Foresight and planning by a Florida hospital prevented a random shooting that resulted in the death of a patient and staff member from escalating beyond the violence that occurred.

Patient Cynthia Zingsheim, 92, and health care aide Carrie Rouzer, 36, were shot and killed for no apparent reason by an armed man who entered Parrish Medical Center, Titusville, Fla., July 17.

Law enforcement officials credited the hospital’s active shooter plan, established in 2008, and brave security guards who confronted and held the assailant until police arrived with saving lives.

“I cannot stress enough [that] the response of the Parrish Medical Center staff, without a doubt, saved more lives,” Titusville Police Chief John Lau said.     

“Ensuring a safe and healing environment for everyone all the time is our highest priority,” says Natalie Sellers, the medical center's vice president of communications, community and corporate services.

That philosophy is in line with the Joint Commission, Oakbrook Terrace, Ill. While it does not specifically require hospitals to develop an active shooter policy, its Environment of Care standards do require hospitals to identify safety and security risks to determine the specific hazards that they may encounter.

Hospitals then must take action to reduce the risks related to the identified hazards. If a hospital determines that it may face a threat from an active shooter, then it must have a plan in place to respond to such a situation, the Joint Commission states.

According to a 2012 study in the Annals of Emergency Medicine, hospitals faced about nine active shooter incidents a year between 2000 and 2005. The rate climbed to 16.7 a year between 2006 and 2011.

How to establish an active shooter plan was the topic of a highly attended general session at the American Society for Healthcare Engineering's 53rd Annual Conference and Technical Exhibition in Denver in July.

Presented by three officials with the International Association for Healthcare Security & Safety, Glendale Heights, Ill., the session, called Active Shooter — Best Practices for the Worst Case, proved prescient. It came six days before the Florida hospital shooting.   

Panelist Constance Packard, executive director of support services, Boston Medical Center/Boston University Medical Campus, outlined a series of best practices her hospital developed in preparation for an active shooter, including:

  • Assessing risks and vulnerabilities in the hospital annually or more often.
  • Developing a plan for prevention and response that emphasizes ongoing staff training and establishing a crisis response team.
  • Collaborating with local law enforcement.

Panelist Thomas Smith, president of Healthcare Security Consultants Inc., emphasized the importance of taking steps to prevent an active shooter situation from occurring.

He says it is essential that hospitals assess access control plans, identify who belongs in the facility, and train staff to report suspicious or unusual behavior. He encourages hospitals to appoint and train a threat assessment team.

Parrish Medical Center has stepped up its security measures after conducting a vulnerability assessment such as the one Smith referenced, Sellers says.

Parrish now maintains a law enforcement presence and enhanced security at public entrances, restricts public access to the main entrance and emergency department by requesting identification, and conducts random bag checks.

Security officers are now armed with additional protective equipment and gear and are receiving more training. The health system also is considering installing metal detectors and other equipment to identify prohibited items.