21 Lessons Learned by Hospitals After the Boston Marathon Bombing

Here are the tips security executives from Boston Medical Center and Massachusetts General Hospital are providing other hospitals that might one day face a patient surge as the result of a terrorist attack.

Published: July 9, 2013Author: Robin Hattersley

Editor’s note: In light of the bombings that occurred in New York City and New Jersey last weekend, CS is highlighting the article below, which we was orgininally published in response to the 2013 Boston Marathon Bombings.

Campus Safety magazine recently interviewed Bonnie Michelman, who is Massachusetts General Hospital’s (MGH) director of police, security and outside services, and Constance Packard, who is Boston Medical Center’s (BMC) director of public safety and control center for parking services, on their experiences managing security during the patient surge that was the result of April’s Boston Marathon bombing.

Here are their recommendations on how other hospitals can appropriately respond during disasters.

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Drill, drill, drill! You have to get people to really simulate what it’s going to feel like to have a major disaster,” says Michelman. “You have to get a lot of departments involved in the exercises and drill, whether they be tabletop of functional. I think a lot of hospitals only drill with the ED, security department and telecom, but they don’t get nursing involved and social services. In this particular disaster, we needed so much help from so many different departments, and it was important for people to understand how things are going to work during a disaster. Otherwise, chaos ensues.”
Have enough radios and batteries because they will be used constantly.
Have the ability to lockdown.
Have pedestrian signage on hand.
Screen patients in the ambulance bay.
When discharging patients, be sure to do so when it is safe and when the media isn’t present.
Be prepared for the sustained deployment of your command structure. The Boston bombing lasted for five days. Can your officers last that long or longer?
“Once you set up incident command, you have to be in that room to make decisions,” says Packard. “One of the problems is you miss what’s going on in the field, and you’re relying on people to communicate, and their hands are full.”
“You need to take some time out to check on your people,” says Packard. “Make sure they’re OK with their families.”
Partner with others on campus, such as facilities, dietary and clinical teams so they can be mobilized when appropriate.
Obtain real-time intelligence from the state fusion center, DHS, etc.
Have security personnel use ear pieces.
Have enough barriers and cones on hand.
Have enough metal detectors and backup batteries on hand. Consider teaching staff behavioral profiling techniques to augment metal detection when screening visitors and patients.
Have a hospital security representative present at the Joint Command Center, along with the FBI, Security Service and local first responders.
Have enough dispatchers working in the dispatch center so they aren’t overwhelmed.
For elevators, have badge and key access.
Advise hospital staff to not pose with SWAT team members and police guarding the facility. It could be perceived by patients and victims’ families as being insensitive.
Adopt a mass notification system. “It would have diminished the rumors and increased the clarity of what was really happening in a much faster way,” says Michelman. “We were sending out mass E-mails to everyone, but not everyone was reading their E-mails. People would have understood what was closed, what was locked, where people should park, where people should come in, why SWAT was outside.”
“It was good to know that we have a robust security system that if you have to, can turn off card readers or [retrieve] video. Everything we needed was in place,” says Packard.
Have a crisis intervention team in place and ready to go.