We’ve heard about active shooters in this country for decades. However, according to the Annals of Emergency Medicine, active shooters and hospital-based shootings are relatively rare compared with other forms of workplace violence (WPV). But that is changing fast today. According to a report from the Associated Press and published on ABC News:

Shootings and other attacks are increasing at hospitals across the U.S., contributing to health care becoming one of the nation’s most violent fields.

Further, the data reveals that active shooters and hospital shootings are as likely in urban healthcare settings as in rural areas. Large medical centers, however, often have two key benefits when active shooter incidents occur, not always found in smaller medical facilities:

  • Most urban hospitals today usually have better security than smaller facilities, more access controls, as well as more effective and more advanced security countermeasures.
  • Police are often already at the scene. They accompany someone in an accident into the emergency room or may escort a prisoner into the hospital for medical care. Whatever the situation, being on the scene means they can respond more quickly should an incident occur.

Challenges of Addressing Active Shooters

But the challenges for large and small medical facilities are many and complexExamples include the following:

  • Medical facilities generally have multiple ingress and egress points making it more difficult to control access.
  • Small medical facilities typically have a small or non-existent budget for security and are therefore more vulnerable to attack.
  • Hospitals see thousands of people each day. The mere size of the numbers makes preventing a shooting or planning a response to one, more difficult.
  • Hospitals are by necessity open environments with patient visitors, vendors, and others having often unrestricted access without rigorous vetting.
  • Demographics and geographical settings may also play a role. Inner-city medical facilities in poorer neighborhoods may have a higher volume of violence and present higher risks to hospital workers.
  • No two medical facilities are the same. What prevents active shooting incidents in one facility may not be as effective in another.

While the challenges of active shooters may differ, what is true today for all hospitals is that they must have a WPV program in place including an active shooter “plan of action”. To create these plans, crucial assessments must be completed, including:

  • A review of existing WPV and security policies and procedures to determine appropriateness and effectiveness as it relates to the site and operation. 
  • An assessment of security at the site to determine the level of security countermeasures in place and how effective they are. This results in gaps in security being identified and solutions recommended.
  • An assessment of risk with regards to WPV and active assailant, and perhaps other natural and manmade hazards. This assessment helps establish the probability of an incident occurring and the consequence if it does.  

To prevent such violence and shootings, many medical facilities are now working with security consulting and risk assessment professionals such as TAL Global.  TAL Global helps hospital administrators take steps to protect their people, patients, and facilities today and _ because WPV and security issues are ever evolving – in the future as well.   

We welcome your thoughts.  Please feel free to Talk to Us.  TAL Global is an elite security, consulting, and risk management firm that protects human and physical assets around the globe.

Stay safe,

Oscar Villanueva


TAL Global
O: 1-408-993-1300



Active Shooter Response – StatPearls – NCBI Bookshelf (nih.gov) Hazardous to Your Health: Violence in the Healthcare Workplace | ASH Clinical News | American Society of Hematology (ashpublications.org)

Schwerin DL, Thurman J, Goldstein S. Active Shooter Response. [Updated 2023 Feb 13]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK519067/

© TAL Global, 2019