LiveProcess HealthCORe
Active Shooter Exercise
<Enter Your Hospital Name Here>
Exercise Plan
HEALTHCORE
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PREFACE
This Active Shooter Exercise Plan (ExPlan) template is intended be used either in a
functional exercise or table top (Situation Manual - SitMan) environment to
collaboratively reinforce coordination between community response entities and
healthcare organizations.
The ExPlan may be viewed by all exercise participants including public and private
entities at the discretion of the coordinating organization.
ADMINISTRATIVE HANDLING INSTRUCTIONS
1. The title of this document is the Active Shooter Exercise Plan (ExPlan) template.
2. This document should be safeguarded, handled, transmitted, and stored in
accordance with regional and organizational directives. It should be released to staff
or participants on a strictly need-to-know basis.
3. Reproduction of this document, in whole or in part, for profit or personal gain without
prior written approval from the LiveProcess Corporation is prohibited.
4. For information on this ExPlan template, please contact the following point of contact
(POC):
LiveProcess Client Services
Email: [email protected]
Phone: 888.400.CORE (2673)
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TABLE OF CONTENTS
Preface……………………………………………….……………………………………………………
1
I.
Chapter 1: Exercise Concept, Purpose and Assumptions…………………………………
3
2. Chapter 2: Exercise Objectives…………………………………………………………………
5
3. Chapter 3: Exercise Scenario……...…………………………………………………………….
7
4. Chapter 4: Exercise Participants, Roles and Instructions…………………………………
8
5. Chapter 5: Exercise Operations …………………..…………………………………………….
10
6. Chapter 6: Exercise Evaluation………………………………………………………………….
11
7. Exercise MSEL…. ………………………………..…………………………………………..……..
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CHAPTER 1: GENERAL INFORMATION
A.
EXERCISE CONCEPT AND PURPOSE
The Active Shooter Exercise Plan template is designed to establish a learning
environment for participants to exercise emergency response plans, policies, and
procedures as they pertain to Active Shooter, safety and security procedures.
Statement of Purpose
The purpose of the exercise is to coordinate hospital and regional command centers in
order to exercise safety, security and other plans in response to an Active Shooter
incident.
The exercise will test and evaluate operational procedures for internal and external
plans as well as collaborative response efforts among regional partners.
Exercise Conduct
 Conduct a simulated exercise with a scenario based on an event identified in the
hazard vulnerability analysis (HVA) – Active Shooter
 Conduct a multidisciplinary after action process to identify opportunities for
improvement
 Develop a corrective action plan to improve the emergency operations plan
(EOP), Active Shooter response procedures and facility readiness
Assumptions
The following general assumptions apply:
 The exercise will be conducted in a no-fault learning environment, wherein
systems and processes, not individuals, are evaluated.
 Exercise timeframes and activities will be simulated.
 Exercise participants will react in activities and/or discussions to the information
and situations as they are presented, in the same manner as if this had been a
real emergency incident.
 Participants will operate in accordance with NIMS and any other appropriate
participating organizational procedures and practices.
 Exercise participants will act as though all appropriate responding partners are
activated and conduct operations accordingly.
 All exercise incidents and events will be based on a scripted Master Scenario
Events List (MSEL) and hospitals should assume all actions directed at them.
 All events, names and incidents are fictitious.
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B.
EXERCISE EVALUATION AND CONTROL
Concept for Exercise Control
Non-participating representatives will be used to facilitate exercise play from a central
location. In addition, representatives from the region or other participating
organizations will serve as controllers and evaluators based on their local plans and
requirements.
Concept for Exercise Evaluation
This exercise enables participants to assess current response capabilities to an Active
Shooter incident, to identify strengths and weaknesses, and to identify future training
needs. The exercise will focus on critical decisions and coordination of participants and
local assets necessary to respond to an Active Shooter event.
Exercise objectives are based on the Target Capabilities for the regional participating
entities and The Joint Commission Emergency Management Standards six critical areas
for hospital and healthcare entities. Specific citations were intentionally not included to
allow for more specific objective development by participants.
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CHAPTER 2: EXERCISE OBJECTIVES
The objectives that have been selected, focus on evaluating emergency response
procedures and coordination among and between public and private response entities.
Regional Emergency Operations Center Objectives
I.
Command, Control, and Communications
Obj. #
A. Manage the regional response effectively as the event occurs
1. Activate the Emergency Operations Center (EOC) or
Medical Coordination Center (MCC)
2. Activate the incident command system and Incident
Management Team (IMT) positions
II.
EOC 1
EOC 2
3. Conduct incident action planning and reporting
EOC 3
4. Exercise communication between the EOC, MCC and
Hospital Command Center (HCC)
EOC 4
Resource Management
A. Test resource management procedures to request, receive, and
track resources
B. Test decision-making processes for critical resource allocation and
prioritization among medical and health entities
EOC 5
EOC 6
Hospital Command Center (HCC) Objectives
I. Activate the Emergency Operations Plan and the hospital Incident
Management Team (e.g. HICS) to manage the response to an Active
Shooter incident and notify regional/community entities.
HCC 1
II. Exercise Communications including:
A. Communications with external response personnel
HCC 2
B. Communication of information and instructions to hospital staff and
patients
HCC 3
III. Manage Resources & Assets
A. Assess and identify processes to obtain medical, pharmaceutical and
non-medical supplies
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HCC 4
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IV. Manage Staffing Issues
A. Test the ability to assign members of the Incident Management Team
(IMT) to the HCC
HCC 5
V. Manage Safety and Security
A. Assess the ability to secure the hospital facility and grounds to protect
staff, volunteers, physicians, patients, visitors, and assets using
internal and external resources
HCC 6
VI. Manage Clinical Activities
A. Test triage and referral processes of hospital patients to the hospital’s
alternate care site(s) or to the community-based alternate care site(s)
HCC 7
VII. Manage Utilities
A. Test the ability to turn off critical utilities in specific areas of the facility
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HCC 8
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CHAPTER 3: EXERCISE SCENARIO
It is early <ENTER DAY HERE> morning and the city of <ENTER CITY HERE> ABCTV has just reported a residential homicide where a young man murdered his parents.
Both had recently developed terminal illnesses and the son was their only caregiver.
Law enforcement agencies are beginning their investigation and have been searching
for the son.
At noon on Friday, area hospitals began receiving threats from an unknown caller. The
messages are all the same. The caller is angry with the high-cost of health care and is
threatening to, “rid the world of the profit-making, doctors and lawyers who are only
interested in money”.
By late Friday, law enforcement agencies are able to trace the calls and have identified
the perpetrator. The person of interest is the 28 year old son of the murdered couple.
He is also a parolee with a history of violence and has been unemployed for the past
several months. Further investigation suggests he had “shopped” his parents around
several emergency rooms and residential care facilities in hopes of finding a long-term
provider for his parents care. Interviews with clinical staff revealed that he was appalled
at the high price of medical help and had often yelled at staff, pacing around while
clenching his fists and pulling his hair. Investigators learned from bank records that his
parents had very little money in savings and were unlikely to be able to pay for their
ongoing medical needs.
Based on media photos, several unconfirmed calls 9-1-1 calls have been made from the
hospital suggesting the son has been seen on campus. Reporters picked up the
messages and are arriving at the facility. Someone overheard that CNN will soon be
arriving to cover the event.
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CHAPTER 4: EXERCISE PARTICIPANTS
A.
EXERCISE ROLES
Exercise Director
The Exercise Director is responsible for planning, coordinating, simulating events and
overseeing all exercise functions. Representatives from the hospital and/or region will
serve in this capacity.
Exercise Simulator
The Exercise Simulator is responsible for coordinating information and injects to
simulate exercise events. Representatives from the hospital and/or region will serve in
this capacity.
Lead Controller - Safety Controller - Site Controllers
Representatives from the hospital and/or region will serve in this capacity.
Evaluators
All participants will share in the exercise evaluation using a simple “hot wash” or
exercise debrief format conducted immediately following the exercise and facilitated by
the Exercise Director and site administrators.
Exercise Participants
Participants are agency and healthcare personnel who have an active role in
responding to the incident by simulating emergency response and recovery roles and
responsibilities during the exercise scenario.
B.
PARTICIPANT INSTRUCTIONS
Before the Exercise
Participants must perform the following duties before the start of the exercise:
 Review the appropriate emergency plans, procedures, and exercise support
documents for your facility or agency.
 Review this Exercise Plan.
During the Exercise
Participants must perform the following duties during the exercise:
 Respond to the exercise events and information through activity and/or
discussion as if the emergency were real.
 Act in a professional manner at all times.
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

If the participants do not understand the scope of the exercise or if they are
uncertain about an organization’s or agency’s participation in an exercise, they
should be instructed to meet with the Exercise Director.
Parts of the scenario may seem implausible. Recognize that the exercise has
objectives that may seem unrealistic. Simply respond using information
available.
After Exercise Play
Participants must perform the following duties after the exercise:
 At the end of the exercise, participate in the hotwash.
 Provide any notes or materials generated from the exercise for review and
inclusion in the After Action Report (AAR) and Corrective Action Plan (CAP) or
Improvement Plan (IP).
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CHAPTER 5: EXERCISE OPERATIONS
A.
EXERCISE SUMMARY
General
The Active Shooter Exercise Plan template is designed to establish a learning
environment for participants to test their hospital and regional responses to an Active
Shooter situation. In this exercise hospitals and community response agencies will
participate by using a central communication medium for:
 Information sharing and coordination
 Resource coordination
 Coordination of risk communication messages to the public
 Coordination of policy decisions that affect safety and security issues
Exercise play is scheduled for 45-50 minutes. Immediately following the exercise, there
will be a short exercise debriefing/hotwash.
The actions of participating agencies will be in response to events outlined in the Master
Scenario Events List (MSEL). The MSEL is limited in scope, serving as a catalyst for
initial actions and as a list of projected operational milestones.
B.
EXERCISE EVENTS AND BRIEFINGS
Participant Debriefing/Hotwash
Immediately following the exercise, participants must gather at the hotwash to share
their impressions about exercise conduct and play.
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CHAPTER 6: EVALUATION AND POST-EXERCISE ACTIVITIES
A.
AFTER ACTION REPORT
The After Action Report (AAR) is the culmination of the Active Shooter Exercise. It is a
written report outlining strengths and areas for improvement identified during the
exercise. The After Action Report will include a timeline, an executive summary and a
scenario description.
Each participating agency will be responsible for providing input into the After Action
Report to meet agency requirements. This includes but is not limited to the Executive
Summary, Conclusions and Improvement Plans.
B.
IMPROVEMENT PLAN
The improvement process represents the comprehensive, continuing preparedness
effort of which the exercise is a part. The lessons learned and recommendations from
the After Action Report will be incorporated into an overall Improvement Plan (IP).
The IP identifies how recommendations will be addressed, including what actions will be
taken, who is responsible for taking those actions, and the timeline for the completion of
those actions.
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HEALTHCORE ACTIVE SHOOTER MSEL
APPENDIX 1: MASTER SCENARIO EVENTS LIST
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EOC
OBJ
HCC
OBJ
MSG
#
Type
Time
(00:00hrs)
From
To
Message
EOC-1
1
Task
Region
Counties or
Jurisdictions
EOC-2
2
Task
Region
Counties or
Jurisdictions
EOC-3
3
Task
Region
Counties or
Jurisdictions
EOC-4
HCC-1
HCC-5
4
Task
Counties or
Jurisdictions
Hospitals
EOC-4
HCC-2
5
Info
Counties or
Jurisdictions
Hospitals
HCC-4
HCC-6
6
Reqst
Hospitals
EOC
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Please activate your Emergency
Operations Centers (EOCs) in
response to the ongoing hospital
threat
Please identify and provide contact
information for the person serving
in the IC position at your EOC.
Please identify any relevant
command and control as well as
strategic/tactical objectives from
your initial incident action plan
(IAP).
Please confirm activation of your
HCC. Also, please provide contact
information for your IC, Security
Branch Director and Liaison Officer
The County EOC has activated their
Joint Information Center (JIC).
Please have your PIO’s join a
coordinating call at 1800 hrs today.
Media is beginning to arrive and we
want to coordinate regional
messages.
We are increasing our security
measures and would like an
additional two officers to assist with
visitor screening efforts. Also, staff
are worried about coming in. Can
you provide barricades or other
tools we can use to better screen
visitors?
Expected Actions
HEALTHCORE ACTIVE SHOOTER MSEL
EOC
OBJ
HCC
OBJ
MSG
#
HCC-3
Time
(00:00hrs)
From
To
Message
Task
Hospital IC
Hospital PIO
7
Task
EOC IC
EOC Logistics
HCC-6
8
Info
HCC
EOC
HCC-7
9
Reqst
HCC
EOC
HCC-8
10
Task
HCC IC
HCC OPS
EOC-5
EOC-6
EOC-6
Type
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We are going to need messages
prepared for the media, our staff
and our patient/families. How soon
can you make these available and
how will you disseminate to each
group?
What resources can we provide to
the hospitals? Please make them
available immediately.
A man has entered our Emergency
Room and started shooting. There
are many people hurt but we’re
unsure what to do. Our Security
Chief was nearby and looks to be
shot. He is not moving. What
should we do?!!
The shooter is now in the basement
cafeteria and has several hostages.
We’ve counted at least 5 dead and
10 injured. We’re not able to care
for the patients. Can you please
provide immediate transportation
to another hospital?
There may be punctures in our
medical gas lines and other utilities
within the ER walls from the
gunshots. Can you evaluate and
control from a safe distance?
Expected Actions
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EOC
OBJ
HCC
OBJ
MSG
#
Type
Time
(00:00hrs)
From
To
HCC-6
11
Task
EOC
HCC
HCC-2
12
Task
HCC
EOC
EOC-5
HCC-4
13
Reqst
HCC
EOC
EOC-4
HCC-2
14
Info
EOC
HCC
15
Info
All
Participants
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Message
Can you contact all department
heads to find out their status. Also,
be sure to have them lock their
doors and stand by for further
instructions.
There seems to be several different
public safety agencies in our parking
lot. Can you tell us who is in-charge
and how we can communicate with
them?
The news has just broadcast that we
have a shooter and there are
several dead. The parking lot is
completely full and the news vans
are blocking all traffic. Also, there
are dozens of people surrounding
the facility, many that are sobbing
and seem to be in severe distress.
We have no idea how to manage it.
Can you assist?
The shooter has just committed
suicide and all of the hostages are
safe. We will continue to keep the
facility secure until you’re able to
resume routine operations.
The exercise is concluded.
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Expected Actions