Facility Active ShooterCMS Style Operations & Community

Based Full Scale Exercise

October 25, 2018

Thank You To

David Gerstner

for the Code Silver Extreme

exercise developed By

GDAHA/DMMRS Hospital and

Healthcare Security which

serves as the basis of this

exercise.

&

House Keeping

• Phones

• Exits

• Restrooms

• Snacks & Drinks

Introductions

• Exercise planning team & support agency representatives

• One person at each table state your facility name and type

How this works - Overview• There are two modules in which the scenario is

presented with timeline of events.

• Followed by a list of discussion items.

• Discuss at your tables, utilizing your operation plans, floor plans, and reaching back to your facilities.

How this works – Documentation• Document the steps you are taking, as well as items

that need further attention to be utilized in the AAR document.

• Will provide SITMAN as a documentation tool.

• We will have a few tables report on their status after each module, which we will document the highlights of.

• Will then do a Hotwash covering what went well, and areas for improvement.

How this works – After Action/Compliance

• Do a basic walkthrough of creating an AAR/IP with HSEEP “style” template we will provide.

• This presentation as well as sign in sheets will be available for download off our website.

• www.clarkhcc.com

Important!!!

• Any messages (phone calls, texts, emails, etc.) –MUST begin and end with “THIS IS AN EXERCISE”

An Exercise is an Objectives Driven Pie

9

The entire

response is

saved for future

discussionsToday’s

Objectives

Purpose

• To provide facilities with an opportunity to evaluate current response concepts, plans, and capabilities used to manage an active shooter incident.

10

Core Capabilities

• Operational coordination: Establish and maintain a unified and coordinated operational structure and process that appropriately integrates all critical stakeholders and supports the execution of core capabilities.

• Operational communication: Ensure the capacity for timely communications in support of security, situational awareness, and operations by any and all means available, among and between affected communities in the impact area and all response forces.

Objectives

• Discuss operational coordination and response between facilities, first responders, and public safety agencies based on your plans.

• Discuss operational communication issues, capabilities, and roles and responsibilities in a dynamic situation between internal and external stakeholders.

Assumptions and Artificialities

• In any exercise, assumptions and artificialities are necessary

• During this exercise:

• The scenario is plausible, and events occur as they are presented

• Don’t fight/argue the scenario

• There is no hidden agenda, and there are no trick questions

Exercise Guidelines

• This is an open, low-stress, no-fault environment

• Varying viewpoints are expected

• Decisions are not precedent setting; consider different approaches and suggest improvements

• It is hoped that you will continue discussions in the days and weeks following the exercise

Participants

Players discuss what their responses would be to the situation presented on the basis of expert knowledge of response procedures, current plans and procedures, and insights derived from training.

Observers generally do not participate in exercise play.

Facilitators provide situation updates and moderate discussions. They also provide additional information or resolve questions as required.

Your Homework was

• Run. Hide. Fight.® video

• https://www.youtube.com/watch?v=5VcSwejU2D0

• Active Shooter in Healthcare Environment video

• https://www.youtube.com/watch?v=8yWPnbuGNh4

• Determined participation level at your facility

Background Information

On average there are about 17 shootings in health care facilities a

year per HHS

Ranking of active shooter event on HVA.

Kirkersville – population 535

• While on a routine traffic stop a 911 call came through dispatch and Chief DiSario was told there was a man with a shotgun.

• Chief Steven Eric DiSario(421) was gunned down and two others were also shot and killed. The gunman then killed himself.

• 100+ officers / 32 Fire/EMS Units

Dayton Veterans Administration Hospital

• May 5, 2014: Neil Moore, 59, of Trotwood carried a handgun into the VA and shot a man in the leg

• Escaped facility; later arrested at another hospital

SITMAN Overview

• Documentation!!

• Basic exercise information

• Module discussion notes / actions

• Answer capture sheet

• Hotwash notes

• Used to build your AAR/IP

• Template will be available on our website www.clarkhcc.com

Questions Questions Questions Questions

at this at this at this at this

point?point?point?point?

Module 1

Incident Notification

9:05 am Shooter Enters your Front Door

Shots Fired

• Shooter makes his way to the front desk

• Opens fire and strikes a nurse who had her back to the gunman

911 Call

A visitor witnessed the shooting and called 9-1-1

“There is a man with a rifle and he just shot a nurse in XYZ Nursing Home, I am running for my life”

The call abruptly ends, and local police and fire begin their response

Discussion Items

1. What steps are your staff taking?

2. How is law enforcement notified by your facility?

3. How are you informing your staff, patients, and visitors of incident?

a) What is the message?

b) What is the method of delivery?

c) Who is responsible for doing this?

Report Back

Module 2

Response

Help Arrives

Within minutes Law Enforcement and EMS/Fire begin arriving on scene

Actions Occurring Now?

• Law Enforcement

• Fire/EMS

• Facilities

• Others

Lockdown

Officers are recommending a full lockdown of facility and asks for assistance from your management

At Tables, Think about…

4. What does your lock down plan entail?

5. Who can initiate the plan?

6. Who is responsible for the various pieces, and are there redundancies?

Report Back

Shooting Ends

• Police find the shooter in the facility and engage the gunman

• The shooter is shot but not killed by police and taken into custody

9:30 am – Info We Have

• One victim is dead – the nurse

• Three patients with serious wounds

• Three visitors with moderate wounds

• Some computers and medical equipment have been destroyed, and multiple windows have been shot out

• Many people are in shock and are still in disbelief

10:45 am - 1 hour and 15 min later

• Police determine facility is clear of further threats

• Crime scene investigation commences

Law & Fire/EMS

• What level of access to the facility was allowed in last 1 hour – 15 min?

• What do you foresee happening at this point?

Discussion Items7. How do you account for your staff?

8. How do you account for your patients?

9. Are patients transferred to another facility?

a) What is your method for sharing info and medical documentation, for residents under your care with other health care providers, to maintain continuity of care?

10. How do you communicate with patients families or representatives?

Report Back

Hotwash

3 – 2 – 1……

•3 Things that went well

•2 Things that need improved

•1 Question you are leaving with

AAR/IP Overview

Next Steps

• Develop after action report/improvement plan (AAR/IP)

• Finalize AAR and distribute to exercise participants and stakeholders

• More drills and exercises?

More Pie to Eat

50

The remaining

response is

further saved for

future exerciseNext Exercise’s

Objective

Thank You Partner Agencies!

Thank You For Participating!

Michelle Clements-Pitstick

Emergency Preparedness Coordinator

Clark County Combined Health District

529 East Home Road

Springfield, OH 45503

Office: (937)390-5600, ext. 228;

Cell: (937) 572-7498

Fax: (937) 342-5500

MPitstick@ccchd.com

www.ccchd.com

Ken Johnson

Deputy Director

Clark County Emergency Management

3130 East Main St, Suite 1E

Springfield, Ohio 45505

Direct Office Line: (937) 521-2178

Main Office Line: (937) 521-2175

Fax Line: (937) 327-3862

Cell Phone: (937) 605-2692

kjohnson@clarkcountyohio.gov

www.clarkhcc.com