Mac’s Safety Space: When you can’t swat back

By Steve MacArthur, Hospital Safety Consultant

To reflect on popular culture for a moment, I’ve always been more a fan of crime procedural television than I’ve been of “reality” TV (I suspect part of that is my reluctance to engage in “conversation” with something I sense is too contrived—at the moment, too much of everything on TV could be described contrived, but crime procedurals don’t pretend that they aren’t a contrivance—I like my “deep fakes” to be up front about it).

A week or so ago, my wife and I were watching an episode of Blue Bloods in which one of the highlighted story lines dealt with a “wronged” party getting back at one of the support characters by making a 911 call to a local police department and indicating that a hostage situation was taking place at the support character’s residence, resulting in a law enforcement response of the Special Weapons And Tactics (SWAT) force. The interaction between law enforcement and “civilian” life, as portrayed on Blue Bloods, was harrowing. To be honest, until I had first seen this particular episode, I had never heard of “swatting,” but, from the get-go, I could see the opportunity (particularly given the very limited number of safeguards that can be brought to bear) for a lot of mayhem to be sown. But I didn’t really extrapolate to the potential for it to be used “against” healthcare facilities. Unfortunately, there are others that are ready willing and able to do just that, which is more than apparent from the information provided in a recent issue of Healthcare Facilities Today.

While you are not alone relative to this potential disruption, there are certainly some things you can do to make it as difficult as possible for someone to “swat” your organization. Communication with law enforcement is an important step in the prevention process—let them know the process by which they would be alerted to a violent or other related situation at your facility. Encourage them to visit your facility so they have a sense of the layout of the facility—where are likely “pressure points” or “flash points,” what’s your plan for securing the perimeter in the event of an emergency, etc.

Make sure your organization’s staff are familiar with the process for initiating internal response—for most hospitals, there is an internal emergency number to call—make sure everyone knows it by heart. Hopefully, the reported “uptick” in these types of events is an aberration, but I think we’ve all been in this too long to think that the wave of these types of incidents has crested. A standard, unified response will help keep things calm in the moment—but that takes some doing!

About the Author: Steve MacArthur is a safety consultant with Chartis Clinical Quality Solutions (formerly known as The Greeley Company) in Danvers, Mass. He brings more than 30 years of healthcare management and consulting experience to his work with hospitals, physician offices, and ambulatory care facilities across the country. He is the author of HCPro's Hospital Safety Director's Handbook and is contributing editor for Healthcare Safety Leader. Contact Steve at