Shootings in hospitals have recently raised questions about what hospital leaders can really do to ensure the safety of their patients and employees.
While all hospitals and health systems tend to make emergency preparedness a top priority, organizations with varying resources must implement strategies that both suit their needs and fit their budgets. For example, safety-net hospitals face a unique set of challenges when designing emergency preparedness initiatives.
Safety-net hospitals have higher rates of uncompensated care and largely depend on government sources to supply their revenue. While they strive to provide effective emergency preparedness training, many safety-nets may not have the resources available to hold large training events. Instead, emergency preparedness efforts must be designed to meet the hospital's individual conditions and limits.
José R. Sánchez, president and CEO of Chicago's Norwegian American Hospital, says the hospital uses frequent, small-scale training sessions for staff along with daily security maintenance methods to protect patients and staff from potential danger. Norwegian American Hospital is located in the Humboldt Park neighborhood and serves a predominantly Medicaid and poor Hispanic population. The hospital's payer mix is 31 percent Medicare and 55 percent Medicaid, with just 1 percent of patients having commercial insurance.
While emphasizing the importance of safety, Mr. Sánchez says the hospital exists to give people medical care, not to act as a vehicle for law enforcement, so he opposes including a police presence in the hospital on a daily basis.
"You risk more having armed security inside the hospital," he explained. "We are a healthcare organization and we are here to serve our people, not to enforce the law. If someone comes inside with a gun, we have a protocol to call the police, protect our staff and patients and deescalate the situation."
Norwegian American, as with all hospitals, strives for the balance between being a source of compassion and ensuring security.
Mr. Sánchez explains Norwegian American consistently retrains staff in many safety protocols. Monthly training consists of simulation drills that teach the workforce to look for clues of danger, initiate its active shooter protocol and develop tools to deescalate potentially violent situations.
Norwegian American focuses significant attention on ensuring staff in the emergency department and behavioral health department are prepared to handle violent situations, because such episodes most commonly occur there.
"We provide Crisis Prevention Intervention training to our front-line staff working with individuals who have persistent mental illness and those who are substance abusers. This provides them tools to manage unpredictable and potentially harmful behavior in a safe way for our staff and patients," Mr. Sánchez said.
In the event of a major catastrophe, the hospital utilizes the National Incident Management System for healthcare organizations. Norwegian American is a member of the Chicago Health System Coalition for Preparedness and Response, ensuring a coordinated response to any disaster with other healthcare providers as well as city, state and federal agencies.