In the wake of two shootings at health care facilities on Wednesday, many hospitals and health systems are renewing their focus on preparing staff for active shooter scenarios.

2 shootings at health care facilities

On Wednesday, two shootings occurred at separate health care facilities. One happened at Saint Francis Hospital in Tulsa, Oklahoma, which resulted in four deaths and many other injuries, according to authorities.

According to Deputy Chief Eric Dalgleish of the Tulsa Police Department, authorities received a call about a shooting at 4:52 p.m. and arrived at the scene four minutes later. Dalgleish said the shooting is believed to have taken place in a section of the second floor of the Natalie Medical Building at Saint Francis.

As officers entered the second floor of the building, the gunfire stopped, according to Capt. Richard Meulenberg. As police searched the building, they eventually found the shooter, described as a Black male between 35 and 40 years old, who had apparently shot himself with a pistol, Meulenberg said.

Tulsa Police Chief Wendell Franklin on Thursday said the shooter was a former patient who was released from the hospital in May following back surgery and "blamed" his doctor, Preston Phillips, for the chronic pain he experienced afterwards.

According to Franklin, the shooter purchased an AR-15 style rifle the day of the attack and went to the hospital with the intention to kill Phillips and anyone else who got in his way. Phillips was among those found dead.

Meanwhile, another shooting occurred Wednesday at Miami Valley Hospital in Dayton, Ohio. According to Dayton police Maj. Brian Johns, a struggle took place in a private ED room at the hospital where an inmate was receiving treatment while detoxing.

The inmate took a security guard's pistol, shooting and killing him before escaping and shooting himself in the parking lot, police said.

Hospitals renew focus on active shooter preparedness

Hospitals commonly have active shooter drills, especially at academic medical centers, Modern Healthcare reports. But experts said hospitals have discretion as to what hazards are relevant to their facilities.

Following the Saint Francis shooting, the health system said it has mass shooting "training and educational modules," but executives "couldn't speak to actual drills."

"There's going to be a thousand questions that we as an organization are going to need to answer, and that's going to be one of them," Cliff Robertson, president and CEO of Saint Francis, said in a press conference Thursday.

"In principle, hospitals should consider 'active shooter' as one of the relevant hazards to plan and train for as part of 'all hazards' preparedness. But in practice, hospitals have broad discretion," said Glen Mays, a professor of health system management and policy at the University of Colorado Anschutz. "Academic medical centers are especially tuned into active shooter risks because of their educational mission alongside their clinical care mission."

Nationally, health care facilities have two requirements for emergency preparedness: an emergency preparedness rule from CMS and the accreditation mandate from the Joint Commission. Both rules require hospitals have emergency response plans for "all hazards." In June 2021, the Joint Commission included active shooter preparation as a requirement.

Many health systems already have active shooter protocols in place. A spokesperson for the Cleveland Clinic said the health system has several active shooter training programs during the year.

Northwell Health said it reviewed the shooting in Tulsa with its staff and went over the protocols in place, what should be changed, and how the health system would respond.

Northwell performs an active shooter drill at least once a year, Modern Healthcare reports, and all its employees receive training on active shooter situations, de-escalation, and other processes. According to Scott Strauss, VP of security at Northwell, armed security guards are in place at all Northwell hospitals.

The health system also created a "safe place initiative group," consisting of employees from the health system's legal, quality, patient experience, and other departments. The group discusses how workforce safety and patient experience can be improved. They implemented a thorough visitor-access control system and are considering implementing a system to detect concealed weapons, Strauss said.

"Here at Northwell, we have been very fortunate to have buy-in from senior leadership on security protocol," Strauss said. "If you don't have buy-in from senior leadership, you don't have anything."

There is also legislation in the works to address shootings at health care facilities, Modern Healthcare reports. The House of Representatives passed a bill recently that would require health care employers to implement workplace violence prevention plans.

"Tulsa's terror on Wednesday should remind us all of both the accelerating incidents of violence in healthcare settings and the urgency of legislative action to safeguard our caregivers, other healthcare staff, and every patient or family member in those facilities," said Jean Ross, president of National Nurses United. (Kacik/Berryman, Modern Healthcare, 6/2; Perry, Journal-News, 6/2)