Bridging the Gap Between Safety Management and Crisis

[Guide] Bridging the Gap between Safety Management and Crisis

Crises of any form overwhelm affected organisations. The list of affected companies, however, is always dynamic, often increasing apace as the effects of a major safety and security event or emergency cascade out from the initial point of impact.


Such was the case with the 15 March 2019 Christchurch shootings at the Al Noor Mosque and Linwood Islamic Centre. The targeted mass shooting quickly became a major safety and security event for organisations outside of the immediate perimeter of the incidents, specifically Christchurch Hospital.

A mere two kilometres from Al Noor Mosque, Christchurch Hospital was only separated from the scene of the first shooting by Hagley Park, a large urban space. So close to the incident was the Hospital that witnesses of the shooting actually ran across the Park to warn Hospital staff to expect an influx in victims.

And come those victims did. They soon arrived in droves, by ambulance and car. Christchurch Hospital ended up treating in a matter of hours nearly three times the number of gunshot victims that peer hospitals treat in an entire year:ii 50-plus patients and 30-plus surgeries over the course of a day, with many patients receiving multiple surgeries.iii

This sharp uptick in patients was enough for the Emergency Room to activate its major incident plan, a pre-planned response triggered when the Department has to treat ten or more patients. Not only were all resources in the Emergency Room mobilized (i.e. surgeons, nurses, coordinators, orderlies, and social workers), but care providers and other staff from around the hospital were also called in or volunteered, whether they were on site or off.

The superlative medical intervention garnered headlines. Less so the incident response, a standard integrated crisis and safety response to major incidents, emergencies, or disruptive challenges that can negatively impact health or patient care. But the integrated crisis and safety response actually enabled the medical intervention. Why? Because throughout much of the medical intervention, Christchurch Hospital was, in fact, under lockdown, a crisis response tactic. The public could not attend Christchurch Hospital. Nor could staff or patients enter or leave the building.

Major security events, like the Christchurch shooting, can trigger lockdowns at healthcare facilities, even if the hospital itself isn’t the site of the mass-casualty incident. The worst-case thinking informing this logic goes that suspects might come to hospitals in the event of a public shooting to inflict further harm on victims. The public at large might also retaliate against injured perpetrators who’ve been taken to the hospital for treatment. The crisis itself also creates second-order business continuity challenges for hospital staff in the form of crowding. For instance, big crowds might rush to emergency rooms. This convergence of publics also exacerbates the challenge of treating other emergency patients who show up at the hospital in private cars and on foot, rather than in ambulances

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