By Mackenna Moralez, Associate Editor

It is no secret that there has been an increase in violent acts reported at hospitals and other healthcare facilities. As the reports of violence continues, more healthcare facilities have begun reevaluating their organizations’ active shooter plans and reconfiguring their access control systems, all with the main goal of only allowing people with approved access to enter the building. But even as facility managers begin to make these adjustments, it’s not going to entirely prevent these acts from happening. If anything, attackers are now changing their approach. 

A report from the Safeguarding Health in Conflict Coalition found that 2022 was the worst year for acts of violence against healthcare facilities and personnel on a global level. Nearly 2,000 acts of violence occurred in 32 countries and territories, a 45 percent increase compared to the previous year. In 2023, there has been an uptick of swatting attempts at hospitals, prompting managers to remain alert about new threats. 

According to the International Association for Healthcare Security and Safety (IAHSS), swatting is when a person makes a false report to emergency services or 911 in order to elicit a response to dispatch police or even a SWAT team. These attempts disrupt hospital operations and cause explicit distress among everyone involved.  

“Most of these swatting calls that we’ve seen come in is through a telephone operator,” says Connie Packard, president of IAHSS. “We make sure the telephone operators are trained on what to ask. ‘Where are you calling from?’ ‘Where are you coming to?’ I think it’s just the challenge of trying to mitigate that risk, try to keep them on the phone, particularly when they’re saying that there’s a danger somewhere, which there may or may not be. What we can do is narrow it down and get that information to us [healthcare personnel] and determine what our next steps are.” 

Communication is key 

There are a few things that facilities managers and safety professionals can do to be aware of when swatting happens. First is to have a close relationship with local police departments and 911 centers. Some swatting attempts happen through 911 calls, rather than directly reaching out to the hospital. When this happens, law enforcement can call the healthcare facility and ask if there is a violent situation occurring. 

“Hospital associates need to quickly communicate if a violent situation is happening,” says Scott Cormier, vice president of emergency management, environment of care and safety, Medxcel. “We have to have a process that we’re confident in so when events do happen, they are quickly escalated to the security officer, operator and leadership. Then, when the police call to identify an incident, they can quickly understand if it’s legitimate or not.” 

It is important that hospitals and other healthcare facilities proactively address potential swatting issues.  Facility managers should remind associates about reporting incidents and talk to local partners about how to best contact them in a potential violent situation.   

“Facility staff must also remain calm,” Cormier says. “That’s hard to do but trust the system: Communicate clearly if and when there’s an event in the facility or if we see something suspicious. Then, practice it. This is important because these events do happen. We don’t want associates getting on their phones and posting pictures on social media to give the wrong impressions. There is a downstream effect in that swatting may discourage people who are in need of immediate care from coming to our hospital. We don’t want to disrupt the continuity of care for our patients.” 

Healthcare facilities – particularly hospitals – are operational 24 hours a day. There is only seldom reasons for it to be closed. Having these spacious, open environments can often make it hard to manage. It is imperative that managers work with safety and security personnel to do regular risk assessments. This can evaluate crimes that have to do with both people and property within a certain mile radius of the facility. If the building is located in an area with a higher crime level, it is likely that swatting attempts may come more frequently.  

Keep up with training 

Everybody in the facility should be aware of the safety goals and programs are. Understanding a safety and security program can help reduce incidents, which aids in recruiting and retaining new talent. Having regular training on these processes is crucial because people who once attended may no longer be with the organization and new faces may have joined. Everybody needs to be on the same page during a high-risk event so that no lives are compromised.  

“When you can, have a debriefing and look at your strengths, your weaknesses, your opportunities that can determine how effective you’ve been,” Packard says. “But I also think there’s a learning curve to any incident, whether it’s swatting or any other potential violent incident where we get emergency management involved. When you look at the after action report, that’ll tell you how people were involved in the incident and what you could’ve done better or if you forgot to notify anyone.” 

Security should be seen as part of patient care, not as law enforcement or property protection. Patients, residents, visitors and employees need to feel safe and listened to. Pushing them into an environment where their emotions could be escalated can have detrimental effects on the healing process.  

“If a swatting incident occurs and public safety responds en masse, you must immediately communicate what’s going on,” Cormier says. “That includes visitors, staff and patients – and may need to be done in more than one language. Keep them up to date. You don’t want people forming their own opinions and conclusions and then using them to determine how they will respond to the situation. You want to be sure to control their interpretations and reactions.” 

When it comes down to it, though, healthcare facilities are in the business to save lives, not create chaos. Swatting initially started with people playing online games with one another, but now it is being used to purposefully cause harm and terror in places that are supposed to be caring for others. The only way to stop these acts of violence, or at least reduce it, is to educate people on the effects it has on facilities and its occupants.  

“I think that if you are prepared, train, educate and are proactive, you can get your team on the same page,” Packard says. “Even if you do it at a department or building level, you just need to do it. It is disruptive, but you’re trying to prevent a bad outcome. We all want to be able to come home every day. I want to be safe and if I feel unsafe, I can’t do my job. So we’re going to continue to save lives and do our best to prevent any confusion as to make it not worse for the employees, patients or staff.” 

Mackenna Moralez is the associate editor for the facilities market.