PhotoYou go to a hospital because you are trying to get well or recover from an injury but sometimes a hospital stay just makes things worse.

Hospital Safety Score grades U.S. hospitals on how safe they keep their patients from errors, injuries, accidents, and infections. Hospital errors are alleged to kill thousands of patients each year.

Lately, however, there is a new safety concern involving U.S. hospitals – the fear of getting shot. Or more specifically, the fear of medical personnel being shot. A new report says the fatal shooting death of a Boston surgeon in January was another in what appears to be an increasingly frequent series of "active shooter" incidents in U.S. health care facilities.

Active shooters

"We would like to think that hospitals are not an area that would be subject to harm, and maybe that's why we want them to be free and accessible and not overly secure like a fortress," said report co-author Dr. Eli Adashi, former dean of medicine and biological sciences at Brown University. "But I think times are changing."

On January 20 Stephen Pasceri walked into Boston's Brigham and Women's Hospital and asked to see cardiologist Dr. Michael Davidson. Then, according to witnesses, he shot Davidson before turning the gun on himself. Relatives said the gunman blamed the doctor for his mother's recent death.

It might seem like an isolated tragedy but Adashi says it is not. In the year leading up to Davidson's murder there were 14 other active shooter incidents at hospitals around the country that left 15 people dead.

Problem getting worse

Adashi and fellow researchers cite a 2012 study in the Annals of Emergency Medicine that shows this alarming trend isn't new. By looking through archival news accounts, the researchers found that while hospitals faced about 9 active shooter incidents a year between 2000 and 2005, the rate had climbed to 16.7 a year between 2006 and 2011. Regardless of the motives or circumstances surrounding the shootings, 161 people ended up dead.

FBI statistics show a lower death toll but the same disturbing trend – active shooter incidents at U.S. hospitals are increasing.

In December, less than a month before Davidson was gunned down, the U.S. Department of Health and Human Services (HHS) advised health care facilities to incorporate active shooter planning into their emergency plans. Accreditation already requires planning for active shooters.

What to do

Not having an adequate plan to deal with an active shooter in the halls of a health care facility can expose a hospital to civil liability, the authors write. But the needed response to this growing threat isn't exactly clear.

Putting up a sign declaring that firearms aren't permitted in the building probably isn't going to deter a determined or mentally unbalanced gunman. Traditional security measures include more cameras, better lighting, "panic buttons," well-defined evacuation plans, limiting the number of entrances and exits, employing metal detectors, and even stationing armed police within the hospital.

Will they work? The authors say it is really the only thing hospitals can do in the absence of national policies that would improve behavioral health or limit access to firearms.  


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