Murder-suicide exposed training, communications gaps

ANAHEIM, Calif. — The need to improve staff training and communications are among lessons learned following a murder-suicide at a hospital in Pennsylvania, a hospital executive said Wednesday.

The March 2013 case involved a husband who shot his wife, who had suffered a stroke and was in a hospice unit of Lehigh Valley Health Network’s Allentown, Pennsylvania, hospital. The man then shot and killed himself, said Carolyn Coleman, Lehigh Network’s Allentown-based director of risk management.

Staff members heard two “pops” and then rushed into the room, Ms. Coleman said during the American Society for Healthcare Risk Management’s annual conference in Anaheim, California.

“They had never in their lives heard gunshots,” Ms. Coleman said of hospital staff members and their reaction. “That’s what clinicians are trained to do,” she said. “They’re going to go to that site.”

But what if the husband were still alive and a nurse rushed into the room? “This could have been an even greater tragedy,” Ms. Coleman said.

There also was a problem with notifying authorities, she said. Staff members called both 911, where dispatchers could not pinpoint the specific place of the call because of the trunk line phone system, as well as an internal security number. Staff now calls internal security, she said of revised procedures.

Ms. Coleman said staff members also are victims of such incidents, an issue that should also be addressed during post-crisis services. “They question themselves and ask, ‘What did we miss? Were there any red flags?’ ” she said.

“We needed a bit more awareness of how emotionally charged some of these situations are,” she said.

Ms. Coleman said one step the hospital system has taken since the incident is having hospice patients’ families fill out questionnaires with information such as whether there is a gun at home and if other family members have been in hospice care.

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