Latest / Becker’s Healthcare Podcast / Public Safety, Trust, and Violence Prevention in Healthcare Settings with Brian Uridge

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Public Safety, Trust, and Violence Prevention in Healthcare Settings with Brian Uridge · Becker’s Healthcare Podcast

• 0:01
  This is where health care leadership comes together.
• 0:04
  Becker's sixteenth annual meeting brings more than 3,500
• 0:07
  hospital and health system executives and nearly 800
• 0:10
  speakers to Chicago, April 13 through the sixteenth.
• 0:14
  This year's event includes keynote conversations with Dallas
• 0:17
  Cowboys legend Troy Aikman and former president George
• 0:20
  w Bush. For the agenda and event details,
• 0:22
  visit beckershospitalreview.com
• 0:25
  and click on the events tab in the
• 0:26
  upper right. We're looking forward to hosting you
• 0:29
  in Chicago.
• 0:32
  This is
• 0:33
  Scott Becker with the Beckers Health Care podcast.
• 0:36
  I I'm thrilled today to be joined to
• 0:38
  be a brilliant leader.
• 0:40
  We're joined today by Brian Urich.
• 0:42
  Brian's with Michigan Medicine,
• 0:45
  and he's gonna tell us a little bit
• 0:46
  what he does. He's got a a fascinating
• 0:48
  financing career there. He's the senior director,
• 0:51
  the Department of Public Safety and Security,
• 0:54
  which in health care has become more and
• 0:56
  more important on so many levels.
• 0:58
  Brian, can you take a moment to introduce
• 1:01
  yourself? And and I'm gonna ask you a
• 1:03
  lot today about how you ended up in
• 1:05
  the world in the area that you're in.
• 1:07
  I'll try not to ask you too much
• 1:08
  about Michigan football,
• 1:10
  but we will talk to you about your
• 1:12
  career and your life and and FBI and
• 1:14
  everything else. Brian, take a moment and introduce
• 1:17
  yourself.
• 1:18
  Well, Scott, first of all, thank you for
• 1:19
  having me. This is, an incredible opportunity.
• 1:22
  So happy to be here. As you said,
• 1:24
  my name is Brian Uriage, and I'm a
• 1:26
  senior director of public safety and security at,
• 1:29
  U of M Health System.
• 1:30
  And
• 1:31
  it's an incredible system. We see
• 1:34
  over 3,000,000
• 1:36
  patients per year just at our Anarbor location.
• 1:39
  That does not include our different locations throughout
• 1:41
  the state of Michigan. And we have about
• 1:43
  40,000
• 1:45
  employees overall.
• 1:47
  And on our team, we have a little
• 1:49
  over,
• 1:50
  300
• 1:51
  team members,
• 1:52
  and they are a combination of dedicated police
• 1:55
  officers,
• 1:57
  dedicated threat assessment investigators,
• 1:59
  security officers,
• 2:01
  k nine teams, and guest services.
• 2:03
  And all of that works together.
• 2:06
  And we like to say we have a
• 2:08
  a focus of trust,
• 2:09
  training, training, and technology to make sure that
• 2:12
  that our team members are safe.
• 2:14
  And talk a little bit about
• 2:16
  public safety in hospitals and health systems.
• 2:19
  If you went back twenty years ago,
• 2:21
  this seems like a very minor concern.
• 2:24
  You might have a security guy around,
• 2:28
  often was an older, nice gentleman,
• 2:30
  you know, and and I don't mean to
• 2:31
  stereotype,
• 2:33
  just sort of hanging around.
• 2:35
  And security at health systems has moved from
• 2:38
  that
• 2:39
  to being like a serious, serious, and very
• 2:42
  important,
• 2:44
  and and not scary, but there's lots of
• 2:47
  challenges in safety at health systems.
• 2:50
  You know, you hear often about an incident
• 2:52
  at a health system,
• 2:54
  a nurse shot, a patient
• 2:56
  knifed, so many different things. Tell me that
• 2:59
  evolution of what health system public safety has
• 3:01
  has become over the years.
• 3:03
  Well,
• 3:04
  great point.
• 3:05
  People don't and for the most part, the
• 3:07
  the rest of the world does not understand
• 3:09
  what's happening in health care.
• 3:11
  So we know that right now, Scott, seventy
• 3:14
  two percent
• 3:15
  of all violence in any workplace occurs in
• 3:18
  a health care setting. Seventy two percent.
• 3:20
  And we know that according to Press Ganey,
• 3:22
  two nurses are assaulted
• 3:24
  every single hour, twenty four hours a day.
• 3:27
  Yet,
• 3:28
  all of those statistics I just talked about
• 3:30
  are actually very much underreported
• 3:32
  because we know that only twenty six percent
• 3:34
  of nurses who are physically assaulted ever report
• 3:35
  the fact that they're assaulted. So the numbers
• 3:35
  are are
• 3:36
  assaulted ever report the fact that they're assaulted.
• 3:39
  So the numbers are are are very, very
• 3:42
  low compared to what is actually occurring.
• 3:45
  And I like to use the example in
• 3:47
  in 2019,
• 3:49
  there were one hundred and forty nine documented
• 3:52
  cases
• 3:53
  of people becoming angry and assaulted on airplanes.
• 3:56
  Fast forward to 2021,
• 3:58
  COVID starting to end. We had two thousand
• 4:01
  five hundred documented cases
• 4:04
  of people assaulting people on airlines.
• 4:07
  And all that's just an example of
• 4:10
  our society has changed, and all of those
• 4:13
  people
• 4:14
  need health care. And we know that according
• 4:16
  to the joint commission,
• 4:18
  that crowded waiting rooms and long waits for
• 4:21
  care
• 4:22
  are two of the driving factors
• 4:25
  in what's causing health care violence, and we
• 4:28
  know that every health system throughout the entire
• 4:31
  United States has crowded waiting rooms and long
• 4:34
  waits for care. So that's just a quick
• 4:36
  snapshot into what we're dealing with today, and
• 4:38
  that's what you see the change. And and
• 4:40
  take a second,
• 4:42
  Brian. This concept that on airplanes,
• 4:44
  we've got triple the amount of incidents from
• 4:46
  before.
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  In health systems,
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  probably 10 times the amount of incidents from
• 4:51
  twenty years ago.
• 4:53
  Is that a problem with society, or what
• 4:55
  drives that? And I know that's deeper than
• 4:57
  this discussion,
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  but but why is that? What what has
• 5:00
  gone wrong that we have so much of
• 5:02
  that going on? Well, that's a great question.
• 5:04
  And I I don't know, like, that I
• 5:06
  can speak to the actually, what's happening in
• 5:08
  our society. I can tell you between 2011
• 5:11
  and 2018,
• 5:13
  this is before COVID, we saw a sixty
• 5:16
  eight percent
• 5:17
  increase
• 5:18
  in violence in healthcare. And that's before the
• 5:21
  exacerbating factor of COVID. So, yes, things that
• 5:24
  are happening.
• 5:25
  We have to realize that
• 5:28
  every
• 5:29
  hospital system is a community,
• 5:31
  and every floor is a neighborhood.
• 5:33
  Everything that you see happen out in the
• 5:36
  community and where I don't care where where
• 5:37
  you live or it's it's the same in
• 5:40
  health care. The only difference is our communities
• 5:42
  go straight up in the air. They have
• 5:44
  10 or 15 floors.
• 5:46
  But the same principles that we use to
• 5:48
  help combat crime and violence in the community,
• 5:52
  those are the same principles that we have
• 5:54
  to apply in health care.
• 5:56
  Thank you. And talk a little bit about
• 5:58
  your career in public safety.
• 6:00
  I I know that you're at Michigan Medicine
• 6:02
  now. At some point, you spent time in
• 6:05
  Kalamazoo, one of the great cities in America,
• 6:07
  maybe
• 6:08
  underrated great city in America. But but talk
• 6:10
  a little bit about your career and how
• 6:12
  you ended up in public safety and a
• 6:13
  little bit of your background.
• 6:15
  Well, I got really lucky. So, my entire
• 6:18
  life, I wanted to be a police officer
• 6:21
  or a firefighter.
• 6:22
  So I went to college,
• 6:23
  and one day I found out there's this
• 6:25
  incredible place called Kalamazoo.
• 6:27
  That's the largest
• 6:29
  fully integrated police, fire, and medical EMS department
• 6:32
  in The United States.
• 6:34
  So I applied and I thought I will
• 6:36
  never get in. Sure enough, I was lucky
• 6:38
  enough to get in. I spent a twenty
• 6:41
  five year career
• 6:43
  at Kalamazoo, and I retired as their assistant
• 6:45
  chief.
• 6:46
  And I remember one day, and I had
• 6:48
  about ten years in, I was at a
• 6:49
  community meeting,
• 6:51
  and
• 6:52
  a lady was talking about the crack cocaine
• 6:54
  problem. And it was it was my moment.
• 6:56
  I realized, wait a second.
• 6:59
  I she knows that we are not gonna
• 7:01
  be able to stop crack cocaine. But what
• 7:03
  she wants to know is that, can she
• 7:06
  have a relationship
• 7:07
  and trust us to know that we're on
• 7:09
  the same team
• 7:10
  and that we're working together to try to
• 7:13
  solve problems.
• 7:15
  So when I retired from Kalamazoo and I
• 7:16
  got into health care, I realized, wait a
• 7:19
  second. This that those same principles of trust
• 7:22
  and training technology,
• 7:23
  all of those apply
• 7:25
  in health care.
• 7:27
  And talk for a second, Brian. What's the
• 7:29
  most interesting thing that you see currently in
• 7:32
  health care and public safety when when you
• 7:34
  look at the overlap of those two areas?
• 7:37
  Well,
• 7:38
  probably the biggest thing is first of all,
• 7:40
  you have to understand
• 7:41
  the the key principle is we've gotta make
• 7:44
  sure that our patients, staff, and visitors are
• 7:46
  safe.
• 7:48
  But just as importantly, we need to make
• 7:50
  sure that they feel safe. And if they
• 7:52
  don't feel safe, we've not accomplished our mission.
• 7:54
  And for those of the that that will
• 7:56
  listen to this, that are old enough to
• 7:58
  remember the movie Gladiator,
• 7:59
  there's a portion of Gladiator with Russell Crowe
• 8:03
  where the head gladiator is talking about, you
• 8:06
  know, I wasn't the best gladiator because I
• 8:08
  was the best swordsman.
• 8:09
  I was the best gladiator because the crowd
• 8:11
  loved me. If you wanna be the best,
• 8:13
  win the crowd. And I show that video
• 8:15
  to my staff, and I always talk about
• 8:17
  win the crowd. So the biggest issue facing
• 8:21
  facing health care security is understanding that
• 8:24
  we have to use nontraditional
• 8:26
  public safety outreach. We have to focus on
• 8:28
  relationships.
• 8:30
  We have to focus on building that trust
• 8:32
  so that we can make sure people feel
• 8:35
  safe because emotion
• 8:36
  will always trump data.
• 8:38
  People will see something on the news, and
• 8:40
  even though it's a rare event, that's the
• 8:42
  only reason it's on the news,
• 8:44
  they will equate that, well, that's gonna happen
• 8:46
  in my hospital. So we have to understand
• 8:48
  that focusing on that relationship based
• 8:51
  public safety outreach is the number one key
• 8:55
  to keeping people safe.
• 8:57
  Thank you. No. I I I love that
• 9:00
  perspective.
• 9:01
  And how does that work in process in
• 9:04
  trying to defend and keep safe a large
• 9:06
  health system?
• 9:07
  How does that work in process in in
• 9:09
  in in in in in in how many
• 9:11
  people work in public safety at a system
• 9:13
  like Michigan Medicine?
• 9:15
  Well, we know the vast majority of hospitals
• 9:17
  in the nation are critical access hospitals. They
• 9:20
  don't have those resources.
• 9:22
  So the most I always tell people the
• 9:24
  most effective
• 9:25
  tool that you have is what's between your
• 9:27
  ears.
• 9:29
  It's your it's your mind. And so having
• 9:31
  a trained and engaged staff that has training
• 9:35
  in situational awareness, understands personal safety,
• 9:38
  that is engaged
• 9:40
  and works with their security teams. That's the
• 9:43
  most important thing,
• 9:45
  that that we can do,
• 9:47
  to help keep peep people safe right now.
• 9:51
  Thank you. And and when you look at
• 9:53
  the future of public safety and health systems,
• 9:56
  what are things that people should be thinking
• 9:57
  about? What what are what changes do you
• 9:59
  see? What is there more and more use
• 10:01
  of technology?
• 10:03
  But the technology only goes so far on
• 10:05
  monitoring everything. You still need people on the
• 10:06
  ground to see things and develop relationships. Right?
• 10:08
  What's what's this mix of where technology fits
• 10:10
  into public safety?
• 10:12
  What you absolutely do, and you you know,
• 10:13
  I didn't really do a good job of
• 10:15
  answering that first question when you talked about
• 10:17
  process. So let's
• 10:19
  you're absolutely right. Technology is key. Right now,
• 10:21
  we have cameras with analytics. They can they
• 10:23
  can capture exposed firearms. They can capture people
• 10:26
  who are loitering. They can capture physical fights.
• 10:29
  But nothing will ever be able to replace
• 10:32
  that human touch. So So what do we
• 10:33
  do about about process? So let's talk about
• 10:36
  that. We
• 10:37
  we know that what we do is we
• 10:39
  ask our staff every day, do two simple
• 10:42
  things. Number one, go meet a staff member
• 10:44
  that you've never met and engage them in
• 10:46
  a two minute conversation about nothing. Talk about
• 10:49
  where they're from. Talk about what the weather's
• 10:51
  like there. Talk about their background.
• 10:53
  And then two, go meet a patient or
• 10:54
  a visitor that you've never met and simply
• 10:57
  engage them in a conversation
• 10:59
  about where they're from. Reduce their anxiety.
• 11:02
  If you've ever read the book, If Disney
• 11:04
  Ran Your Hospital Nine and a Half, Think
• 11:06
  You Do Differently,
• 11:07
  incredible book. And it talks about the number
• 11:09
  one patient need is assurance.
• 11:12
  We've gotta get our staff out and understand
• 11:14
  that we've gotta reduce
• 11:16
  that level of anxiety. So let's focus on
• 11:19
  one of the biggest things in health care
• 11:21
  now is behavioral
• 11:23
  threat assessment and management.
• 11:25
  We all know about the tragedy that happened
• 11:27
  to the UnitedHealthcare
• 11:28
  CEO.
• 11:29
  Well, that person who committed that atrocity,
• 11:32
  that person was on what was on what's
• 11:34
  called a pathway to intended violence.
• 11:38
  So now what I always recommend is you
• 11:40
  need to have a multidisciplinary
• 11:43
  behavioral threat assessment team who focuses on people
• 11:47
  who could be on a pathway to intended
• 11:51
  violence. People who are giving pre incident indicators
• 11:54
  or they're exhibiting behaviors of concern
• 11:57
  Because we know, and this is a horrible
• 11:58
  statistic, that fifty four percent of all active
• 12:01
  shooters start with what? They start with domestic
• 12:05
  violence. And we know when we look at
• 12:07
  the other parts, it's an adverse employment action.
• 12:09
  And we know that the vast majority of
• 12:11
  times, they will exhibit
• 12:13
  pre incident indicators. And I'll never forget, I
• 12:16
  was talking about this in front of about
• 12:18
  40 nurses. I was explaining
• 12:21
  behaviors of concern. And Scott, there was a
• 12:24
  nurse in the back and she was crying.
• 12:26
  And her manager was rubbing her back, and
• 12:28
  I I walked up at the end of
• 12:30
  the presentation. And I said, you know, was
• 12:32
  the presentation that bad? And her manager said
• 12:35
  no.
• 12:36
  The problem is that her husband, her soon
• 12:39
  to be ex husband, is exhibiting
• 12:42
  everything you're talking about, every one of those
• 12:44
  pre incident indicators, and she's scared to death.
• 12:47
  Now let's think about that for a minute.
• 12:49
  That's a horrible tragedy.
• 12:50
  And is that nurse able to deliver good
• 12:53
  patient care? Absolutely not. She is not. So
• 12:57
  our job is to identify those behaviors of
• 13:00
  concern, but that would not start unless we
• 13:03
  build relationships with our staff so they can
• 13:05
  trust us. And it starts with that non
• 13:08
  traditional public safety,
• 13:10
  which goes to that process you talked about,
• 13:12
  which then goes to those pre incident indicators,
• 13:14
  which lets us disrupt that pathway to intended
• 13:18
  violence. It's all interrelated.
• 13:21
  Thank you so much. And and talk about
• 13:23
  this. Like, from your perspective,
• 13:25
  having that intelligence,
• 13:27
  whether it's on a
• 13:29
  patient who's got trouble or an employee who's
• 13:32
  got trouble or anybody who comes in the
• 13:34
  hospital that has trouble, how challenging is it
• 13:37
  to access some of that information
• 13:39
  that must be so out there in an
• 13:41
  AI world,
• 13:43
  but there must be privacy issues in how
• 13:45
  you access it? Because, like, you talked about
• 13:47
  the shooter of the United CEO,
• 13:50
  and people knew he was on the pathway
• 13:52
  to violence. He as much said he was
• 13:53
  on a pathway to violence, but trying to
• 13:55
  connect dots is so hard.
• 13:57
  Do we get to
• 13:59
  spot
• 14:00
  where it's easier to utilize different types of
• 14:02
  data to get a better sense of where
• 14:03
  we could have problems?
• 14:05
  Well, very good points because, obviously, we run
• 14:08
  it we run into all sorts of barriers
• 14:10
  because there's obviously law enforcement sensitive data that
• 14:14
  may not be easily easily accessible
• 14:18
  by people who were not actually in law
• 14:20
  enforcement.
• 14:21
  That's a key component right there, and that's
• 14:23
  why I always recommend to the critical access
• 14:26
  hospitals,
• 14:27
  build that relationship
• 14:29
  with your local police department,
• 14:32
  have them in when times are good,
• 14:34
  have them sit down for coffee so that
• 14:36
  in the event there's a critical incident, I
• 14:39
  can call police officer Scott up and say,
• 14:41
  Scott, I have a problem. I I have
• 14:44
  a person who's exhibiting behaviors of concern.
• 14:46
  Can you come over and help me? And
• 14:49
  that is
• 14:50
  key. And then the second key is understanding,
• 14:53
  and this is really, taking making headway now
• 14:55
  in The United States. It's a trauma
• 14:58
  informed
• 14:59
  care approach. Meaning,
• 15:01
  I need to understand what is Scott's background?
• 15:05
  What trauma has he been exposed to? Because
• 15:08
  the last thing I wanna do is retraumatize
• 15:10
  Scott. So if I can respectfully
• 15:13
  understand what is your background? What is it
• 15:15
  what have you experienced, and how can I
• 15:18
  relate to that, and how can I adjust
• 15:20
  my care
• 15:21
  to more respectfully
• 15:23
  support you and your family
• 15:26
  and understand
• 15:27
  what differences we may have?
• 15:29
  That way, I can make sure I don't
• 15:31
  retraumatize
• 15:32
  you and perhaps
• 15:34
  not cause you to escalate into some type
• 15:36
  of violence.
• 15:38
  Thank you. When you look at this year
• 15:41
  coming up,
• 15:42
  what's the biggest priority this year in 2026?
• 15:46
  Our big our biggest focus at Michigan Medicine
• 15:49
  is is really threefold. Number one, building our
• 15:52
  behavioral threat assessment and management teams
• 15:56
  at all of our hospitals
• 15:58
  using that multidisciplinary
• 15:59
  approach
• 16:00
  to help
• 16:02
  support people who may be on a pathway
• 16:04
  to an intended violence. That's number one. Number
• 16:07
  two
• 16:08
  is developing training
• 16:10
  in collaboration
• 16:11
  with our nurse educators
• 16:13
  that reduces both risk and anxiety of our
• 16:16
  staff. And I always tell people, you can
• 16:18
  build it in house.
• 16:20
  All you need is two things. You need
• 16:22
  people who care
• 16:23
  and people who are creative. And I guarantee
• 16:25
  you, I don't care what hospital you go
• 16:27
  to in The US, there's somebody out there
• 16:30
  that is very caring and very creative. Otherwise,
• 16:33
  they would not be in healthcare.
• 16:35
  And then finally,
• 16:36
  using technology that actually reduces risk. And that
• 16:41
  people talk about weapons detection or metal detectors.
• 16:44
  Yep. They they do have benefit, but there's
• 16:47
  other technology like we talked about before.
• 16:49
  Cameras with analytics
• 16:51
  that can focus on identifying
• 16:53
  that threat level, making sure that we have
• 16:55
  access control
• 16:57
  so that there's an on stage and an
• 16:59
  off stage presence, meaning your waiting room where
• 17:03
  it's on stage, but there's access control
• 17:05
  to get back to your clinical areas because
• 17:08
  that's your offstage area. So those are really
• 17:10
  our three areas that we're focused on.
• 17:15
  Fantastic. And and just one more question for
• 17:17
  you, Brian. You've had this great leadership career.
• 17:20
  We'll ask you first, I'll ask you the
• 17:21
  the tough question. The tough question is this.
• 17:24
  Have you become a University of Michigan fan?
• 17:27
  Were you always a University of Michigan fan,
• 17:29
  or do you
• 17:31
  avoid that like like the plague?
• 17:33
  Well, I will tell you this. So my
• 17:35
  wife's from Michigan State University, graduated from there,
• 17:38
  so I can't even talk about it. I
• 17:39
  can just tell you this.
• 17:41
  I was never, nor would I ever be
• 17:43
  smart enough to get into the University of
• 17:45
  Michigan. In fact, my claim to fame is
• 17:48
  every meeting that I go to at the
• 17:50
  University of Michigan Health System,
• 17:52
  they are some of the smartest people
• 17:55
  I have ever met in my life. And
• 17:57
  I can honestly say that I am always
• 17:59
  the dumbest guy in the room, and I'm
• 18:01
  just honored to be there.
• 18:03
  Well, you're you're you're a good man and
• 18:05
  no no better put than saying it somewhat
• 18:08
  like that, especially with the wife who's a
• 18:10
  Spartan and you're a Western Michigan guy.
• 18:13
  We get it. Well stated.
• 18:15
  Last question. You've had this great leadership career
• 18:18
  regardless of that tremendous humility even though you're
• 18:21
  really bright and just fantastic.
• 18:23
  Talk for a second about any advice you
• 18:25
  would give to emerging leaders generally on the
• 18:27
  public safety field.
• 18:29
  Yes. Absolutely. And I'm gonna give you a
• 18:31
  quick story.
• 18:32
  My first
• 18:33
  day as a sergeant in Kalamazoo Public Safety,
• 18:37
  my first time ever being alone,
• 18:39
  my first call
• 18:41
  was a garage that was on fire attached
• 18:43
  to a house.
• 18:44
  I was the first one there, Scott. I
• 18:46
  was scared to death. There were flames everywhere.
• 18:49
  It was starting to burn the house and
• 18:51
  the garage was fully involved
• 18:53
  and the fire truck pulled up and I
• 18:55
  was in charge of the person on the
• 18:57
  fire truck, but he knew more. He'd been
• 18:59
  there longer. He was more experienced.
• 19:01
  And I looked at him, and his name
• 19:02
  was Dave Toth. I said, Dave.
• 19:04
  I said, we need to connect to the
• 19:07
  fire hydrant to get more water. He said,
• 19:09
  Brian,
• 19:10
  that is the wrong decision. We need to
• 19:13
  put on our gear. We need to climb
• 19:14
  in the living room to stop the fire
• 19:16
  from getting into the into the house. So
• 19:18
  I said, you know what? That's a lot
• 19:20
  better idea. So we did it, and we
• 19:22
  saved the house.
• 19:23
  And I walked away. I was mortified.
• 19:26
  I was like, my first day, my first
• 19:28
  decision, my first call, and it was wrong.
• 19:31
  But, Scott, what I learned from that
• 19:33
  is three things. Number one,
• 19:36
  create a culture
• 19:37
  where your staff feel free to disagree.
• 19:41
  Number two, always ask for help.
• 19:44
  Always ask for advice. And number three, always
• 19:47
  remember
• 19:48
  the next person on scene of any situation,
• 19:52
  any critical incident
• 19:53
  always has a better idea because they don't
• 19:56
  have tunnel vision. And that's my leadership advice.
• 20:00
  That is literally
• 20:01
  brilliant.
• 20:02
  Brian, I love that. Again, we're fortunate today
• 20:06
  to to get to visit with Brian Urich,
• 20:08
  department of public safety at the University of
• 20:11
  Michigan.
• 20:12
  Brian,
• 20:14
  remind me of the exact title for our
• 20:15
  audience, if you don't mind.
• 20:18
  I'm the senior director for public safety and
• 20:20
  security
• 20:21
  for University of Michigan
• 20:23
  health system.
• 20:25
  Fantastic. It is really a pleasure to visit
• 20:27
  with you.
• 20:28
  You've also got several educational degrees and certificates.
• 20:32
  You're a lifelong learner,
• 20:34
  constant improvement person. Brian, fantastic to visit with
• 20:37
  you today on the Becker's Healthcare podcast. Thank
• 20:40
  you so much for joining us. Thank you.