Strengthening Active Shooter Response Through Interprofessional Training: The Role of Health Security Teams in Healthcare Systems
Abstract
Background: Active shooter incidents in healthcare settings have emerged as a critical health security challenge, disrupting care delivery and threatening staff and patient safety. Hospitals, designed for accessibility and continuous operation, are increasingly recognized as vulnerable “soft targets” for firearm-related violence.
Aim: This study aims to examine the operational complexities of active shooter preparedness in healthcare facilities and propose interprofessional strategies to strengthen response and resilience.
Methods: A comprehensive review of epidemiologic data, regulatory frameworks, and case analyses was conducted, focusing on U.S. hospital shootings and global hybrid-targeted violence (HTV) events. The study synthesizes evidence from occupational safety guidelines, law enforcement protocols, and healthcare contingency planning literature.
Results: Findings reveal that hospital shootings are often targeted, relational, and concentrated in high-risk zones such as emergency departments and outpatient clinics. Five typologies of violence—criminal intent, patient-related, worker-to-worker, domestic spillover, and ideological—shape risk profiles. HTV incidents, involving coordinated multi-weapon tactics, pose additional threats requiring all-hazards preparedness. Effective response hinges on facility-specific contingency plans, rapid communication systems, and simulation-based training.
Conclusion: Active shooter preparedness in healthcare demands a multidimensional approach integrating physical security, behavioral threat assessment, and interprofessional collaboration. Continuous evaluation, scenario-based drills, and robust communication protocols are essential to mitigate harm and sustain clinical operations during violent crises.
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Copyright (c) 2025 Ziyad Saad Bin Hulayyil Almutairi, Jaser Nasser Almuqati, Fahhad Abdullah Aldusari, Khawlah Mohammed Judayba, Taghred Ayad Alshalwi, Reem Sunaytan Alotaibi, Manal Saud Alharbi, Abdulrahim Ahmed Alsurayhi, Fahad Shuayfan Mohsen Alotaibi, Abdullah Hamoud Abdulrahman Al-Nefaie, Faisal Majed Saeed Alshahrani, Mohammed Nasser Sulaiman Alhusaynan, Abdulrahman Ali Ahmed Hadadi
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