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Is Your Hospital Prepared for Gang Violence and Injuries?

March 4th, 2019 by Guest Communications

 

Written by: Amy Rock, Campus Safety Senior Editor

Los Angeles County has more than 1,300 gangs with over 150,000 members. In the city of Los Angeles alone, there are an estimated 450 active gangs with a combined membership of over 45,000 individuals.

In the last three years, there were over 16,398 violent gang crimes in Los Angeles, according to the Los Angeles Police Department. Those crimes included 491 homicides, 7,047 felony assaults, 5,518 robberies and 98 rapes.

For Los Angeles-based hospitals, treating patients with gang affiliations isn’t something new. Many of the active gangs in the area have been around for more than half a century.

Martin Luther King, Jr. Community Hospital, located in the heart of South Los Angeles, has provided medical services to many local gang members over the years.

South L.A., according to Jonathan Westall, VP of Ancillary Services at MLKCH, has been dominated by the Bloods and the Crips for decades.

“I would say quite a few of our [patients] are gang members or associated with different gangs,” Westall tells Campus Safety magazine. “Some of the largest housing projects in Los Angeles – Nickerson Gardens and Imperial Courts – are across the street [from the hospital].”

While outside influences and a simple lack of awareness might lead the average person to believe that gang-affiliated patients are usually at a hospital to receive medical attention for injuries sustained due to gang violence, Westall says most of the time, they are there to receive treatment for common ailments.

“The Crips and the Bloods formed in the 70s, so you have elderly gang members who have normal aging issues,” says Westall. “They have canes and walkers. These are old men. Now don’t get me wrong, there is violent crime and stuff does happen, but a lot of them are also here because their kid is sick, or their wife is pregnant, or their brother or mother is in. They have all these normal medical issues that all non-gang members have. So, at that point, they’re worried about their family member like anybody else would be.”

While violent occurrences are rare, hospitals still need to be prepared for the potential problems that can arise when a gang member becomes a patient due to gang-related injuries.

How MLKCH Has Handled Gang-Affiliated Patients

A 2018 guideline from the International Association for Healthcare Security & Safety (IAHSS) surrounding gang awareness recommends hospitals establish a specific patient care plan that addresses the potential security risks when a known or suspected gang member presents as a patient or a visitor.

The association says protective measures and protocols based on situational threat assessments might include protecting the privacy of the patient’s identity, location and associated health information.

When treating a gang member who is admitted for injuries sustained due to gang violence, MLKCH will place them under an alias and assign a hospital employee to watch their room. In some situations, security personnel or police must be involved.

“We try to start from a medical standpoint with a ‘sitter,’ which is non-security personnel,” Westall describes. “But sometimes, especially if the patient has a history of violence or lashing out, we’ll assign them an officer. If the person is under police custody, then they hold them. Then the officer has a safety briefing and works with our security.”

IAHSS also recommends a change in room location and other environmental modifications, such as patient transport and controlling patient visitors.

When rival gang members are injured in a fight, it is ideal to transport them to different hospitals to avoid potential issues. However, in California, most hospitals don’t own the ambulances.

“They are private contractors, so they bring the victims to the closest hospital. So oftentimes, they end up at the same one,” says Westall.

In situations like this, MLKCH locks down the emergency room and creates two separate waiting rooms.

“We won’t even address the gang affiliation,” says Westall. “We’ll find out who the visitor is here to see and put visitors for one family group in one room and the other visitors in another to keep them separated. We try to downplay the fact that they are in a gang as much as possible.”

Prior to joining MLKCH, Westall worked at a hospital in North Los Angeles. Between 2016 and 2017, there was a longstanding feud between the Pasadena Bloods and the Duarte Crips.

“We were having shooting and trauma victims brought in weekly,” he says. “Then there would be a memorial service for one of the gang members that got shot and killed and then the rival gang would shoot up that memorial service, which would, in turn, create another issue. It becomes a lot of crowd control, especially when there’s a shooting at a large event like that. We have to balance the needs of the family to be with their loved one as well as the safety and security of the institution.”

Best Practices for Handling Gang-Affiliated Patients in Your Hospital

Although each hospital’s patient population is different, it is important for all healthcare facilities — not only those located in inner cities — to adopt programs and training that emphasize gang awareness and prevention.

Overall, hospital security surrounding gang-affiliated patients requires cooperation, dedication and support from all stakeholders.

While the following best practices are recommendations regarding gang-affiliated patients, they can be applied to all types of security issues.

  1. Community Involvement

Many hospital safety officials believe working with community stakeholders is the best course of action to prevent gang violence from spilling through their doors.

IAHSS agrees, stating that healthcare facilities should identify and monitor the presence of gang activity in the community through an established information-gathering mechanism.

The process may include:

  • Communicating with local law enforcement
  • Establishing an open line of communication with community leaders and those knowledgeable about gang activity
  • Monitoring social media and environmental signs of gang presence
  • Strong employee screening, including thorough background checks

Westall describes a time while working at a hospital in Pasadena, Calif., when there was a drive-by shooting at a memorial for a murdered gang member. Since the memorial was two blocks away from the hospital, all of those who were shot were brought over in cars before an ambulance could respond to the scene.

“About 100 people who were at the memorial came to the emergency department at two in the morning and kind of overran it. It was a scary situation,” Westall recalls. “Everybody is out in the parking lot wanting to know who got shot, and its all active gang members from this memorial, plus the family. We had to get support from three neighboring law enforcement agencies to do crowd control and parse out who should be here, who shouldn’t be here and who is a family member that we can let into the hospital.”

This chaotic instance emphasizes the importance of working with law enforcement. At MLKCH, there is a radio room in the ER that monitors radio traffic coming from ambulances, the sheriff’s department and local law enforcement agencies.

“And they’ll call in and say, ‘I’m bringing a combative person,’ or a gunshot victim, or a stabbing victim,” says Westall. “So, we’re prepared to lock down the area and keep the folks who should be in the hospital, in the hospital, and the folks who should be out of the hospital, out of the hospital.”

MLKCH also does its part to effectively establish an open line of communication with community leaders, as IAHSS recommends.

Every week, staff from the community benefit and security departments attend a meeting hosted by the Watts Gang Task Force. The task force consists of members from the Los Angeles Police Department, the Los Angeles County Sheriff’s Department, the Los Angeles Unified School District, service providers, gang intervention workers, local elected officials and community members.

“Watts is the section of Compton that we operate in, so we meet with them and they tell us what’s going on in the neighborhood and we tell them what we know,” says Westall, adding that additional outreach programs have come out of these meetings.

In January, Westall spoke at Career Day at Los Angeles’ King Drew Magnet High School of Medicine and Science.

“I went to [the] high school to talk to kids about careers and how they don’t have to join gangs – you don’t have to go to jail,” he says. “There’s plenty of opportunities out there. Start out on LinkedIn and build a network. We have a ton of community outreach.”

Westall explains gang members often start young, and the high school is only four blocks away from the hospital.

“They have to walk by these gang members,” he says. “They know who they are. Their brothers are in the gang or their uncles or their dad. It’s definitely ingrained in them at a younger age.”

The hospital also recently started a program where employees go into barber shops to talk about healthcare screenings and what’s going on in the area.

“Barbershops are kind of the community meeting place around here,” he says.

2. Staff Training

At MLKCH, staff have an annual 40-hour in-service training and also participate in quarterly trainings. Although not completely focused on gangs, both contain a significant piece on the topic.

There are also briefings before each shift change, which Westall believes to be the most important.

“We’ll pass down pertinent information from the different shifts: what we’re expecting, what happened in the last 24 hours for people coming in,” he says. “Getting a good briefing is important because if the information doesn’t flow between the shifts, then it can cause problems.”

Training staff members to also be able to identify potential issues significantly helps to reduce gang-related incidents, says Mark Reed, Director of Support Services at MLKCH, who oversees security, safety, emergency management, parking and other programs.

“There are numerous gangs in the surrounding area of MLKCH and they don’t always get along, which can cause incidents at the hospital,” Reed says.

One way to prevent potential confrontations between gang members is to understand how gangs in the area operate.

Reed provided Campus Safety with a Google Maps link*, which gives updated information on Los Angeles County gangs and their territories. Clicking on each block provides the name of the gang that runs that area, along with a brief description, including who they feud with or who they have an alliance with.

(*Please excuse some of the language within the map. Although Reed is unsure who maintains the map, he and his team have reviewed it and believe it accurately depicts what they see in the community on a daily basis.)

Additionally, clinical staff should be trained to look for gang identifiers. Many gang members can be identified by tattoos or clothing. For instance, Blood members might tattoo the initials “CK” on their bodies, an acronym for “Crips Killers.” Crips will often wear Dallas Cowboys jerseys while Bloods will wear Chicago Bulls jerseys.

Charles Moore, the director of security at Northwest Hospital in Randallstown, Md., also suggests employees have a strong understanding of the three “R’s” associated with gang culture: reputation, respect and retaliation.

  • Reputation is crucial for the endurance and promotion of the gang as a viable criminal enterprise. The fear of reprisal and violence is created through reputation. Members gain their reputation by their willingness to do whatever it takes to achieve a good reputation.
  • Respect is wanted by all gang members. They seek respect and demand it in return for themselves and their affiliated gang.
  • Retaliation is a common occurrence when a gang member doesn’t feel they are being respected. Many are willing to risk serious injury or death to ensure they receive it.

Due to the potential consequences associated with three “R’s,” staff should be trained on how to speak to and interact with gang members.

“If you come off too medical or too clinical, you don’t relate to them – you build no rapport,” says Westall. “You get a lot more cooperation when they think they’re talking to a friend or to someone they have something in common with. I think that’s been my most successful tactic around it. Just sit down and have a conversation.”

3. Treat Gang Members As Patients, Above All Else

Westall and Reed both agree that treating all patients with respect and care is of the utmost importance.

“At MLKCH, we want to provide compassionate, collaborative, quality care, regardless of our patient’s background or affiliation,” says Reed.

Staff members are trained not to acknowledge if a patient is a known gang member.

“We try to keep it even-keel and treat everybody as a patient before anything else,” Westall says. “We kind of try to ignore those outside influences. Obviously, that becomes a challenge, depending on the individual, but the rule of thumb is to ignore all of that.”

At the end of the day, it’s about communication.

“You want to avoid any kind of altercation or confrontation,” Westall adds. “They don’t come in spitting and fighting and kicking just because they’re gang members.”

This article appeared on Campus Safety and is shared with consent: https://www.campussafetymagazine.com/hospital/gang-member-patients/2/


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