Lebanon
Jim Alexander, D-H’s emergency management director, said hospital officials are in a listening mode and are not presupposing what security changes the hospital may need to make following the death of 70-year-old Pamela Ferriere, of Groton, N.H., who police allege was shot by her son, Travis Frink, 49, of Warwick, R.I.
“What’s really important is that we don’t rush through the process of healing,” Alexander, a former Lebanon police chief, said in an interview on Wednesday.
The balance DHMC and other hospitals need to strike is between offering a comfortable environment for patients and visitors to receive health care and the need to keep everyone safe, Alexander said.
“(It’s) early to say where we’ll fall,” Alexander said. DHMC has “always been an open campus. … Rushing to close down and lock down a facility … that would be quite a drastic move.”
Aside from those carried by uniformed law enforcement officers, D-H currently prohibits weapons on its campuses, according to the hospital system’s written policy. D-H staff who bring weapons to campus could face termination. Others would be asked to leave, could be barred from future visits and could face criminal prosecution, the policy says.
Signs at entrances on the Lebanon campus alert patients and members of the public to the “no weapons” policy.
In addition to holding a town hall meeting with staff last week, Alexander said, the hospital continues to hold smaller debriefing sessions to allow employees to provide feedback about how they felt last week’s shooting was handled and how the response might be improved in the future.
Questions he hopes employees will answer include: “How can they feel safe?” and “How can we have the campus that we want?”
Alexander emphasized that “it’s all about our people.”
In order to “make patient experience work, (we) have to have our staff feeling really good about the place that they work,” he said.
In the wake of the Sept. 12 shooting, counseling has been made available to D-H employees, D-H spokesman Josh McElveen said.
Aside from Ferriere’s death, there were no adverse medical effects related to the shooting, McElveen said. As of Tuesday, 90 percent of impacted appointments had been rescheduled, he said.
While as many as five of DHMC’s 50 intensive care unit beds were unavailable as some staff took time to process the shooting, which was witnessed by at least one ICU nurse, D-H notified its affiliates and partners, McElveen said.
“In the event there was a capacity issue, they were ready to accept them,” McElveen said, adding that there was no major emergency that required outside assistance.
On Wednesday, McElveen said the hospital was “back to normal operations.”
A “code silver” alert warning of an “active shooter” was activated following the shooting, and much of the hospital was evacuated, while other patients and staff sheltered in place. Frink, who has pleaded not guilty to a first-degree murder charge, was arrested about 90 minutes after the shooting in a car at the intersection of Lahaye Drive and Mount Support Road, near DHMC.
He is being held without bail, and his stepfather told the Associated Press that Frink has had a history of erratic and sometimes violent behavior that may have been caused by post-traumatic stress disorder from his military service.
There is no particular timeline for how long DHMC’s security review might take, Alexander said.
“(We’re) not going to just listen forever,” Alexander said. “When there is not as much to hear, that’s a good measure.”
Alexander said he arrived at this approach, in part, through consultation with Dr. Eric Goralnick, medical director of emergency preparedness at Brigham and Women’s Hospital in Boston, who helped guide that hospital’s response to the on-campus shooting death of Dr. Michael Davidson, a cardiovascular surgeon, in 2015.
Alexander said Goralnick said: “Don’t throw up some type of immediate response without listening to your people.”
Following the shooting at Brigham and Women’s, Goralnick has published papers on the hospital’s response.
One, “A Death in the Family: Lessons from a Tragedy,” published in the Annals of Surgery in February 2016, outlines some security changes that hospital made, though it makes clear that none of them would have prevented Davidson’s death at the hands of a 55-year-old man whose mother had been a patient.
For example, the Boston hospital added key card locks in some areas and panic buttons in others. But hospital officials decided against placing metal detectors at Brigham and Women’s entrances, Goralnick and his co-authors wrote.
“We reviewed the placement of metal detectors at our entrances, a solution that most health-care facilities have chosen to forgo because it is nearly impossible logistically with more than 25,000 people accessing our facility daily and seems antithetical to our identity as a safe haven and welcoming environment,” they wrote.
They also noted that metal detectors are “likely to prevent less than a third of these unusual episodes.”
Active shooter events on hospital campuses are rare. Just four active shooter events occurred at health care facilities between 2000 and 2013, Goralnick and a co-author wrote in The Lancet in May 2015.
DHMC is not the only hospital in New Hampshire to have been the site of such a shooting. In 2014, a man shot his wife, who was in critical care at Wentworth-Douglass Hospital in Dover, N.H.
As D-H reviews its security policies, Dartmouth College — which has 868 graduate and undergraduate students, faculty and staff who work on DHMC’s campus — is also taking stock of the response to last week’s shooting. One area of focus is improving communication.
On Tuesday, Geisel School of Medicine alerted the school community that anyone with a Dartmouth.edu email address can now sign up to receive Dartmouth-Hitchcock emergency alerts via the Alertus+ app on their iOS or Android smartphone, Dartmouth spokeswoman Diana Lawrence said in an email.
Geisel officials are also aiming to begin offering D-H desktop alerts to Dartmouth employees who work on the DHMC campus, Lawrence said.
Some questions are likely to go without answers for some time. Like Alexander, Goralnick and his team noted that healing following a hospital shooting takes time.
“The emotional toll on our staff was significant; the resilience of our organization and its individuals has been tested,” Goralnick and his team wrote. “The most common question at our debriefings is still, ‘Why?’ ”
Nora Doyle-Burr can be reached at ndoyleburr@vnews.com or 603-727-3213.
