A police vehicle sits outside Mercy Hospital, where four people were shot dead on Monday. Chicago police officer Samuel Jimenez was shot and killed while answering a hospital call. Tamara O'Neal, a 38-year-old emergency woman, and Dayna Less, a 25-year-old pharmacist, were shot dead. Juan Lopez, a year, also died in the incident.(Photo: Scott Olson, Getty Images)

CHICAGO – US hospitals are increasing training in the security and safety of their staff in response to growing reports of violence, security breaches and theft on medical campuses.

But Monday's mass shots at Chicago's Mercy Hospital could demonstrate both the pros and cons of increased alertness in hospitals across the country, according to experts in health care and safety.

"It's very difficult for health care administrators who are trying to strike a balance between an open and caring environment and the ability to protect their patients, their staff, and their visitors," said Alan Butler, elected chair of the board of directors. 39, administration of the International Association. for the safety of health care and safety. "The situation in Chicago shows it well."

A doctor from the emergency room and a pharmacist, as well as a Chicago police officer, were killed during the shooting at Mercy.

The gunman shot his ex-fiancée, 38-year-old Dr. Tamara O'Neal, in the parking lot next to the hospital, before entering the building and killing the resident of the Dayna Less drug store. , 25, and Chicago police officer Samuel Jimenez, 28.

The shooter Juan Lopez, 32, has died of a stomach injury and a self-inflicted wound to the head.

Witnesses testified that the employees acted quickly, prompting colleagues and patients to barricade themselves in rooms or to go to the shelter. Hospital and police officials said the death toll could have been much worse without the quick reaction.

Mercy organized her first ever active shooting exercise just a few weeks before the shooting and added classroom training and Internet instructions for the workers on how to react if an armed man fired at the medical center.

"With the help of the Chicago Police Service, our emergency management team will take stock of what has happened to see what lessons can be learned," said Michael Davenport, Chief Medical Officer of Mercy. "We anticipate that there are lessons to be learned …

"We know that life will never be the same for us here at Mercy and things will change."

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Concerns about violence among health care providers, especially those working in emergency rooms, have been increasing for years.

Forty – seven percent of emergency physicians say they have been physically assaulted at work and 60% of them claim that these assaults took place last year, according to a poll of the United States. American College of Emergency Physicians conducted with 3,500 emergency physicians last month.

Almost 7 out of 10 say that violence has increased in the last 5 years; 25% say it's increasing dramatically. Forty-nine percent say hospitals can do more by adding security guards, cameras, car park security systems, metal detectors, and increasing visitor control in hospitals, especially in services. d & # 39; emergency.

"There is still much to be done," said Vidor Friedman, president of the organization. "Violence in emergency services does not affect only the medical staff, it also affects patients."

At present, about half of hospitals have portable metal detectors that can be used to spot visitors' weapons, the American Society for Health Care Engineering announced in its 2018 safety survey. hospitals. This represents a 33% increase in 2016.

Fifty-six percent of hospitals reported that they spend more to upgrade their security systems or increase their staff. And 96% of hospitals now have an active sniper policy.

Gabor Kelen, director of emergency medicine at Johns Hopkins Hospital, undertook with his colleagues to study shots in a hospital following an incident that occurred in 2010 at the center. Baltimore Medical Center.

Paul Warren Pardus, 50, shot a doctor, Dr. David Cohen, in the abdomen. Cohen had announced bad news about the mother of Pardus, a patient on cancer treatment.

Cohen survived. Pardus killed his mother before committing suicide.

The huge Hopkins Medical Center, one of the world's most renowned hospitals, remained shut up for about four hours.

When Kelen and his colleagues examined more than a decade of shootings in hospitals, they found that events were rare and unpredictable and that it was complicated to create effective deterrence practices.

Shots on 154 shootings in hospitals between 2000 and 2011 were most often motivated by grudge, the desire to commit suicide, to kill a sick family member or to escape from the place of detention.

Forty-one percent of shots on hospital grounds began or took place entirely outside the hospital, according to a 2012 report Annals of Emergency Medicine paper that Kelen co-wrote.

"There is no security that can handle that," Kelen told the United States today. "It's so unexpected. You can not place a security feature at every entrance to every hospital to be on the lookout for an individual being assaulted. "

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