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Protecting Healthcare
Personnel Through
Emergency Communications
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Table of Content

Introduction 3
Recent Incidents 3

Effective Communication 4

Use Cases 5

Communication as a Part of
Emergency Preparedness 6

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Introduction
Healthcare is a rapidly evolving industry. Each year brings
significant new technological advances in the identification
and treatment of disease, and medical staff are among
the most dedicated employees anywhere in the world.
And while in other business sectors profits and products
occupy the majority of working hours, the physical safety
of patients and staff in healthcare is always top of mind.
Amidst the constant forward march of medicine, however,
is one unfortunate development in the healthcare industry:
increasing violence. According to the International Committee
of the Red Cross, more than 2,300 threats or acts of violence
were reported just between January and July of 2014, with
the consensus that many more incidents go unreported. The
Bureau of Labor Statistics reports that the rate of violence-
related workdays missed for healthcare workers is nearly
4 times that of private industry. A single year, from 2009 to
2010, saw a 13 percent increase in acts of violence directed
at healthcare and social assistance workers.
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According to the federal government, healthcare is the
largest industry sector in the United States. And because
everyone needs medical care at some point, individuals
of all kinds may be found receiving treatment – including
those with violent tendencies. When a violent incident
does occur, then, rapid response is critical. According to
the FBI, the typical active shooter incident lasts just 12
minutes. And with the average 100-bed hospital employing
as many as 850 staff members, hundreds of them may be
on duty when a violent incident occurs. Failure to quickly
alert staff to the situation puts lives at risk.
This paper will examine recent incidents of violence in
healthcare settings, considering the role communication
played in the outcome. It will then present
recommendations for implementing an effective crisis
communication system.
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Effective Communication
A recent survey conducted by AtHoc revealed that
the average business requires one hour to inform 80
percent of its employees during an emergency. In a
healthcare setting where there is the threat of violence
or an active shooter, every minute of delay greatly
increases the risk of death and injury. A facility must
have the communication tools in place in advance to
maximize safety during such an emergency. In fact, the
Occupational Health and Safety Administration (OSHA)
recommends that businesses use devices including
alarms, radios, cell phones and other security devices as
part of an emergency response system.
Healthcare organizations should carefully consider the
state of their emergency notification system before
they face incidents of violence. Not only is there the
risk of injury or death, but hospitals and clinics may find
themselves facing litigations, regulatory fines and other
consequences that impact the long-term viability of the
business. In order for employees to rapidly send and
receive emergency alerts, the organization should deploy
a system with these capabilities:
• Authoritative, two-way communication:
Incidents of violence in hospitals and clinics could
begin in the offices of management, but these
incidents most commonly occur in areas where
patients are being treated. Any staff member –
nurse, doctor or administrator – should be able to
immediately notify management of the situation. A
central authority can then rapidly distribute alerts
to every employee with instructions that will keep
them safe and provide a single source of reliable
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information. Those who are in the immediate vicinity
of the violence can then provide regular updates
and receive additional instructions to quickly and
peacefully resolve the situation.
• Multi-channel capability: Healthcare facilities
typically utilize a series of communication and
warning systems, from landlines and radios to
message boards, PA systems and electronic
signage. Authorities need to be able to quickly
distribute alerts to all these systems simultaneously,
as well as personal cell phones carried by staff
members. By addressing as many communication
channels as possible, employees receive
notifications more quickly and safety will improve.
• Scalability: As hospitals and healthcare systems
grow over time, more employees need to be
supported by the emergency communications
system. It must be able to handle sudden spikes
when an incident occurs while maintaining peak
performance. Anticipating growth will prevent costly
upgrades later.
• Off-site, mobile-friendly capabilities: For staff
members who work beyond the physical confines
of the office, such as those working providing
healthcare in private homes, protection should
include rapid alerting options such as a panic
button on a cell phone in case a patient becomes
aggressive. Combined with abilities such as geo-
tagging, this supports other measures designed
to establish personnel accountability including
checking into and out of locations.
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Use Cases

Hospital Intruder Home Healthcare Threat

One night during her shift in the emergency room, a nurse
takes a patient to an examination area for assessment. As
she takes the man’s vital signs, he produces a knife and
demands a medication that is a controlled substance. The
nurse agrees to take him to the secure room where the
substance is kept. He threatens to harm her if he hears
anyone call security.
A nurse providing home care for patients is making her
rounds one day, delivering medication. She reaches the
last home, where she is invited in. Her patient has a
history of mental illness and is acting strangely. Sensing
that something is wrong, she gets her cell phone out as
they speak, opening the company’s communication app.
She attempts to leave, but the patient bars the way.

One of the other nurses is at a workstation where she
hears the situation. She uses the emergency notification
system to send an alert to the hospital’s control center
with information about where they are going. The control
center silently alerts security, which reaches the storage
room before the attacker. They wait and are able to
disarm him as he enters the room.
The nurse quickly hits the panic button on her phone
without the patient’s knowledge and tries to keep him
calm while she waits for assistance. He continues to
threaten her, and she locks herself in the bathroom until
the police arrive, which were contacted by the hospital
after they received her alert. They take the patient into
custody so he can be reevaluated for treatment.

Sources
http://www.who.int/hac/events/HCWviolence/en/
http://www.fbi.gov/about-us/cirg/active-shooter-and-mass-casualty-incidents/active-shooter-statistics
http://www.beckershospitalreview.com/lists/200-hospital-benchmarks-october-2012.html
http://wgntv.com/2014/11/18/dramatic-surveillance-video-released-in-suburban-hospital-shooting/
http://fox6now.com/2013/11/14/significant-police-presence-at-childrens-hospital/
http://www.medpagetoday.com/EmergencyMedicine/EmergencyMedicine/45535
http://www.latimes.com/local/lanow/la-me-ln-shooting-mlk-hospital-20150126-story.html
http://www.dailynews.com/general-news/20150127/nurse-wounded-in-los-angeles-mental-health-care-facility-shooting
http://www.safetyandhealthmagazine.com/articles/11172-workplace-violence-in-health-care-nurses
https://www.osha.gov/SLTC/healthcarefacilities/violence.html
https://www.osha.gov/Publications/OSHA3148/osha3148.html
http://www.cdc.gov/niosh/topics/violence/training_nurses.html
http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-18-2013/No1-Jan-2013/Workplace-Violence-Strategies-for-Advocacy.html

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Communication as a Part of Emergency Preparedness

Saving lives is the primary concern of our healthcare alone outside their facilities are particularly
system, so it is a natural extension of this duty that these vulnerable and should have access to emergency
organizations protect their staff and patients from the communication technology.
threat of violence. An effective emergency preparedness • Establish a daily work plan for field staff to keep a
plan involves a large number of factors that can be designated contact person informed about their
supported by a comprehensive communication system. whereabouts throughout the workday. Have the
OSHA’s recommendations include the following: contact person follow up if an employee does not
• Control access to facilities other than waiting report in as expected. A crisis communication
rooms, particularly drug storage or pharmacy system can provide reports of employees who do
areas. As physical security systems are connected not respond to alerts, simplifying the personnel
to networks, the capabilities of a networked accountability process.
emergency notification system are expanded.
More than a single aspect of emergency preparedness,
• Prepare contingency plans to treat clients who are
communication abilities in a crisis are an integral part
“acting out” or making verbal or physical attacks or
of nearly every aspect of ensuring safety. As healthcare
threats. Notification capabilities allow employees
facilities consider the best ways to promote safety,
to quickly alert administrators of a situation that
improving communication in a crisis can have a significant
escalates to endanger staff or patients.
impact on reaching that goal.
• Develop policies and procedures covering
home health care providers. Employees working

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