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CHAMPAIGN — On just one of the occasions where someone fired a gun inside a health care facility this year, a woman was fatally shot by a family member in the intensive care unit of New Hampshire's Dartmouth-Hitchcock Medical Center.

This June, a gunman opened fire at the Center for Wellness and Pain Care of Las Vegas, injuring two people and then fatally shooting himself. The shooter was identified as a regular patient who was refused an unscheduled appointment.

Violence is a potential threat at all health care facilities, and training has been underway at both Christie Clinic and Carle to teach staff members how to respond to a shooter, should the need ever arise.

Christie Clinic staff members are undergoing ALICE — Alert, Lockdown, Inform, Counter, Evacuate — training, with most of the 900-plus employees completing an online part of the training this past July, said Lisa Cheely, Christie's education and training manager.

This week, the first 200 on Christie's staff are taking it a step further by participating in live simulated drills.

They've been warned to wear protective clothing, because airsoft guns will be used during these exercises and they may be hit with pellets, she said.

"It does make the training seem more realistic for the people and the shooter," Cheely said.

She knows about that firsthand, having played the role of a shooter in previous ALICE training.

Cheely said she's had no prior experience with firearms, and arming her in the exercise helped show how easy it is for a shooter to hit a stationary target, for example, someone who has chosen to hide.

Health care doesn't rank as one of the nation's most hazardous professions, but health care employees are at some risk of being injured in episodes of violence on the job.

Between 8 percent and 38 percent of health care workers experience physical violence during their careers, mostly inflicted by patients and visitors, according to the World Health Organization.

Those most at risk are nurses and other staff involved directly in patient care, emergency room staffs and paramedics, the organization said.

Christie Clinic is undertaking this training as a precaution, according to Jenna Koss, the clinic's marketing and public relations manager.

"There has not been any recent incident of violence that initiated this training," she said. "This training is a proactive measure to educate our team, should there ever be an unfortunate situation."

The drills were scheduled for Tuesday and today, away from clinical care areas, at the clinic's administrative office building in downtown Champaign.

Cheely said this will give participants a chance to put into practice what they learned online.

While the online training was required for all staff, the active shooter training involving live drills isn't, she said. But the hope is that most Christie employees will sign up for this next part of the training.

She and six others at Christie Clinic have taken the instructor training, and will be offering further training for those who aren't participating with an ALICE instructor this week.

"The thing that is really unique about ALICE training is, they tell you there isn't any one way to respond to a shooter event," she said.

For example, sometimes a lockdown is appropriate. Sometimes, it's better to evacuate, and sometimes people faced with a shooter are best taking countermeasures, she said.

About half of the participants in the exercises this week are clinic leaders, among them administrators and department supervisors, Cheely said.

"We're really looking forward to going through this next phase of it, and really hope it keeps not just our team members safe, but our visitors," Cheely said. "It's unfortunate that we have to think about this."

Carle staff receives some training for active-shooter response annually, according to Chuck Plotner, Carle's director of security.

"We really want to emphasize prevention, have our employees be aware and report threats," he said. "We also let our employees know that all physical threats of violence we're going to report to police. We're not going to put up with that."

All employees are required to do online training every year. They don't all participate in the kind of simulated situation drills going on at Christie Clinic this week, though the hospital emergency department has had that type of training, Plotner said.

Carle Foundation Hospital's response plan uses the run, hide, fight model, similar to ALICE training, he said. If escape is possible, that's what employees are encouraged to do, he said. If running or escaping isn't an option, than hiding and locking the doors is the plan. Fighting back becomes the option if a shooter is actually in a person's space.

This training is also done as a precaution at Carle, Plotner said. While the staff has contended with angry patients on occasion, he said, "no one has come through the door displaying a weapon here at Carle."


Debra Pressey is a reporter covering health care at The News-Gazette. Her email is, and you can follow her on Twitter (@DLPressey).