Model "code silver" internal lockdown policy in response to active shooters.

Hospitals, even five years past the events of September 11, with their unguarded front doors and unlocked patient rooms have conspicuously failed to implement even basic security procedures to protect the society's most vulnerable against violence. The degree of complacency is so great that even hospitals that have experienced shootings refuse to institute basic security measures such as metal detectors and identification checks. Over the six-month period, from June through December 2006, there were at least eight hospital shootings in the United States and Canada. This article outlines these shootings and presents a model "Code Silver" policy that hospitals can adopt to mitigate some of the risk of internal hospital shootings. Key concepts of the policy include training hospital staff to "shelter in place" during a violent event, marking locked doors, and having hospital security respond in an appropriate manner.