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“While St. Francis has multiple policies and practices designed to deal with difficult situations, ‘I don’t know that any health system in the country has (policies) in place (that) can stop somebody with two weapons that are hell-bent on causing harm.’”

– Tulsa-based St. Francis Hospital CEO Cliff Robertson quoted in Modern Healthcare

What it Means for Healthcare Providers

You already know something about gun violence. You treat it, train for it and insure against it. You experience it.

Its victims are rolled into your ER. It’s the leading cause of death of children and teens. It’s why “No Weapons” signs are posted outside your building. Why Code Silver calls exist. Why the Joint Commission requires active-shooter preparedness and why you run the drills.

And yet, here we are.

The shootings over the last week elevate (again) the urgency for this national conversation on this continuing public health crisis and made real (again) the exposure of healthcare facilities on this very issue.

As the definition of “healthcare” grows to encompass social determinants and the conversation around gun violence expands to include mental health and more, hospitals – as providers of said care – are increasingly expected to have a stance on and solutions for yet another urgent, terrible public health crisis.

It’s an issue to address in at least two tracks:

  • As a public health crisis, with statements that express your condemnation of gun violence, articulate your organization’s position on what needs to be done to address it plus the meaningful action you’re taking that reflects your mission and your community.
  • As a crisis communications issue with clear plans for responding to an incident on your campus or in your community, and for active work in support of the mental health of your colleagues.

We’ll state the obvious: Whether speaking out on gun violence or responding to a local crisis, it’s critical to be prepared now with communications plans, articulated positions, templated materials and decision trees that will allow you to move quickly when thoughtful pondering is impossible.

And this: If your leadership team didn’t meet on this topic last week to make new plans or review and refresh old ones, send that calendar request now.

Gun Violence as a Public Health Crisis

We recognize that discerning your position, weighing in and taking action to mitigate gun violence is yet another challenge for already overburdened health systems. It’s another politically fraught issue that has landed in your ER.

Nevertheless, health systems have a role beyond being a place to physically care for its victims.

By yoking your power as a trusted voice in the community with your mission to make lives better, your health system can be an effective advocate for change through the investments of your time and resources and by working in collaboration with other healthcare organizations and community institutions.

Consider these steps:

  • Develop a formal stance on gun violence. We’re not talking about digging up a boilerplate statement condemning it. Rather, you’re looking for an explicit delineation of what your organization sees as its role in addressing the problem. Is it a clinical issue, a board issue? A political issue?The statement by Kaiser Permanente’s CEO is a good example of a full-throated, missional response to gun violence.
  • Catalogue what your organization is doing now related to gun violence mitigation. It may be more than you think. Relevant mental health services? Programs that address the social determinants of health that help people identify and interdict at-risk behavior? Community partnerships in place that are resourced and active? Studies of gun violence data?Michigan Medicine, for example, is talking about how its Institute for Firearm Injury Prevention is working to reduce gun-related mortality.
  • Determine how your organization is prepared to act. How important is addressing gun violence to your organization, really? What investment are you willing to make by leveraging your money, people, time and brand strength? What are you willing to do less of so you can do more for gun violence mitigation? A candid understanding of the priority of the issue will help you set expectations for your plans.
  • In any case, ensure support for your colleagues and affiliated caregivers. This should be relatively simple. Hopefully. This is your EAP, on-site clergy, counseling services as well as any HR policies that relate to trauma and grief.
  • Build a plan. Determine the investment that you’ll make (or, are already making) and a plan for communicating your commitment and the “why” that drives it. And, if you’re not investing here, be prepared to answer, “Why not?”Gun Violence as Crisis Communications

Because active-shooter situations are often over within 15 minutes, before law enforcement arrives, healthcare organizations must prepare their staff for an active shooter situation.

The Joint Commission

Tulsa and Dayton remind us that hospitals are at high risk of gun violence. Sadly, there’s no excuse not to be as prepared as reasonably possible today.

You know what to do: Gather your leadership team to ensure your gun-violence procedures and security measures are in place and staff training is current. Review your emergency response plans so that everyone who would be involved in an event knows who calls who, who does what, who says what and who makes what decisions when. Then, role play against it. You don’t want an event to be the first trial of your plan.

A note of encouragement

The solutions for “solving” gun violence are politically polarizing. Even so, there are some glimmers of hope that we might bridge our different viewpoints.

This week, Axios published its Two America’s Index and showed that the percentage of people saying they have something in common with someone of a different background is at its highest level in months. That finding is consistent with our recent survey showing that about one in four people are open to ideas from someone with a different viewpoint. And on the specific topic of gun policies, there are a number of areas where a strong majority of Americans agree.

Maybe, just maybe, we can grab onto that fingerhold of hope and use it to pull ourselves up.

Keep Reading

There’s so much to read on this topic beyond what we could fit into the Quick Think. Here are a few more items we read and pondered while preparing this week’s edition:

This piece was originally published over the weekend in our Sunday Quick Think newsletter. Fill out the form to get that in your inbox every week.

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