Hostage Barricade Response Exercise

Session Leader: Mary Massey

This Hostage Barricade Tabletop Exercise is an application of the an emergency response plan defined per the guidance of the Hospital Incident Command System. This is an active shooter hostage situation. 

In this exercise attendees will be assigned various roles and responsibilities, according to the emergency response plan, and will follow up as guided and prompted by the GroupDoLists software tool and the direction of the exercise leader, Marry Massey.

Incident Action Planning

Incident response action planning will include:

  1. Assess the Situation
  2. Set the Operational Period
  3. Determine Safety Priorities and Incident Objectives
  4. Determine Objectives for the Incident Command Team Chart Branches (such as Medical Care, Security, Hazmat, Patient/Family Assistance) and Sections (Operations, Planning, Logistics, Finance & Administration) must be Activated
  5. Determine Strategies and Tactics
  6. Determine Needed Resources
  7. Issue Assignments
  8. Implement Actions
  9. Reassess and Adjust Plans

Incident Scenario

  • A patient’s son has been very upset about his mother’s condition. She is in ICU and may die. On each visit, he is increasingly agitated and demands information from the staff.
  • On today’s visit the son seems calmer. However, upon seeing his mother he becomes agitated, demanding to see the doctor. The nurses are attempting to calm him, but he becomes increasingly agitated.
  • He pulls 2 handguns from his jacket and fires twice into the ceiling. A security guard rushes into the unit and the gunman shoots him in the leg.
  • The gunman demands that staff move equipment and beds to barricade the doors and announces that he will kill anyone who gets in his way and demands to see his mother’s physician
  • The ICU is full and there are visitors at the bedsides
  • An employee escapes from the ICU and notifies security
  • Power and communications services are functioning normally in the area
  • Time: 1400
  • Weather: Clear, 75º F, no winds

The Session Leader will direct the execution of the incident response in accordance with the incident response planning and the guidance of the Hospital Incident Response System.

Exercise Scenario Update Points

Starting at the beginning of the incident, as the incident progresses between the Scenario Update Points, attendees will take response actions, report individual status and assess immediate and overall status, taking appropriate actions based on status and then-available resources.

Scenario Update #1

  • It has been 20 minutes since the gunman barricaded the ICU
  • Law enforcement has arrived at the hospital and is in communication with the ICU
  • SWAT team is responding

Scenario Update #2

  • It is now 1530 – 1.5 hrs into the incident
  • The gunman has released the wounded security guard.  He has been received in the Emergency Department.
  • No other hostages have been released
  • What are your major concerns?

Scenario Update #3

  • It is now 4 hours into the incident
  • The gunman has surrendered to law enforcement
  • All hostages are released and safe
  • What issues should be considered?

Upon Incident Completion

  • Share information
  • Demobilization and Recover
  • After Action Report
  • Improvement Plan