Strengthening Active Shooter Response Through Interprofessional Training: The Role of Health Security Teams in Healthcare Systems

Background: Active shooter incidents in healthcare settings have emerged as a critical health security challenge, disrupting care delivery and threatening staff and patient safety. Hospitals, designed for accessibility and continuous operation, are increasingly recognized as vulnerable “soft targets” for firearm-related violence. Aim: This study aims to examine the operational complexities of active shooter preparedness in healthcare facilities and propose interprofessional strategies to strengthen response and resilience. Methods: A comprehensive review of epidemiologic data, regulatory frameworks, and case analyses was conducted, focusing on U.S. hospital shootings and global hybrid-targeted violence (HTV) events. The study synthesizes evidence from occupational safety guidelines, law enforcement protocols, and healthcare contingency planning literature. Results: Findings reveal that hospital shootings are often targeted, relational, and concentrated in high-risk zones such as emergency departments and outpatient clinics. Five typologies of violence—criminal intent, patient-related, worker-to-worker, domestic spillover, and ideological—shape risk profiles. HTV incidents, involving coordinated multi-weapon tactics, pose additional threats requiring all-hazards preparedness. Effective response hinges on facility-specific contingency plans, rapid communication systems, and simulation-based training. Conclusion: Active shooter preparedness in healthcare demands a multidimensional approach integrating physical security, behavioral threat assessment, and interprofessional collaboration. Continuous evaluation, scenario-based drills, and robust communication protocols are essential to mitigate harm and sustain clinical operations during violent crises.