Hospital shootings rare but purposeful, study finds
Shootings in U.S. hospitals typically generate widespread media publicity, but the likelihood of being shot in a hospital is less than the chance of getting struck by lightning, according to research at The Johns Hopkins University School of Medicine in Baltimore.
In a report published in the Annals of Emergency Medicine online and conducted by four researchers at Johns Hopkins, the investigators reviewed 11 years of data and identified some disturbing flashpoints. For one, almost 30% of U.S. hospital-based shootings occurred in emergency departments (EDs). Fifty percent of the ED incidents involved a police or security officer's firearm that was stolen to shoot victims or used by security to fire at an assailant.
The International Association for Healthcare Security & Safety (IAHSS) responded with criticism of the study, particularly aimed at what it says is too little focus on the use of trained and certified security professionals in hospitals.
An in-depth review of the 154 hospital-based shootings, which resulted in 235 dead or injured, found that such shootings are difficult to prevent because most involved a "determined shooter," says Gabe Kelen, MD, the lead author of the report and the director of The Johns Hopkins Hospital Department of Emergency Medicine in Baltimore. Another key finding, Kelen says, was that most perpetrators had a personal association with victims. "Most of the events involved a determined shooter with a specific target," Kelen and the other authors write in the study.
Common motives for shootings were a grudge or revenge; suicide; and euthanizing an ill relative. The latter motives all appeared to be the case in the Sept.16, 2010, shooting at The Johns Hopkins Hospital in which an assailant shot a doctor and then killed his ill mother and himself. That incident was the impetus for the study, Kelen says.
In the study report, the Hopkins research team concludes that specialized training for law enforcement and security personnel, such as proper securing of firearms, might prove a more effective deterrent to future incidents than investment in expensive or intrusive technologies, such as magnetometers.
Such technologies might create a false sense of security, primarily because potential weapons get into hospitals by a variety of channels and because more than 40% of all the shootings studied occurred on hospital property outside of buildings, the authors note. Many security experts, the authors add, view metal detectors and similar measures as impractical solutions in hospitals because they typically have multiple public entrances and large numbers of visitors each day.
Although the study found shootings at hospitals to be infrequent, Kelen points out that no hospital is immune. Zero risk "is not achievable," the authors write. The IAHSS, however, says several key strategies were not discussed. Specifically, the group cites the need to seek out the guidance of a healthcare security expert during the decision-making process of a security program, such as when installing metal detectors or arming security officers is being considered.
Other recommendations put forth by the association touched upon the need for greater professionalism and training of security personnel, the value of due diligence and risk assessments for effective decision-making at the time of an incident, and the importance of liaison work with a hospital's local law enforcement community.
Source
Gabe Kelen, MD, Chair, Department of Emergency Medicine, The Johns Hopkins School of Medicine, Baltimore, MD. Telephone: (410) 955-3182.
Shootings in U.S. hospitals typically generate widespread media publicity, but the likelihood of being shot in a hospital is less than the chance of getting struck by lightning, according to research at The Johns Hopkins University School of Medicine in Baltimore.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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