Preparing for the Unknown: Unit-Based Active Shooter Exercises

A small conference room, a break room, a reception space, or a good size office are sufficient to allow Captain Mike Redmond and his team to deliver their message of safety to clinical groups across MD Anderson and UTHealth Houston. With often a standing-room only crowd, UT Police has been delivering short presentations on hostile intruder response to clinical teams since mid-2022. 

To date, over 2,200 personnel have participated – primarily in the inpatient units and UT building entrance staff have engaged in the 20-minute unit-based active shooter exercises. The experience with UT Police officers aims at guiding clinical teams through hostile intruder scenarios and at providing them the opportunity to consider their response. 

Staff learn to assess and anticipate unit-specific vulnerabilities, consider how to protect patients during a hostile intruder incident, and what happens when law enforcement arrives to the scene. 

“Where the Run, Hide, Fight methodology is emphasized for non-clinical areas, these exercises focus on the Avoid, Deny, Defend methodology which is for clinical areas,” Redmond said. “We are meeting our clinical team where they are, and we are providing quick talks that get to the heart of surviving a terrible situation.” 

UT Police trainers provide unit-specific guidance such as: what clinical staff should communicate to 911 dispatchers, how best to help patients in the area, identifying safe spaces, what to expect when law enforcement arrives, specific vulnerabilities within their clinical area, and what to know about reunification.   

Health care professionals have a duty to care for patients in their care. In clinical areas, staff are taught to Avoid, Deny, Defend if they are not able to evacuate the area.  

Avoid: Plan and know how to avoid/escape by silencing any alarms or monitors that might attract attention, minimize movement and talking, avoid being seen or heard and silence cell phones and only provide life-saving patient care.  

Deny: Prevent the attacker from accessing you or others by hiding in rooms with locking doors, barricade entry points, move to most hardened, sheltered area in your space, away from windows and doors and securing an exposed door with belt or rope to prevent opening.  

Defend: Defend yourself and others by spraying, swinging or throwing fire extinguishers, throwing hot liquids, sharp objects, or office supplies.  

“We also make sure to remind participants that when law enforcement responds, our priority is to first neutralize the threat,” Redmond said. “Only then can we turn our attention to the wounded.” 

Staff are also encouraged to identify a reunification location away from their work area to account for everyone in a specific work group in case of an emergency. 

More unit-based active shooter exercises are being planned. Additional clinical units will be contacted throughout the Spring. General audience Active Shooter Prevention and Response classes are offered most Tuesdays.