​The general public and healthcare professionals share similar views about the role of healthcare professionals in protecting patients from harm if an active shooter event erupts in a hospital, although their perceptions differ about the safety of hospitals, according to results from a national survey published online in the Journal of the American College of Surgeons. The survey of 1,017 adults from the general public and 684 healthcare professionals was conducted in early March 2017 by the Hartford Consensus, a group convened by the American College of Surgeons to establish national policy to enhance survival from mass casualty and active shooter events. More than half of the general public (61%) and healthcare professionals (62%) surveyed said they expect healthcare professionals to protect patients if an active shooter event occurs in a healthcare facility. The standard approach to active shooters of “run, hide, fight" has a different connotation in hospitals, where healthcare professionals are responsible for patients, some of whom cannot get out of harm's way. These strong beliefs about healthcare professionals' duties drop if healthcare professionals must incur a high degree of personal risk. About 39% of the public and 27% of healthcare professionals thought doctors and nurses should accept a high degree of personal risk. “How healthcare professionals should respond is an intensely personal decision," write the authors. The survey also found that while 72% of the public believe hospitals are “somewhat" or “very prepared" for active shooter events, only 55% of healthcare professionals felt that way. Healthcare professionals were more likely than the general public to indicate that hospitals are at “high" or “very high" risk of an active shooter event. The authors conclude that hospitals must take steps to ensure their entire staff is prepared to deal with an active shooter event. “Ten years ago an active shooter event was a non-concept for hospitals, but clearly things have changed," say the authors. An estimated 2.5% of active shooter events have occurred in hospitals. The lead author, a surgeon, chairs the Hartford Consensus. 

HRC Recommends: Because they have public spaces, hospitals and other healthcare organizations are at risk for active shooters. Hospitals should conduct a systematic assessment to identify gaps in current readiness and then put in place measures to fill those gaps. All staff members should be trained on how to respond during an active shooter event, and procedures should be reviewed regularly.