800.231.9106
Healthcare Response to the Active Assailant
Preparing for Active Assailant Threats
Active shooter events have increased significantly since 2009, driven by documented increases in workplace violence and firearm access. Healthcare facilities face a documented and growing threat. Since 2000, the United States has experienced 327 hospital-based shooting events, with an average of 13 incidents per year. This is a 6.4 percent annual increase since 2012. Between 2012 and 2024, these events resulted in 81 deaths and 108 injuries to staff, patients, and visitors. Active shooters are only one type of threat. The term active assailant covers numerous other types of attacks.
Healthcare facilities face fundamentally different challenges during active assailant incidents than other public facilities. Staff must maintain patient care while implementing lockdown and evacuation procedures. Surgical teams must manage patients on operating tables. Psychiatric units present unique security challenges. Patients unable to move must be protected in place. Traditional guidance such as "Run, Hide, Fight" often fails in healthcare settings. Retrospective reviews of healthcare active shooter events have identified critical flaws: staff unaware of lockdown procedures, staff never hearing warnings, staff ignoring warnings, uncertainty about what to do with patients, and lack of awareness of escape options.
Healthcare police and security often fail to recognize the manpower-intensive nature of active shooter events. Healthcare administrators frequently underestimate legal liability exposure from inadequate planning and preparation. This course examines how healthcare organizations can develop effective active shooter response plans, train staff across clinical and administrative disciplines, and coordinate with law enforcement and EMS.
The Threat to Healthcare
Hospital workplace violence has reached endemic proportions, with more than half a million healthcare providers assaulted each year in the United States. Active shooter events are one manifestation of this broader threat.
A systematic 2026 review by Wanberg and colleagues of 327 hospital-based shooting events from 2000-2024 identified multiple motives: suicide (30.9%), mental instability (15.6%), personal grudge (11.6%), community spillover violence (11.6%), inadvertent discharge (4.9%), euthanasia (4.3%), and attempted escape from custody (4.0%). Understanding these motives helps healthcare organizations identify warning signs and implement threat assessment programs.
What This Course Covers
History and Current Threat Assessment
The course examines the history of healthcare active shooter events and current trends in healthcare violence. Participants learn epidemiology, demographics, and operational characteristics of attacks. This historical context informs the development of facility-specific response plans.
Perpetrator Profiles and Recognition
Participants learn to identify typical active shooter profiles and understand motivations driving healthcare violence: grudge-based attacks, disgruntled employee incidents, spillover community violence, and other scenarios unique to healthcare. Recognition of warning signs enables early threat management interventions.
Why "Run, Hide, Fight" Does Not Work in Healthcare
Traditional active shooter guidance does not account for healthcare-specific operational realities: patients unable to move independently, ongoing surgical procedures, psychiatric patients, patients under law enforcement custody, and ethical obligations of staff to remain with vulnerable patients. The course addresses the six myths in active shooter response and resolves conflicts and confusions surrounding active shooter policies in healthcare settings.
Staff Response Procedures and Training
Participants examine lockdown procedures, notification systems, evacuation protocols, patient management during lockdowns, and coordination required between clinical, security, and administrative staff. The course addresses practical challenges: maintaining patient care during lockdowns, managing patients who cannot evacuate, securing psychiatric units, operating under stress, and managing security concerns while maintaining a healing environment. Participants develop protocols tailored to their facility's layout and operational structure.
Healthcare Security Assessment
Published research on healthcare safety and security programs is reviewed. Multiple studies show that healthcare staff often do not know how to report potentially violent behavior, healthcare organizations lack internal threat management teams to address potentially violent employees, code words for emergencies create confusion rather than clarity, and staff cannot effectively lockdown work areas. Participants learn how to assess gaps in their own organization's preparedness and design targeted training.
Mass Casualty Surge and Receiving Facility Operations
The course examines lessons from receiving facilities during major active shooter events. Sunrise Hospital, a Level II trauma center in Las Vegas, received 212 gunshot wound patients in less than 30 minutes. Healthcare organizations need to understand that they will receive an overwhelming number of gunshot patients who will typically self-transport, creating unique surge, triage, and resource management challenges. Participants learn how emergency department operations, surgical capacity, trauma team activation, and staff allocation must be adjusted for active shooter mass casualty scenarios.
Law Enforcement Coordination and Healthcare Security's Role
Participants learn what to expect during law enforcement tactical response, how healthcare security can assist (or inadvertently hinder) police operations, communication protocols with law enforcement, and the manpower requirements for searching and clearing a healthcare facility. Clear understanding of law enforcement priorities and capabilities improves response coordination.
Lessons Learned from Major Healthcare Events
The course analyzes multiple healthcare active shooter events and identifies operational lessons and failures. Case studies highlight what worked, what did not, and why. Participants apply these lessons to identify vulnerabilities in their own facility's planning and procedures.
Intended Audience
This course is designed for healthcare administrators and executives responsible for facility safety and emergency preparedness. Healthcare security and police personnel need to understand tactical response, search procedures, and law enforcement coordination. Emergency department leaders and trauma surgeons must understand surge operations and resource allocation during mass casualty events. Nursing leadership and psychiatric staff must address staff safety and patient management. Facilities and safety personnel must understand lockdown mechanics and building systems. Healthcare system emergency management coordinators must integrate facility response with community-wide emergency plans. Board members and compliance officers must understand legal liability and governance requirements.
Course Logistics
Duration: Four to eight hours, based on the host agency's objectives, audience, and desired level of discussion.
Format: Instructor-led lecture, facilitated discussion, current research, case studies, policy review, and healthcare-specific response analysis. Available in person or as a live webinar.
Class Size: Host-specific and scalable. Final limits depend on room capacity, delivery platform, and the desired level of participant interaction.
Prerequisites: No prior tactical or law-enforcement qualification is required. Participants should be familiar with their organization's emergency-management and workplace-violence policies.
Host Responsibilities: Provide classroom space with seating suitable for expected attendance. Technical requirements include computer, projector, and audio capability. Host should identify participating departments (administration, security, nursing, emergency services, facilities, etc.). Before delivery, share organization-specific concerns, prior incidents, operational layout challenges, or unique patient populations that should be addressed.
Cost
Standard on-site lecture rate: $3,500 for a half day or $6,000 for a full day, plus travel and lodging. Half-day on-site programs are typically offered when bundled with another service or for local engagements. For a stand-alone half-day request requiring non-local travel, virtual delivery may be recommended.
Government agency on-site rate: $5,000 per instructor-led day, plus travel and lodging. Government agency pricing applies to qualifying federal, state, local, tribal, and other public-sector agencies. Travel and lodging are billed separately.
Virtual lecture rate: $2,500 for a half day or $4,000 for a full day.
Customized programs, unusually large audiences, multi-course packages, and practical components may require separate pricing. Contact us for a formal, scope-specific quote.
REQUEST A QUOTE | DOWNLOAD COURSE DETAILS
To schedule this course for your agency, discuss customization options, or learn more about instructor qualifications and delivery format, please contact us.
Email: info@ThreatSuppression.com
Phone: 800.231.9106
Download the full course description (PDF) with detailed learning objectives, topic breakdown, and host requirements.
