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Riot or Civil Disturbance Response Plan

POLICY:
A civil disorder may escalate a minor disturbance to a major riot through the actions of one or a group of individuals who are well organized.  The first ingredient is a "cause" or reason for upsetting the normal routine or committing aggressive action against the hospital, its personnel or one or more of its patients.

A hospital is particularly susceptible to incursions by malcontents or individuals with a "cause," because of its lack of security and open admissibility to the public.  An individual determined to enter the hospital to start trouble will pay no attention to signs restricting entrance, such as "Emergency Ambulance Entrance," "Authorized Personnel Only," "Hospital Personnel Only" and other similarly restrictive notices.  In fact, such an individual will probably go to the rear or side entrance where he/she is not likely to be observed, and probably won't be challenged if he/she is seen entering the building.

PROCEDURE:
General:

As soon as it is determined or suspected that a person with no official business or medically related reason for being in the hospital is, in fact, circulating within the premises, he/she shall be challenged, preferably by an official of the hospital and escorted out of the building as discreetly as possible, on the basis that he/she has no reason for being in any part of the facility except the reception area, and that it is a private institution.  If he/she objects, the hospital official shall notify the police department, and the challenged individual shall be allowed to speak to the police department on the telephone. In most cases, the person will not avail himself/herself of the opportunity, but the hospital will have protected itself from any charges of unfair treatment or discrimination.

When it has been determined that a group of individuals are in the hospital on other than official or medically related business, all entrances shall be secured, and, where possible, the group shall be isolated by activating the fire doors, and prevented from circulating through the rest of the hospital.  The police shall be summoned by the Security Director or designee who shall brief the police watch commander over the telephone.

Responsibilities:  Potentially Violent Situation:

Switchboard:

Maintain a current list of phone numbers for the police and fire departments, and key hospital personnel to be notified in an emergency situation.

Be prepared to report any disturbance in accurate detail. It is essential that the true nature of the disturbance be reported in order that the appropriate course of action and corrective measures can be applied.

Engineering Department:

Maintain contact with the police and fire departments.

Since engineering personnel are often the first contact with participants in any type of civil disturbance, it is most important that they correctly estimate the situation and avoid aggravation of the existing situation. Engineering Services personnel will be the first and most reliable sources of information needed by the police to properly respond to a potentially violent situation. Information regarding the circumstances surrounding the situation of unrest shall help hospital officials in dealing with the group or individual ringleader in the early stages of the controversy. In the case of an organized group attempting to reach a patient or a member of the hospital staff with intent to harm, the Engineering Director's only recourse is to prevent entry to the area where the target individual is located.

Be prepared to call the police if a trouble situation appears to be developing. If there is any doubt, it is better to inform them too early rather than too late, as the situation can often be resolved before violence occurs.

Special precautions shall be taken to protect the liquid oxygen storage area and tank, and a supply of auxiliary cylinders shall be maintained in the hospital as back-up to the main storage and supply source, and for use in an emergency situation. The generator and boiler room shall also be guarded against actions by intruders.

Responsibilities: Violence Imminent or in Progress:

Engineering Staff:

Contact police and fire departments. (Use business phone numbers if no violence has occurred). Use emergency phone numbers if violence has occurred or is imminent. Carefully report the incident in terms of numbers of participants, reasons for unrest, observed conduct of group leaders and any other information requested by the police. Write down instructions given and follow their procedures.

Contact Switchboard and report nature and extent of incident.

Switchboard:

Notify the hospital Chief Executive Officer or his/her designated representative, and give details of the incident or disorder, including steps taken by Engineering.

In the event the incident requires additional staff to respond to the site of the incident switchboard will announce over the overhead audio paging system; “Code Green”.

In the event the incident requires staff to stay away from the site of the incident switchboard will announce over the overhead audio paging system; “Code 10 in (name area)”.

Follow instructions received from Chief Executive Officer.

Hospital Chief Executive Officer or Designated Representative:

Decide on course of action to be taken pending arrival of police.
-Hospital could be closed to all except bona fide emergency cases, i.e., those confirmed by the radio, or by calls from staff physicians or other authentic sources. The Emergency Department entrance could be guarded by Engineering Department personnel until arrival of police.

Instruct Switchboard to call off-duty personnel and inform them of the situation. All except Engineering Department personnel shall be instructed to remain out of the hospital until further notice. Engineering Department personnel shall be directed to report immediately to assist in coping with the situation.

Depending on estimate of the seriousness of the situation, determine whether to secure vital records by locking them in a vault or in a safe cabinet, or turning them over to key employees for transport to a safe place off the hospital premises. Special care shall be taken to safeguard the accounting office and any electronic or computer operations areas.

Direct the Director of Engineering to prepare for a fire alert and to have his/her forces standing by to shut off electrical power, natural gas or any source of ignition. It is imperative that the Engineering Department forces of the hospital cooperate fully with the police and fire services of the community responding to the disturbance.

In the final analysis, any local condition of unrest or social upheaval which affects the orderly conduct of the hospital functions shall be handled by the local public protection services with full assistance and cooperation from the hospital and it's staff.

US Patent Numbers 7,720,998 B2, 7,836,207