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Hospitals around Wyoming, including Cheyenne Regional Medical Center (pictured), have increased their focus on emergency preparedness, whether that means dealing with disasters like tornadoes, severe winter weather, utility outages and interruptions, or security issues. Wyoming Tribune Eagle photo

A hospital should be a place to recuperate, rest, recover and gain strength. But like other public spaces in the United States, hospitals are not immune to natural – and man-made – disasters.

While hospital shootings are rare, they do happen. According to 2012 research by Johns Hopkins, the likelihood of being shot in a hospital is less than the chance of getting struck by lightning. Almost 30 percent of U.S. hospital-based shootings occurred in emergency departments, and 50 percent of the ED incidents involved a police or security officer’s firearm, which was either stolen to shoot victims or used by security to fire at an assailant.

Johns Hopkins found that common motives for shootings included grudge or revenge; suicide; and euthanizing an ill relative.

On March 4, Mitchell D. Taylor of Casper was arrested after he fired a handgun inside Wyoming Medical Center, according to reports from the Associated Press. No one was hurt in the 1 a.m. incident, and Taylor, 20, was arraigned in Natrona County District Court on May 8 two counts of aggravated assault for threatening to use a drawn, deadly weapon; one count of property damage; and one count of possession of a deadly weapon with unlawful intent.

Police arrived at the hospital’s emergency room and found signs of shots fired in the radiology department in the early hours of March 4. They took Taylor by surprise in a mechanical area on the hospital campus. There they subdued him with a Taser, Casper Police Chief Keith McPheeters said in a news conference at the hospital, according to the AP.

Emergency room staff evaluated Taylor before police took him to jail. His motive was unknown, but is being investigated. ER patients heard the gunshots, and barred a door to a patient room with a hospital bed. They were not allowed to leave until a lockdown was lifted at 2:30 a.m.

Other threats face hospitals in Wyoming. Severe weather and closed roads can lead to supply shortages – and those weather incidents don’t necessarily have to be in Wyoming to affect the state’s medical community. Late in 2017, hospitals across the nation faced a shortage of IV fluids and critical medical supplies within their pharmacies when Hurricane Maria hit Puerto Rico.

Nearly 80 pharmaceutical companies in Puerto Rico were at the time manufacturing approximately 10 percent of all drugs consumed by Americans, in addition to manufacturing supplies like IV fluid bags and saline products. After the devastating hurricane in 2017, many hospitals couldn’t get the supplies they needed, and U.S. Sens. Mike Enzi and John Barrasso, both R-Wyo., joined other lawmakers to ask Congress and the FDA to work toward long-term solutions to future shortages.

Neither weather nor human behavior can be fully anticipated, but preparation is key to ensuring patient safety, experts say.

“The safety of patients, staff and physicians is our top priority, and we appreciate the professionalism of our staff as we undergo a vulnerability assessment following the March active shooter event,” said Dave Hulshizer, security manager at Wyoming Medical Center.

Wyoming Medical Center has implemented several new security actions since the March event, Hulshizer said. These include limited access after visiting hours and a badged check-in on main entry and exit doors.

In addition, only the Emergency Room doors remain open to the public after 10 p.m.

The security team is distinguishing between public and employee entrances to mitigate open-campus access facility-wide, Hulshizer said, and is planning a “security control center” that will allow for focused monitoring via camera and surveillance system.

Local law enforcement completed a site visit and assessment, Hulshizer said. The hospital security team is awaiting results. Similarly, a vulnerability assessment is being conducted by a professional assessment firm, and planning and preparations are underway to provide focused active-shooter training for all staff.

“(We want to) emphasize to staff that if you see something out of place or (feel) uneasy, say something. Escalate it to a manager or security,” Hulshizer said.

Two security supervisors have been certified in crisis intervention training, which can be used to assist individuals in mental crisis, and the hospital is planning ongoing training in that area.

Across the state, the Cheyenne Regional Health System is also preparing for the unexpected.

“Our world has changed, and for that reason, emergency preparedness in health care is changing, too,” said Candis Pickard, facility safety officer/emergency preparedness coordinator for the Cheyenne Regional Health System, which includes Cheyenne Regional Medical Center and its affiliated medical group, Cheyenne Regional Medical Group.

At CRMC, the emphasis is on mitigation, preparedness, and response and recovery plans for disasters like tornadoes, severe winter weather, utility interruptions and outages.

“Planning is done to ensure we have enough emergency resources on hand, whether that be staff, food/water, linen or fuel,” Pickard said. “We have also developed plans that would allow us to communicate inside and outside of our organization during an emergency.”

CRMC also focuses on employee education, training and regular incident exercises that test the organization’s response to an emergency.

There are several security officers on site at Cheyenne Regional, contracted through a Denver security firm. Their focus is to provide a secure environment so hospital staff can spend their time caring for patients, Pickard said.

Security officer training includes cultural integration, safety and survival skills, patrol techniques, incident/scene management, critical incident response, use of force and case law, equipment inspection, vehicle contacts and searches, and suspicious package recognition.

“Having highly trained security officers on site optimizes Cheyenne Regional’s ability to provide a safe environment for patients, employees and visitors,” Pickard said.

Wyoming Medical Center also currently contracts with an outside company to provide its security officers, but is transitioning to bring the security team in-house, Hulshizer said.

“This will give us more direct control in training, staffing levels and more for health care-specific security,” Hulshizer said.

In addition to other duties, Casper’s on-site security staff monitor and respond to actual and potential security threats, and provide information and assistance to staff and visitors to promote safety. They also conduct routine patrols by foot or with an assigned vehicle, looking for suspicious persons, vandalism or hazards.

Currently, WMC uses a focused approach to training employees at the manager/employee level to continually re-enforce “Run, Hide, Fight” tactics, which emphasize ways to stay safe in an active-shooter event, Hulshizer said.

While more training is underway, Hulshizer said that because of the nature of the hospital environment, it’s difficult to conduct a full-scale active-shooter drill.

“Due to (a hospital’s) unique situation, focused training that does not interfere with patients and their needs is conducted,” he said.

Kristy Bleizeffer, spokeswoman for Wyoming Medical Center, said facility has been designated as StormReady by the National Weather Service.

“This means we have demonstrated clear, effective plans for preparing for severe weather and ensuring we have everything we need to provide excellent patient care – that includes effective plans and policies for adequate staffing, food, medicine and power,” she said.

“We have been located in central Casper for more than 100 years, and are well versed in Wyoming’s extreme weather. We have long-standing staffing, supply and patient-care policies and procedures to ensure we are always well-stocked before severe weather hits.”

Wyoming Medical Center dispatch monitors the weather through a weather alert radio and a professional weather station on the hospital roof. The radio system has a direct connection to the National Weather Service office in Riverton and the Natrona County Emergency Response and Management system.

“We also have plans for the severe weather events based on our location and drill those on a regular basis. Weather safety is paramount to everyone at Wyoming Medical Center,” Bleizeffer said.

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