercise
27 DECEMBER SCHEDULED Experienced in-house warming New Leadership see how it goes Table Top Exercise
28 DOMINO EFFECT No Stopping
29 9/16/13 RUN - HIDE FIGHT not effective message for hospital personnel Need options relative to Healthcare Workers NAVAL YARD I can t run Where am I going to go?
30 10/21/13 SPARKS, NV SCHOOL SHOOTING Mike Landsberry
31 11/1/2013 Airport in Los Angeles TSA Officer shot & killed
32 12/17/13 Renown Medical Center Approved Tabletop EX scheduled AT CHH
33 CODE SILVER - 13 Key leadership from multi-discipline service areas Nursing/EVS/Lab/Admitting/Radiology etc Administration ARMOR (All-Hazard Multi-Organizational Response) Metro Northern Command Timing is everything Door s Opened
34 HIGH LEVEL LEADERSHIP INTEREST Patient Safety Council No Pressure! 5 minutes
35 NO REPEATING OF HISTORY RISKY INITIATIVE Do you like your job?
36 PRIORITY Leverage recent events we need to be ready Full Scale Exercise approved with many stipulations
37 MACTAC MULTI-ASSAULT COUNTER TERRORIST ACTION CAPABILITIES LOOKING FOR THE BEST I can help
38 THE PITCH Extent of Play Logistics Where - When - How
39 MOVING PARTS Not Been Done Use of Blanks approved
40 I MUST BE CRAZY
41 JUNE EVERYTHING CHANGED
42 EXERCISE EXECUTION Evaluators & Controllers Actors Hospital Staff Followed HSEEP Standards
43 TRAINING Actors Controller & Evaluators 90% participants Healthcare Employees RUN HIDE FIGHT Video
44 OBSERVERS Spread like wildfire; everybody wanted to observe Did not want to comply with Safety requirements
45 SEPTEMBER 17 Operation Wilcox In memory James Wilcox
46 Operation Wilcox Evening Operations No Budget Year Planning Approximately 60 Participants Medical Office Building Media honored request for closed Exercise Home Video Recorder Tremendous Success
47 PLAN OF ACTION Train LIVE Project Buddy Badge mirroring Best Practice from WSI Nevada Model Revise Policy and Procedures Exercise the Plan 2015; tabletop format
48 L.I.V.E. MESSAGE L - Leave or Lockdown I - Invisible V - Violence E - Evade
49 LIVE PROJECT : Run-Hide-Fight message not enough! The Message: How do you LIVE when faced with an Active Shooter
50 MAD MAKE A DIFFERENCE Lost October 25, 1998 It s Personal
51 STOP THE VIOLENCE Vigilant Duty Diligence Situational Awareness & Analysis What are you doing? Have you done everything you can? Educate-Teach Train Plan Prepare - Practice ADOPT THE LIVE PROJECT SAVE LIVES
52 LIVE PROJECT in Memory Officer Alyn Beck Officer Igor Soldo James Wilcox Chastity F. Dorrill
53 LIVE PROJECT Training within Hospital Department Specific Buddy Badge UHS Corporate Review State of Nevada s Coalition s OSHA Adoption Building a LIVE PROJECT Website Posting of Training Video for Healthcare Resources Working with Clark County School District (5 th largest in U.S.)
54 HOW TO RESPOND WHEN AN ACTIVE SHOOTER IS IN YOUR VICINITY QUICKLY DETERMINE THE MOST REASONABLE WAY TO L.I.V.E. L LEAVE AND/OR LOCKDOWN Leave your belongings behind. Lock your area down to restrict the active shooter s access and movement in the facility. Have an escape route and plan in mind. I INVISIBLE Hide in an area out of the active shooter s view and block entry to your hiding place. V VIOLENCE As a last resort and only when your life is in danger use violence to incapacitate the active shooter. E EVADE Evading detection from the active shooter is still the best option. Call As Soon As Possible. Keep your hands visible to police personnel when they arrive
55 How Can I Help You? Nancy Newell R.N CHEC Emergency Preparedness & Trauma Coordinator Centennial Hills Hospital Medical Center 6900 N. Durango Dr. Las Vegas, NV nancy.newell@uhsinc.com or nlnc@cox.net Office: Cell:
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