Aug. 28, 2023 Campus Shooting After-Action Report: Executive Summary

(PDF Version of This Executive Summary)

Background

On Aug. 28, 2023, the University of North Carolina at Chapel Hill experienced an active shooting incident that resulted in the tragic murder of faculty member Dr. Zijie Yan. At 1:02 p.m., UNC Police were notified of shots fired in Caudill Laboratories. Two minutes later, Alert Carolina sirens began to sound, and campus members were advised via text and email messages to shelter inside immediately because an armed and dangerous person was at large. Following a coordinated search conducted by UNC Police and multiple local, state and federal law enforcement agencies, the suspect, graduate student Tailei Qi, was taken into custody at 2:38 p.m. and later charged with first-degree murder and possession of a weapon on educational property, both felonies. Following an hours-long lockdown, UNC Police issued an “all clear” to campus at 4:15 p.m.

The University shifted to Condition 3, meaning that classes were canceled and non-mandatory operations were suspended, through Aug. 30.

Following the incident, UNC-Chapel Hill invited students, faculty, staff, families and other members of the Carolina community to share their perspective and insights via a feedback portal.

In keeping with emergency preparedness best practices, UNC-Chapel Hill then initiated a formal review conducted by CNA Corporation, an independent research and analysis organization. It analyzed the incident and the University’s response and then provided an after-action report (AAR) with recommendations regarding future emergency response plans.

Designed for institutional learning and improvement, the now-completed AAR allows for a candid assessment that will facilitate meaningful growth and improvements. The report is a record related to the planning and development of emergency response plans and not subject to public disclosure pursuant to G.S. 132-1.6. In addition, the report includes sensitive public security information not subject to public disclosure pursuant to G.S. 132-1.7. Below is a summary of the review process and recommendations to inform our campus community and the public.

Methodology and scope

The independent contractor used multiple methods to perform its review, including:

• Conducting 31 semi-structured interviews with 70-plus individuals representing key stakeholders across campus and the local community to obtain a comprehensive understanding of the incident. These stakeholders included but were not limited to:
  • Representatives from various units and offices across the University.
  • Local emergency management and public safety partners.
  • Students, faculty, staff and administrators.
• Reviewing the responses to the feedback portal that was open to the Carolina campus community, including students, faculty, staff and parents and families.
• Thoroughly reviewing existing policies, procedures, guidelines and standards in place at the time of the incident, including the Emergency Policy and Crisis Communications plan.
• Providing a comparison to real-world application to assess the adequacy and effectiveness of the University’s response and to identify gaps and areas for improvement.
• Comparing national standards and similar instances in higher education to benchmark the University’s performance and identifying industry norms, emerging practices and coordination expectations.

Key themes and recommendations

The AAR identified six key themes that will help the University prioritize and strengthen campus safety:

1. Preparedness and planning
   • This theme provides an analysis of the University’s emergency preparedness resources and training provided to the campus community. It highlights active assailant training offered to students, faculty, and staff at the individual and department levels upon request along with likely outcomes of a volitional training approach.
2. Public safety response and incident management
   • This theme provides an analysis of active assailant response training and tactics applied by UNC Police and supporting public safety agencies to include on-scene management, interoperability and decision-making.
3. Emergency coordination and information sharing
   • This theme provides an analysis of the University’s emergency management system, specifically the organizational structure used for emergency coordination. It acknowledges both the current and desired state of training needs for clarity of roles and communication pathways.
4. Public information and communications
   • This theme provides an analysis of the University’s emergency notification system, Alert Carolina, and how corresponding alerts are developed, released and interpreted. It addresses the content and frequency of messages from initial alerts through the “all clear.”
5. Campus counseling and behavioral health services
   • This theme provides an analysis of when and how the University provided crisis counseling resources. It addresses the availability of counseling services for students, faculty and staff in the days after Aug. 28.
6. Safety and risk management
   • This theme provides an analysis of the University’s campus security infrastructure, including camera systems and physical building exterior and interior locking mechanisms.

As the University improves its emergency preparedness, response and recovery processes and procedures, it will consider the following recommendations outlined in the AAR.

• Planning and policy
  • The University should create or adjust multiple plans and policies as a way to create centralized guidelines for video surveillance and building safety and security measures.
  • Additionally, consistency should be ensured between the Emergency Communications Plan, the Emergency Operations Plan and the Alert Carolina System Protocols. Definitions and descriptions of emergency response keywords should also be added to preloaded emergency messages.
• Operations, management and structure
  • UNC-Chapel Hill should conduct a feasibility study to centralize access, monitoring, maintenance, management and storage of camera surveillance footage.
  • Additionally, a threat and hazard risk assessment could comprehensively examine buildings and facilities across campus to review vulnerabilities and safety and access control measures.
• Equipment
  • The University should use multiple approaches to prioritize campus and building safety, including upgrading existing camera systems and ensuring the ability for offices and all classrooms to lock from the inside.
• Training and exercises
  • The Office of Emergency Management and Planning should hold additional and a greater variety of training and exercises for campus safety stakeholders. Coordination between emergency response and coordination officials should be prioritized. Specifically, a training program and job aids should be established to strengthen crisis communications with cross-departmental drills, which could potentially align with the triannual testing of emergency notification sirens.
  • The University should also create a mandatory active assailant training program for faculty and staff that includes general best practices and additional, specified information based on the variety of cross-campus facilities. Classroom safety procedures and locks should be reviewed with students at the start of each semester, and all new student orientations should include armed assailant training and safety resources.

Executive Priorities and Improvement Planning

An improvement plan is a pivotal component of the AAR process. Following an incident, the AAR can identify gaps and opportunities for development. The improvement plan, in turn, serves as the strategic framework through which recommended actions are systematically addressed. It functions as the blueprint for translating insights gleaned from the report into concrete strategies and initiatives aimed at strengthening our emergency response capabilities. Recognizing the importance of improvement, the framework for the improvement plan emphasizes accountability and achievability, with the expectation that efforts will be diligently pursued and completed within a timeframe ranging from six months to three years.

Below are the executive priorities for each key theme that will guide the improvement planning process.

• Preparedness and planning
  • Executive priority: While it was noted the University has accessible preparedness materials and offers introductory emergency preparedness course training, UNC-Chapel Hill will work to establish a unified approach to campus preparedness and training. This will ensure consistent access to these materials and training across all departments and units at the University.
  • Anticipated improvement: The University will actively explore practical options to implement standard active assailant training for faculty and staff within the upcoming academic year, with a focus on actions to take in the classroom, office or other campus facilities that provide guidance to occupants of the space based on emerging practices.
• Public safety response and incident management
  • Executive priority: UNC Police holds active assailant training on an annual basis. Moving forward, it will work to improve interagency collaboration, incident management and interoperability to ensure a better coordinated and effective public safety response in conjunction with partnering public safety and law enforcement units.
  • Anticipated improvement: Within the next year, UNC Police, with support from Emergency Management and Planning, will host a multi-agency exercise drill to test our response protocols and capabilities for responding to an active threat on campus with mutual aid law enforcement resources integrated into our response framework.
• Emergency coordination and information sharing
  • Executive priority: The University will enhance coordination procedures and activity, including improving understanding of official roles and responsibilities during incidents; addressing challenges in information sharing; and fortifying formal communication pathways to promote situational awareness and timely decision-making.
  • Anticipated improvement: Emergency Management will develop written guidelines on the roles of policy and coordination personnel along with conducting training on the application of said roles during emergencies.
• Public information and communications
  • Executive priority: To best align the University’s Emergency Communications Plan with the Alert Carolina System Protocols, the University will ensure effective public information and communications during emergencies by addressing gaps in the current process for releasing emergency messaging.
  • Anticipated improvement: Emergency Management and University Communications will explore improved language for Alert Carolina messages and opportunities to provide more frequent updates during an incident. They will also create an education campaign so the campus will know what communications to expect in an emergency.
• Campus counseling and behavioral health
  • Executive priority: Following the incident, the University quickly arranged for mental health services to be provided to community members. UNC-Chapel Hill is now working to streamline the processes for the establishment and communication of crisis counseling and mental health resources for students, faculty and staff immediately following an incident. Identified gaps for accountability will be addressed by developing and implementing a systematic approach for reunification.
  • Anticipated improvement: Emergency Management will work with the Office of Human Resources and Student Affairs to incorporate coordination of counseling and behavioral health services into the University’s Emergency Operations Plan during its next update.
• Safety and risk management
  • Executive priority: The University has begun an assessment of building and classroom door locks and is working to address needed improvements in campus safety systems and policies to optimize centralized standards, including camera systems, building/room access controls, lockdown procedures, training guidelines and the sharing of sensitive information.
  • Anticipated improvement: The University has developed a working group charged with identifying, acquiring and implementing an integrated camera management system along with a corresponding streamlined policy.