Marilyn Hollier University of Michigan: Case Study Boston Marathon


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Marilyn Hollier, CPP, CHPA, International Association for Healthcare Security and Safety; Director of Hospitals and Health Centers Security, University of Michigan Division of Public Safety and Security delivered this presentation at the 2013 Safe and Secure Hospital Conference. The comprehensive program addressed the following issues:

Early intervention via early reporting of disruptive, aggressive, and bullying behaviour to minimise work place violence
An innovative training model to help clinicians, security and policy makers respond to the problems of challenging behaviours
Therapeutic sedation in the Emergency Department: Best practice in managing the highly agitated patient
A systems approach to the prevention of Occupational Violence and Aggression (OVA)
Contract management security: The change from in-house security to contract security
Role of the Risk Based Approach throughout the design process
Preventing and managing clinical aggression in the paediatric and youth health setting
The roles, functions and training provided by the Mental Health Intervention Team (MHIT), New South Wales Police Force
Interactions between Police, Health staff, Ambulance and Hospital Security and future directions
A Legal Perspective: Prevention and management of violence in hospitals
Code Grey responses - Are they legal?

For more information about the annual event, please visit the conference website:

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Marilyn Hollier University of Michigan: Case Study Boston Marathon

  1. 1. Boston Marathon Bombing July 15, 2013
  2. 2. Notification Process • At 2:50pm Two Explosive Devices Were Detonated Near the Finish Line • At 2:55pm Boston EMS and COBTH Radios Transmitted Notification to All Area Hospitals. Additional Notifications Reported Casualties • Hospital “Code Disaster” Activated at all hospitals around 3:03pm. Disaster Plan and Mass Casualty Protocols Implemented • Hospital Emergency Operations Centers Activated in Administrative Conference Per Plan • First Patients start arriving at hospitals at approx. 3:04pm • 14 Minutes to most of the area hospitals – there are several in the area of the Marathon • Marathon First Aid posts started to immediately attend to the victims
  3. 3. Patient Arrivals • Hospitals Along the Marathon Route Had Been Receiving Some Usual Marathon Related Patients Throughout the Day (Dehydration, Dizziness, Sprains/Strains) • First Bombing Related Patients Arrived at Affected Hospitals Shortly After 3:00pm • Additional Patients With Amputations, Open Fractures, Multiple Trauma, and Extreme Blood Loss – looked like a war zone. • Patients With Limited Minor Injuries Continued to Arrive Into the Evening and for Several Days After the Incident • Three people were killed and 264 injured
  4. 4. Activity and Challenges • • • • • • • • • Hysteria and uncertainty – media reports of other explosions Where there Other devices/other places? Mass casualties -Making room in hospital for all the victims Transportation gridlock – can additional hospital staff get into work? Screening, identifying patients and linking them to family members Suspect injured? Communication – internal and external Gathering and preserving evidence Release of information process/procedures.
  5. 5. Actions Taken • • • • • • • Some hospitals locked down right away – others did not Hospital Incident Command Centers were set up Started gathering evidence Panic/fear (suspect(s) still at large) – suspicious package calls etc. Identification of patients and families Utilize the hospital’s Public/Media Relations experts Ongoing/updated Communications to hospital/Dept. employees - Global email - street closures - break rooms, sleep areas? - communicate to patients
  6. 6. Tuesday -Wednesday • The Media were coming from everywhere • VIP’s are requesting to visit the patients/victims • 19 hour notice that the President was coming – intense strategy planning with Secret Service - President security detail (Secret Service) take charge of planning etc. - visit was a secret - instituted access control - employees wanting to see/meet the President/crowd control - Had to shut off camera systems • Access control was implemented through out his visit
  7. 7. Friday lockdown/Manhunt • • • • Fear Raging Hospital Incident Command Center is re-activated Lockdown implemented – always challenging Transportation Challenges - Parking issues - Road Closures - No Public Transportation - Hospital employees impacted • Disruption of Patient care/disruption of services – Fiscal impact on the area hospitals • Is your hospital prepared to shelter in place?
  8. 8. Lessons Learned • People showed up quickly • Immediately set up internal Law Enforcement command post/work area • Expect little to no notice so be prepared • Hospital staff response to crisis was great – many came in without being called and everyone worked as a team • Keep on call lists updated • Improve mass communication systems • Need more frequent Resources/Duty Assessments • Need enough radios, batteries, Disaster Vests and barriers/cones • Ear Pieces for all of the portable radios • Visual map needed in dispatch – live TV coverage • Double check perimeter doors after lockdown • Needed more clarity on who could get into the Emergency Dept.
  9. 9. Additional Challenges/Lessons • • • • • • • • • • • Inappropriate anger towards muslin employees Continuum of Fear and Force Packages/mail to victims of the attack Dignitary visits Need one major notification system to staff (Emergency Notification Sys.) Managing normal operations during a crisis. Sustaining robust deployment of security staff Centralized process for people looking for their family members Real time intelligence mobilization Recovery and support for staff. Post Traumatic Stress Disorder (PTSD) Establish a resource list Training and preparedness paid off – can never do too much