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Run, Hide, Fight: Hospital tests active shooter preparedness

GILLETTE, Wyo. — It was all hands on deck at the Campbell County Memorial Hospital Tuesday morning as four police officers, shadowed by hospital security, advanced through the emergency department.

They were followed moments later by several loud bangs and incoherent shouting that echoed through the emergency department on Sept. 20.

Within 10 seconds, an announcement came over the public address system: “Code Silver- active shooter in the emergency department.”

The police officers exited the hospital, and then nothing; no sounds or updates came over the PA system or handheld radios for several minutes until the all-clear announced the situation concluded and business as usual resumed for Campbell County Health.

It had only been a drill; one designed to test staff responses in the event a real-life active shooter showed up at the hospital with deadly intent, and was the result of hours of work spread over multiple weeks after the idea was suggested by CCH CEO Matt Shahan earlier this year, according to Lisa Coleman, manager of professional development and emergency preparedness.

One of Coleman’s responsibilities is conducting hazard vulnerability analyses or HVAs, she said, and active shooter scenarios are always one of the health organization’s top concerns.

“We were just saying that it happens every day around the country so we want to be sure we practice and educate staff on how they might respond,” Coleman said.

Federal agencies say that active shooter incidents are on the rise. The Federal Bureau of Investigation reports that the number of active shooter incidents per year in 2021 doubled the number of similar of incidents in 2019 while the U.S. Department of Homeland Security says there have been hundreds of active shooter incidents at hospitals since 2000.

According to the Federal Bureau of Investigation, the number of active shooter incidents in 2021 were double the number seen in 2019 (Federal Bureau of Investigation)

More recently, four people were shot and killed by a gunman, reportedly angry over chronic back pain, at the St. Francis Hospital in Tulsa, Oklahoma, the Washington Post reported.

It was this latest incident that identified a need to assess Campbell County Memorial’s own active shooter preparedness to mitigate any potential loss of life in the event of a real-life scenario, Coleman said.


At CCH, active shooter preparedness is centered around education in an attempt to have hospital staff build muscle memory so they can, hopefully, react and not freeze if they ever come face to face with a gunman, Coleman continued.

The research says that people often freeze up when they come across dangerous situations, she explained, adding that Campbell County Health’s approach focuses on three critical words: run, hide, and fight.

In active shooter scenarios, the safest option oftentimes can be to simply run away, per Coleman, especially if you know the shooter is on the other side of the campus and you can safely remove yourself from danger.

If running is not an option, perhaps because the shooter is blocking the exit, the next safest option could be to simply hide, Coleman said. Staff can lock themselves in a room, silence their cell phones, and turn down the lights.

According to Gillette Police Lt. Kelly Alger, who was onsite during the drill, sometimes something as simple as a closed door is enough to keep a gunman moving in search of an easier target.

If running or hiding fails, and you’re about to come face to face with the shooter, then it might be time to make a decision to fight to save your life, according to Coleman.

An individual’s choice

Coleman and CCH Head of Security Lt. Adam Boothe say the hospital’s run-hide-fight approach is not a blanket guide for staff on what to do in an active shooter incident and that the choice is ultimately up to the individual.

“These situations are too fluid,” Coleman said. “The last thing you want to do is tell people to do something and that is what gets them killed.”

Boothe, who has been to multiple formal training seminars for active shooter situations, says that it really is an independent decision that staff has to make for themselves based on the available information.

The good and the bad

There were some shortcomings identified during the drill, and some things didn’t go as planned, observers reported after the fact.

There was no active shooter notification through the hospital’s Alertus system, which didn’t go out because staff credentials for the system didn’t work.

Some staff, observers reported, chose not to lock down while laughing and talking among themselves during the drill and were satisfied with stating what they would have done rather than acting it out.

Contractors working in the hospital went about their business, one even walked out of the emergency department after the “active shooter” went in and stated he was told by a supervisor to simply go to lunch.

There were some areas in the hospital where the Code Silver announcement couldn’t be heard, observers said, reporting that staff came up to them post-drill to ask when it was going to start and had no idea it had already come and gone.

Bright yellow safety vests distinguished observers from participants in Campbell County Health’s active shooter drill (Ryan Lewallen/County 17)

But there were also many things that went right.

The speed of the Code Sliver PA announcement was second to none, many other staff members locked down like the situation was real while at least one ran away.

Another staff member armed herself with a steak knife in preparation to fight, and a patient barricaded the entrance to a room using a storage shelf.

According to Alger, who shadowed Gillette Police Detective Julianne Witham, the “active shooter” said that she was suitably impressed by how hard it was to find anyone once the announcement went out.

“People were truly hiding and closing the doors behind them,” Alger said, adding that from his perspective as a law enforcement officer, the drill went really well.