Lessons Learned from an Active Shooter Full-Scale Functional Exercise in a Newly Constructed Emergency Department

Objective The primary objective of this exercise was to conduct a full-scale functional exercise utilizing an active-shooter-based scenario to test and evaluate hospital response and coordination with local law enforcement. Methods A multidisciplinary group, including community partners, formulated objectives in accordance with the Homeland Security Exercise and Evaluation Program and defined a scenario. A date to conduct the exercise was chosen on the basis of the expected completion of a large section of the new emergency department but prior to its opening for patient care. Results The exercise highlighted several strengths, but more importantly, illuminated areas for improvement that might otherwise have been missed in tabletop exercises and smaller-scale drills. Educational opportunities to improve functional skills and protocol were recognized. Conclusion Conducting a full-scale functional exercise of an active shooter in a newly constructed emergency department prior to opening for patient care provided valuable insight into areas for improvement while minimizing the impact such an exercise can have on daily operations. Should a similar opportunity arise as a result of new facilities being developed or renovations and maintenance requiring temporary closure, we advise hospitals to consider planning an exercise in the area prior to reopening for patient care. (Disaster Med Public Health Preparedness.