University of Wisconsin–Madison Medical College of Wisconsin

What Do Emergency Department Patients and Their Guests Expect From Their Health Care Provider in an Active Shooter Event?

Kevin Kenney, MD, MPH, MEd; Kevin Nguyen, MD; Erin Konecki, MPH; Corion Jones, MBA; Edward Kakish, DO; Brian Fink, PhD; Paul P. Rega, MD

WMJ. 2020;119(2):96-101.

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Background: “Run-Hide-Fight” is the summative life-saving mantra taught by governmental and private agencies in active shooter training. Initial research focused on patient expectations of health care provider responses in life-threatening situations suggests patients believe health care providers will take significant action to protect patient well-being. The potential disparity between expectations of the public and health care practitioner training must be examined, as conflict, confusion, and delays may have mortal consequences in active shooter situations.

Objective: Public perceptions of the extent of health care practitioners’ duties and responsibilities to themselves and their patients during an active shooter event were investigated.

Methods: A survey that queried perceived expectations of health care provider response efforts in 4 emergency department patient case scenarios interrupted by an active shooter event was developed and implemented to patients and retinue of the University of Toledo Emergency Department. Responses were grouped into provider-centric or patient-centric actions.

Results: One hundred twenty-seven participants responded to the survey and were included in the analysis: 82 patients and 45 guests. In all 4 scenarios, a mean of 87.4% responses was patient-centric. Frequency of patient-centric responses differed significantly by scenario, and women were more likely to have patient-centric expectations.

Discussion: The public has significant expectations that the health care provider will assist them during active shooter situations. Providing for the security of the health care provider and patient simultaneously is in conflict with common hospital crisis training. Efforts must be taken to bring patient expectations and provider training into greater alignment.

Author Affiliations: Emergency Medicine, University of Toledo Medical Center, Toledo, Ohio (Kenney, Nguyen, Konecki, Jones, Kakish); Department of Population Health, College of Health and Human Sciences, University of Toledo, Toledo, Ohio (Fink, Rega).
Corresponding Author: Kevin C. Kenney, MD, University of Toledo Medical Center, Emergency Medicine, Dowling Hall 2455 Mail Stop 1088, 3000 Arlington Ave, Toledo, OH 43614; phone 419.383.6383; email
Funding Support: None declared.
Financial Disclosures: None declared.
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