Boston hospitals react to Brigham and Women's shooting
Boston hospitals react to Brigham and Women’s shooting
After a gunman shot and killed a surgeon at Brigham and Women’s Medical Center, surrounding hospitals are making cautious adjustments
The aftermath of an active shooter incident at Brigham and Women’s Medical Center (BWMC) in Boston that left one surgeon dead has been met with mixed feelings from the medical community. Although surrounding hospitals view this as a horrible tragedy that struck close to home, security experts counter that this was an unpredictable event.
The shooting that made national news has certainly put the local healthcare community on edge, but hospitals aren’t jumping to make drastic changes, says Bonnie Michelman, CPP, CHPA, director of police, security and outside services at Massachusetts General Hospital (MGH) in Boston, and a security consultant for Partners Healthcare. Partners Healthcare owns both MGH and BWMC and Michelman has consulted with BWMC in the past.
“This was not a foreseeable event,” she says. “I certainly don’t think they were at fault at all.”
Around 11 a.m. on January 20, Stephen Pasceri walked into BWMC and asked to speak with Michael J. Davidson, a cardiovascular surgeon at the hospital that had treated Pasceri’s mother. An altercation ensued in the foyer between an examination room and the waiting room and Pasceri shot Davidson twice. Davidson was rushed to surgery, but later died as a result of his injuries. The gunman fatally shot himself.
Although BWMC is currently reviewing the incident, initial news reports indicated the hospital had responded appropriately to the incident. BWMC was featured in the March 2014 issue of Healthcare Security Alert after producing its own active shooter training video to provide staff members realistic, site-specific training. At the time, Barry Wante said that while other training videos focused on the office setting, the BWMC video was created specifically for hospital employees. BWMC declined to comment for this story.
The Boston medical community is tight-knit and collaborative, so an event like this strikes a chord with providers throughout the city, says Christopher Casey, director of public safety at Beth Israel Deaconess Medical Center (BIDMC), which is located across the street from BWMC.
“It has a very significant and immediate impact on us emotionally and as colleagues that live and work in this area,” he says.
Although many see this as an unforeseeable incident, others have called for drastic changes to healthcare security. According to The Boston Herald, some Boston hospitals are considering increasing pat-downs and the use of metal detectors. But both Casey and Michelman say that although this event may factor into their ongoing risk assessment, neither hospital is overhauling security policies or procedures.
Casey points to a 2012 John Hopkins study that showed the likelihood of being shot in a hospital are less than the chance of being struck by lightning.
Both agreed that after any security event, hospitals should take the time to debrief, conduct a root cause analysis, review policies and training, and make modifications where necessary. Hospital shootings, especially one so close to home, often add to the ongoing multidisciplinary discussion about balancing security with an open, welcoming environment, Casey says. Michelman says that MGH has since reviewed its active shooter and workplace violence training and reminded staff members to take advantage of those resources.
“Sometimes there are staff groups that would like us to meet with them and kind of assure them or educate them about what we have here, so we’ve done some of that,” she says.
MGH has several workplace violence training programs that are customized for different employees. Specifically, staff members are trained in Management Of Aggressive Behavior (MOAB®), an international training program that “presents principles, techniques, and skills to recognize, reduce, and manage violent and aggressive behavior,” according to MOAB’s website. MGH also utilizes offers an active shooter training video and is finishing a video on workplace violence in healthcare that will go out to all staff members.
Staff training is crucial since violence prevention has shifted to frontline staff members that may be the first to see or experience aggressive behavior.
“Hospitals are a microcosm of a city,” Michelman says. “They are open 24 hours a day and everyone is allowed and encouraged to come who needs help, but it’s a high-stress environment, so you definitely need the entire hospital community. You need them to be aware, alert, and trained. It takes a village to really be proactive, and that’s our goal; to be very proactive so nothing happens or very little happens.”
She adds that metal detectors may not be the answer that many are looking for when it comes to improving hospital security. Metal detectors come with operational roadblocks—additional staff and a potential gridlock for patients and visitors accessing the ED—and give the psychological signal that the hospital is unsafe.
“I’m not saying they are never useful, but I do not think they are not the end all be all answer to preventing workplace violence whatsoever,” Michelman says.
Casey adds that although metal detectors may be one consideration, the number of people that come to the hospital that have metal implants, crutches, or wheelchairs make it a problematic tool.
“The goal is clearly to provide an environment that isn’t a fortress,” he says. “It’s a balance between one that is as safe and secure as reasonable, while also maintaining an open, welcoming, and comforting environment.”