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00:00:00:03 â 00:00:17:05
Tom Haederle
Welcome to Advancing Health. Today we hear about how one health system has adapted elements of the National Hospitals Against Violence initiative to achieve a safer environment for both its workforce and for patients and families.
00:00:17:07 â 00:00:37:23
Jordan Steiger
Welcome to Advancing Health. My name is Jordan Steiger, and Iâm the director of behavioral health and violence prevention at the AHA. Iâm joined today by Tom Ahr, the senior vice president and chief human resources officer at Hospital Sisters Health System. And he is a member of the AHAâs Hospitals Against Violence Advisory Group as of this year. So, Tom, welcome.
00:00:38:04 â 00:00:38:21
Thomas Ahr
Thank you.
00:00:38:23 â 00:01:12:07
Jordan Steiger
Tom and his organization have been really instrumental in advancing safety and preventing workplace violence across the entire system. He and his team have done some incredible work, especially over the last few years, that the AHA has been privileged to kind of learn about and see grow. And we thought this was a great opportunity today to share this with our membership, because I think thereâs a lot of really, really good lessons learned, especially around things about coordinating violence prevention efforts across an entire system, improving outcomes for the workforce, and then, of course, for patients and families.
00:01:12:13 â 00:01:19:13
Jordan Steiger
So, Tom, to get us started today, can you just tell us a little bit about Hospital Sisters Health System and your role in the organization?
00:01:19:15 â 00:01:43:18
Thomas Ahr
Thank you Jordan. Hospital Sisters Health System is a Catholic health care organization. Weâre based in Springfield, Illinois. We have three primary locations. One is on the Illinois side of Saint Louis, one is in the greater central Illinois area. And then we also have hospitals and other care delivery settings in the Green Bay, Wisconsin area. We have 13 hospitals, and I am the chief human resources officer, HSHS.
00:01:43:20 â 00:02:05:22
Jordan Steiger
Great. And I think coming at this problem of workplace violence from that chief human resources officer position really positions you well to make impact across the entire system. And a lot of times we see clinicians taking on that role. And I think, you know, having you especially come on to our Advisory Group as a CHRO is really, weâre really excited about that.
00:02:06:00 â 00:02:34:09
Thomas Ahr
I tell you, first, Iâm very glad to be on the Advisory Group, but itâs really interesting to see all the different roles and expertises that are involved in this really complex topic. And I think it speaks to the complexity of the issue at hand. As an HR professional for my career, we spend a great deal of time looking at what the experience of our employees and colleagues are and how we can optimize that. And what we recognize as of many organizations, in particular, health care organizations,
00:02:34:11 â 00:02:52:21
Thomas Ahr
violence at work is becoming too prevalent, and it was really harming our people and harming their ability to do what they came to health care to do, which is to provide care for others. So we see it, part and parcel with the work that we do to try to create positive work environments for everyone who is working here.
00:02:52:23 â 00:03:07:02
Thomas Ahr
And so naturally, and our organization fits into the HR space, but I can see where it fits into safety, security, nursing, other critical areas just as easily. Just happen to be one that that really gained traction for us at HSHS.
00:03:07:04 â 00:03:29:02
Jordan Steiger
No, that makes a lot of sense. And I think you mentioned it takes that interdisciplinary approach to really make this work and to enhance safety. I know that you and your organization have been doing a ton of work over the last few years, especially. And thatâs not to say you werenât doing this before, but youâve really made huge strides on improving safety and kind of enhancing your programing around workplace violence.
00:03:29:03 â 00:03:37:22
Jordan Steiger
So tell us a little bit just about how you got started on this path and what was important to you as you were thinking about expanding some of your work?
00:03:38:00 â 00:04:08:09
Thomas Ahr
What was important to us was, was individual safety at work. And then we recognized that coming up with kind of individual solutions wasnât going to solve the problem, because itâs so big and weâre all feeling it, okay. And so we recognized the need for kind of systemic solutions for a dedicated effort to it. We had a no shortage of individuals, working very hard teams working very, very hard in response to it, to these situations.
00:04:08:11 â 00:04:29:22
Thomas Ahr
But we recognized we need more than that. As a leadership team, weâre observing this. We were witnessing what was happening. We just recognized the need for more comprehensive solution, which really happened about 18 months ago for us. Itâs really when we decided to get serious around what weâre going to do. And that initiated a number of activities that have led us to where we are today.
00:04:30:00 â 00:04:46:22
Jordan Steiger
So just to mention and build on what Tom was just talking about, we do have a case study coming out. The companion to this podcast, that is going to go into a lot more detail about some of the programs and approaches that Tom is discussing today. So if youâre curious about anything, heâs mentioning, thatâs a really good place to start.
00:04:47:01 â 00:05:08:20
Jordan Steiger
But thank you for, you know, telling us a little bit more about kind of what youâre thinking was around that. One thing that has really stuck out to me, I think in all the work youâve done, especially in the last 18 or so months, is your focus on prevention and training. So not just waiting for an event to happen, but really trying to empower your workforce to mitigate those events before they actually occur.
00:05:08:22 â 00:05:17:07
Jordan Steiger
What have you been doing to help your staff, you know, recognize signs of trauma, maybe identify behavioral health needs, things like that.
00:05:17:09 â 00:05:45:20
Thomas Ahr
The instances of violence are occurring every day and theyâre easy to see. And we do respond to those. And those are, what kind of gets the headlines in there. But what weâve also recognized is that folks are living in, through trauma in other ways, and we need to spend the time to understand what it means to provide care in an environment where you may be, someone who was, is in other violent environments or is carrying other trauma with them.
00:05:45:21 â 00:06:03:05
Thomas Ahr
And so we look at it on both lenses, both that acute in-the-instant moment, but also what someone may be bringing to work. And we think around, you know, just some of the kind of core elements of trauma-informed care, but really recognizing and responding when we see these things occurring. So how do we actually do that?
00:06:03:05 â 00:06:25:19
Thomas Ahr
I mean, itâs easy to say. Weâre big proponents here of a concept called mental health first aid. And actually, as we started this year, while weâve had hundreds of leaders and colleagues take that certification, we have made that mandatory for all leaders, within our ministry. We want our leadership team, and we make available to all of our colleagues and our external partners as well.
00:06:25:21 â 00:06:56:07
Thomas Ahr
We want them to be able to recognize when someone may be suffering. It could be work-related. But Iâll tell you, itâs also home-related, community-related. And we want them to recognize that so they can help that person get to kind of on a healing path, whatever that might be for them. Certainly, mental health first aid isnât around providing that long term treatment, but at least recognizing when there may be a situation that can be addressed by addressing it, makes the colleague, makes the work environment, stronger.
00:06:56:08 â 00:07:03:22
Thomas Ahr
Is something that we want to give to all of our leaders so that as part of their role in managing others, theyâre looking after their welfare.
00:07:04:00 â 00:07:22:03
Jordan Steiger
I think that makes a lot of sense. And just like you said, that empowerment to understand that, like you are seeing someone on their worst day at their worst time, and that doesnât excuse violence, but it certainly, you know, helps you understand where theyâre coming from, maybe a little bit more. And that that leads to prevention, I think in some, some cases at least.
00:07:22:04 â 00:07:45:14
Thomas Ahr
You know, I think it does. And you try to think through, not only is it around recognizing it in someone on your team, but maybe even recognize it on that family member whoâs coming in, okay. And so it causes a different set of initial reactions there. And we think thatâs valuable, that you have that, that even if itâs just a momentary pause to think about what is going on here,thatâs so preventative.
00:07:45:16 â 00:07:58:05
Thomas Ahr
Things can escalate very quickly. We, as do many other organizations, have de-escalation training and things on those, those rights. But this adds another layer to that that we think has been very beneficial for us.
00:07:58:07 â 00:08:13:06
Jordan Steiger
Absolutely. And I mean, mental health first aid is something that is out there in every community. And I think a really smart approach for your system to take, itâs accessible. And itâs evidence-based and we know it works. So I think thatâs an awesome example to share with other members.
00:08:13:08 â 00:08:33:12
Thomas Ahr
And Iâll add to it, which is, from an HR guy here, itâs not often that you get to offer a class or a program and you have waitlists. We do. And, so we donât have to promote it. Itâs being filled every time that we offer it. Matter of fact, we just going through what our schedule is for the rest of the first six months of the year.
00:08:33:12 â 00:08:51:14
Thomas Ahr
And weâre full. Weâre thrilled for that. But itâs one of the few things where people are asking to sign up. And when they walk out, theyâre sharing with others. So I encourage people to consider this as a great alternative and a great vehicle for this type of learning, and for the support you may want to provide within your hospitals.
00:08:51:16 â 00:09:10:22
Jordan Steiger
Absolutely. I think thatâs great advice to share. We know, though, that as much as we want to focus on prevention and everything, Â that there are still going to be incidents, unfortunately, that happen. But I think the way that you and your team have kind of put some supports in place for your staff after incidents of violence is pretty incredible.
00:09:11:00 â 00:09:18:04
Jordan Steiger
So I was wondering if you could share a little bit about some of the work youâve done to really support your staff after they experience violence?
00:09:18:06 â 00:09:37:11
Thomas Ahr
Yeah, I think the first and foremost thing that we have to do is to make sure that weâre recognizing it when it happens. And so we put in a number of different processes and tools to make sure that itâs initiating the next level of process, next level of action that occurs there. And those are very exciting, what weâre doing.
00:09:37:11 â 00:09:58:12
Thomas Ahr
Iâll share those with you in just a moment. But we need to make sure that thatâs getting entered into our systems and so that we can we can take action there. The thing that is kind of the most heartwarming of it all for us is recognizing that, particularly when violence happens at work, we do not want to re-traumatize that individual.
00:09:58:14 â 00:10:23:22
Thomas Ahr
And sometimes they need a little time away. And make sense if you are slapped or punched or something of that nature, I ask you to come right back to work. Probably isnât the best care solution that we could deliver in the moment, and certainly isnât respectful of the conditions that that colleague is facing. So we instituted last year, a different classification of time off, healing time away.
00:10:24:00 â 00:10:53:06
Thomas Ahr
And, much like many of you may have bereavement models or other of these kind of short-term periods of time where folks can take time away. We have funded and made available at this classification. So if someone needs the afternoon or the evening to reground themselves, or perhaps they need the next day off before theyâre ready to come back in there, they can take advantage of that without having to take time off for their vacation or their holiday or otherwise.
00:10:53:08 â 00:11:15:12
Thomas Ahr
I believe that we had an example right before the holidays, that it would have been a choice between taking holiday time away with their family or coming back to work and not being ready to do so. This was a fantastic bridge for them. You know, we had a concern that it might be overused and and it really itâs not, itâs been pretty, judiciously used, but weâve had a number, Iâll say itâs more than
00:11:15:15 â 00:11:34:08
Thomas Ahr
I can count on my 10 fingers of times of which weâve used it, and itâs been of great value to those individuals. Itâs a terrific thing that weâve done for them. And, and it really sets the stage better for their re-acclimation to work and for them to recognize their colleagues, to recognize that we do value and respect them.
00:11:34:10 â 00:11:50:17
Thomas Ahr
And knowing that this can be difficult. Now we do other things as well. I mean, we have, kind of care kits and, toolkits for leaders on how to check in with others. I already mentioned the mental health first aid to see if thereâs any lingering topics related to that.
00:11:50:19 â 00:11:59:10
Thomas Ahr
Care for colleagues is super important, and thatâs where we spend a lot of our time in the event these things occur. And weâre not naive to believe that theyâre not occurring.
00:11:59:12 â 00:12:30:11
Jordan Steiger
I love this example, and Iâm so glad you brought it up. If you didnât, I was going to ask you about it because I think this is something that other systems can really emulate. Like you said, everyone has a bereavement policy and, you know, others have maybe volunteer time away, things like that. You know, this is I think putting something in place really sends such a strong message to your workforce that you respect them as, you know, professionals, you respect their mental health, and their well-being, and you want them to be at their best so they can provide the best care to your patients, too.
00:12:30:13 â 00:12:50:15
Jordan Steiger
I have not heard of other hospital systems doing this. They might be out there. But I think this is a really, really shareable model. Iâm so excited that you brought it up so others can learn from it. You mentioned a few things, like you wanting to make sure that, like, things are being reported and, you know, recorded as quickly as possible, you know, like events.
00:12:50:15 â 00:13:01:15
Jordan Steiger
How are you using that data and reporting and maybe even enhancing the amount of reporting? Because we hear from members a lot that, these events are kind of going unreported.
00:13:01:16 â 00:13:24:01
Thomas Ahr
Yeah. Itâs kind of hard to manage something that you donât understand how frequently theyâre occurring, and we know theyâre occurring. We know that theyâre occurring twice a day, okay. And I would not have known that otherwise. Now, this is the spectrum of different types of ways in which  violence is lived, okay. And so itâs not always just the punch in the face.
00:13:24:01 â 00:13:46:18
Thomas Ahr
It could be other things as well. It could be harassment and bullying, lots of other different types of activities that really harm the individual. We do ask and we reinforce with our colleagues, with our leaders â report it. We need to know. And itâs given us some great insights into certain things like, which units, at which type of day, which circumstance.
00:13:46:18 â 00:14:09:05
Thomas Ahr
For some reason, itâs Thursdays, you know what are these things that are happening which allow us then to do other things with that, like, well, do we need to do different types of resource deployment? Are there certain conditions in place that are causing this to occur? How do we address those? We do meet monthly on this at a global level to say, what are we seeing and what should we do based on that.
00:14:09:05 â 00:14:28:17
Thomas Ahr
And thatâs with our security team. Thatâs with our care delivery teams, just different groups across the organization. We say now that we know this, our quality teams, our risks teams, now that we know this â what should we do differently to try to prevent or try to mitigate, and try to address, what is going to be going on in our buildings.
00:14:28:19 â 00:14:43:21
Thomas Ahr
The more that we found as you do with many kind of quality events, the more that you you ask for reporting, the more that you get. This is always a good thing. Weâd rather know than not know. And so we follow that same path that you would see as many quality folks and with more.
00:14:43:23 â 00:15:00:06
Thomas Ahr
And you want to get more of those so you can have good information to use to decide, what do we need to do? And what we need to do could be some of those examples that I just shared. But also, bigger picture things like advocacy, and speaking with  lawmakers and otherwise and law enforcement officials.
00:15:00:08 â 00:15:06:06
Thomas Ahr
How can we make changes that can support the care delivery that we want to support in our buildings?
00:15:06:08 â 00:15:25:06
Jordan Steiger
Absolutely. Iâm glad you brought up thinking about partnerships and advocacy. I think thatâs such a key part of all of this. And, you know, one hospital or hospital system canât fix this problem alone. But it sounds like youâre using the information you have to really make some positive changes. Itâs interesting how you say, you know, Thursdays for some reason.
00:15:25:08 â 00:15:41:13
Jordan Steiger
I donât know why, but I mean, thatâs good that you know that. And you can, you know, look at your work, you know, your staffing and understand how you can keep people safer. So thatâs awesome. As weâre kind of winding down here, what is something that youâre really proud of in all this work that youâve done?
00:15:41:15 â 00:16:05:21
Thomas Ahr
Iâm most proud of the way that the entire organization has leaned into it. And, we have monthly all-leadership meetings. Last calendar year, three of those meetings were dedicated to this topic. And usually thereâs two or three topics in those meetings. So it wasnât a one-time, hereâs an important initiative, letâs everyone get on board.
00:16:05:23 â 00:16:33:23
Thomas Ahr
It is reinforced with regularity. Iâm proud of our whole organization for saying this is a real concern, and we are focused on it for the long term. Iâll say, secondly, the work that was done by our colleagues to help to rework our patient visitor code of conduct was transformational for us. It gave them a tool in the moment that they could use to change behaviors as theyâre occurring.
00:16:34:01 â 00:16:50:00
Thomas Ahr
And so Iâm really proud that we were able to do that and to see it, when I round I go and look for that, is it visible? Is it viewable? Do the staff know where to find that? Have they had conversations with folks when they need to use it? Inevitably I do hear stories of it being used.
00:16:50:01 â 00:17:10:00
Thomas Ahr
So that shows that itâs less of someone from the HR team in a corporate office doing something, to it is a tool that is practiced and is has having an effect in there. So itâs very satisfying to see that occurring and knowing thatâs contributing to kind of de-escalating some of the issues that weâre facing.
00:17:10:02 â 00:17:24:23
Jordan Steiger
I mean, it sounds like your whole system and workforce has really embraced this idea of safety. And I mean, that sounds like itâs really coming from you and your team and your leadership and and going throughout the whole organization. So thatâs something I think to be extremely proud of.
00:17:25:01 â 00:17:44:07
Thomas Ahr
We have work to do. You know, violence is at epidemic levels in our society. And thatâs unfortunate. So we have to remain vigilant in it. I wouldnât say that weâve got it right. We still are continuing to work on many different aspects of it, but weâre proud to kind of turn the corner to say itâs less of a program and more of a way in which we work,
00:17:44:07 â 00:17:46:07
Thomas Ahr
and that everyoneâs involved in it.
00:17:46:09 â 00:17:57:23
Jordan Steiger
I love tha. Thatâs exactly what we should all be aiming for. Tom, thank you so much for being here with us today. It was a joy to learn a little bit more about your work, and Iâm sure our membership is going to feel the same.
00:17:58:01 â 00:18:00:13
Thomas Ahr
Thank you, Jordan. Good luck to everyone.
00:18:00:15 â 00:18:08:22
Tom Haederle
Thanks for listening to Advancing Health. Please subscribe and rate us five stars on Apple Podcasts, Spotify, or wherever you get your podcasts.