Tulsa shooting shines spotlight on healthcare security

June 3, 2022
Experts say incident reemphasizes the need for workplace violence training, creating a strong security culture

Another week, another mass shooting. On Wednesday, a gunman walked into Saint Francis Hospital in Tulsa, Okla., and opened fire, killing two doctors, a receptionist, and a patient before turning the gun on himself.

The shooting comes just a week after the massacre at Robb Elementary School in Uvalde, Texas, which left 19 children and two teachers dead and less than a month after 10 people were gunned down at a Buffalo supermarket. 

Like schools, healthcare facilities have been frequent targets of mass murderers through the years. A report published by Becker’s Hospital Review, for example, counted no less than 17 fatal shootings between 2002 and late 2018 at hospitals across the nation.  

Anyone who has followed the security industry for any length of time is aware that the healthcare sector faces an increased risk of workplace violence when compared to any other industry in the country. In fact, according to the Occupational Safety and Health Administration (OSHA), between 70 to 74% of the workplace assaults reported between 2011 and 2013 occurred in healthcare and social service settings.

Despite the alarming and well-documented rate of workplace violence in healthcare, however, Ben Scaglione, Associate Principle at Cerami & Associates, Inc., and the former Director of Security for New York Presbyterian Hospital, says that many healthcare facilities still do not take security as seriously as they should.

“Even today – when you look at how things are and through the pandemic – I think security has made some major strides, but I just don’t think we take it seriously enough,” he says. “Up until last year when the Joint Commission made it a requirement to have a workplace violence program, a lot of hospitals never put it in place. It is the kind of thing where you think it is never going to happen and we need to take it more seriously and understand that it is not a trend. It is going to continue, and we need to be better prepared for it.”  

Bryan Warren, President of security consulting firm War-Sec Security and the former Director of Corporate Security for Carolinas HealthCare System, says while many healthcare facilities focus on striking the proper balance between security, hospitality and convenience, it is more about finding the right “blend” of these things.

“If you have a credible threat or if you have a situation, the blend is going to change a little and it’s not going to stay the same,” adds Warren, who is also a past president of the International Association for Healthcare Security and Safety (IAHSS). “Another issue is the fact that maybe sometimes too often we just look at the numbers and statistically it is true that most workplace violence, at least non-fatal workplace violence, occurs from our patients and visitors, but we can’t get caught up in that and assume that even though it is a large percentage that the other external threat cannot and will not happen.”  

More Training Needed

One of the less popular but effective steps healthcare organizations could take to mitigate future active shooter incidents, according to Scaglione, would be to implement situational awareness training for staff.

“It is kind of like teaching them to see clues when things occur,” he explains. “When you look at the research for active shooter, there are always clues, we just don’t see them. Our days are too busy, or we are just not equipped to understand that those clues are occurring.”

Scaglione says it is also time to place a heavier emphasis on workplace violence in the healthcare environment.

“We spend a lot of time training people on fire prevention and when you look at the statistics – as devastating as a fire can be – fires are probably less likely to happen in healthcare at this point than an active shooter,” he says. “For a lot of places, training is showing a couple of videos and they are done. The reality is we need in-depth training.”

Because workplace violence covers such a broad range of behaviors, from bullying and intimidation up to active shooter events, Warren says that hospitals and other healthcare facilities need to be sure to account for the most extreme incidents on this spectrum when they develop response plans and conduct training exercises.

“Even though the majority of incidents are going to take place in that middle tier, we need to make sure that we also look at things like active shooter because, as we’ve seen, they do occur sometimes,” he says.  

Creating a Security Culture

Within every hospital, Warren says there are three distinct categories of security – physical, operational and culture – and that all three need to be supporting each other or overall security and safety will suffer.

“You could spend a lot of money and have really good physical security. You could have this great access control system, a fantastic video surveillance system and you have a lot of investment into that, but if you have somebody propping a door open, it defeats the purpose. So, the culture can defeat the physical and operational. You could also have fantastic operational planning – these great policies and procedures – but the question is: Can you do what you say can do? I’ve seen some policies say we are going to lock the entire facility down in under five minutes. Well, if you don’t have an access control system that can do that automatically to a certain degree, how are your two (security) officers on duty – when one of them is going to be at the scene of the incident I’m assuming – going to lock an entire campus down?"

Addressing Current Vulnerabilities

Warren advises healthcare organizations to look at the IAHSS’ guidelines for practical recommendations with regards to implementing different security technologies and building design practices.

“The latest iteration is just a couple of years old, and it is very specific to healthcare facilities as far as the security, safety and emergency management design,” he says. “It is not just guidelines, but it is the actual physical guidelines for renovation or construction.”      

Additionally, Warren says having a threat assessment team should be a standard component of every healthcare facility’s workplace violence prevention council or committee.

“With technology now, it is not like it used to be years ago where we had to convene a meeting and people had to be face-to-face,” Warren says. “You can do this quickly now through Zoom, Microsoft Teams or just a phone call, but things like having HR’s input, maybe someone from behavioral health and possibly somebody from clinical and definitely somebody from security/emergency management – we need to get these people and their expertise together to look at some of these potential threats when they come up.”

Joel Griffin is the Editor of SecurityInfoWatch.com and a veteran security journalist. You can reach him at [email protected].