Latest / Becker’s Healthcare - Clinical Leadership Podcast / Dr. Jason P. Stopyra, Regional Medical Director - Safety and Security at Atrium Health Wake Forest Baptist

Transcript

Dr. Jason P. Stopyra, Regional Medical Director - Safety and Security at Atrium Health Wake Forest Baptist · Becker’s Healthcare - Clinical Leadership Podcast

• 0:00
  This is Laura Dedo with Becker's Healthcare Podcast.
• 0:03
  I'm thrilled today to be joined by Dr. Jason Stra,
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  regional Medical Director of Safety and Security at Atrium Health,
• 0:09
  wake Forest Baptist. Dr. Stra, it's a pleasure to have you on the podcast today.
• 0:14
  Oh, the honor's mine.
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  Now, I know we have a lot to talk about.
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  There's so much happening in healthcare right now, and it seems like things are,
• 0:21
  are moving rapidly there. There's something new to think about every single day.
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  But before we type into my questions,
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  can you tell me a little bit more about yourself and your background?
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  Oh, sure. Uh, happy to. I'm, uh,
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  board certified in emergency medicine as well as emergency medical Services.
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  Uh, after residency,
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  I spent the first a decade of my practice in a small but busy rural
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  hospital in mount area, North Carolina. Um,
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  it's the town that Hollywood knows as Andy Griffiths Mayberry. Um,
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  from there I transitioned to become part of the academic faculty at
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  Wake Forest School of Medicine at Atrium Health Lake Forest Baptist.
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  And that was in 2013. Um, I started out and I really,
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  really enjoyed, uh, teaching,
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  being able to provide e m s medical direction and,
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  and do some clinical research that, that really focused on
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  identifying and eliminating rural disparities, uh, in healthcare, uh,
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  using some, some mixed methods in implementation science. All of this,
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  uh, changed though, uh,
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  last July when one of my colleagues was, uh,
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  physically assaulted in the ED by one of her patients.
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  Uh, it was a, it was a pretty, uh, severe assault, um, and it,
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  it really impacted her as well as the rest of our faculty.
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  And in response, our,
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  our group met with our health systems leadership to discuss this incident
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  as well as the violence that, that we have faced for years and years.
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  Uh, from there, leadership stepped up in a really big way and they appointed me,
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  uh, to my current role as the medical director for safety and security.
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  So I spent the past 10 months learning and engaging in this
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  multifaceted international problem. And it's, it's been,
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  uh, a real, uh, experience.
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  It's been eyeopening and, um, unfortunately, uh,
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  my colleague, uh, is still out and,
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  and I don't anticipate her ever being able to come back to the ED and take care
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  of patients. So I am certainly driven to,
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  to try to prevent these kind of incidents in the future.
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  That's so fascinating to hear,
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  and really thank you so much for sharing that story because I think it really,
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  really resonates on how your career trajectory can make a, a sharp turn,
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  um, unexpectedly, and certainly you stepping up to the plate and,
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  and filling that need of being able to really focus on making sure that there is
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  safety for your colleagues, for physicians,
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  for nurses and other clinical workers at the hospital, and really, you know,
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  focusing energy there is so important and critical.
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  I know it seems like the incidences of workplace violence for healthcare leaders
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  have been ticking up over the last few years for several reasons,
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  and certainly it's something that's very important.
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  So I'm just so thankful that you were able to have that opportunity,
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  and it seems like the health system is very supportive of you engaging in,
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  in some efforts to make the organization safer overall.
• 3:32
  Yeah. Thanks, Laura. I, I appreciate those kind words and,
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  and you're certainly right. Um,
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  we have experienced an exponential growth in, uh,
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  the number of incidents of violence within healthcare, uh, since, um,
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  the beginning of covid.
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  Absolutely.
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  So I'm sure some of that colors your response to my first question here and
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  looking at what are some of the opportunities that you're seeing in healthcare
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  right now, as well as the headwinds that you have your eye on. You know,
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  what has been working well for you and what do you anticipate coming in the
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  future?
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  That's a great question and, and I, I guess I'll answer that with, um,
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  we have an opportunity for real culture change. Uh, when,
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  when our, our top leadership met with us, they,
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  they made some pretty valuable statements. Our, our CEO, Dr.
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  Freal, said that we must lower our tolerance for abuse.
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  And our regional cmo, Dr. Andrea Fernandez, said,
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  we can no longer take a whack-a-mole approach to
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  violent acts. We need to, uh, take a,
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  take a holistic, uh, evidence-based, uh,
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  scientific approach to improving our safety. And,
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  you know, because we have taken that approach,
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  the headwinds at Atrium Health, wake Forest Baptist have really changed.
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  And we have, we have shifted, uh, the, uh, impression,
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  the thought process, uh, and the approach, uh, that,
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  that our teammates have that now the,
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  the safety of healthcare workers is equally important
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  to the safety of patients. And, and that's, that sounds,
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  um, like it should always have been that way, but it really hasn't.
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  As healthcare providers, we, we have always yielded to the patient,
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  and we've, we've come to realize that, that we can't,
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  can no longer survive with that mindset, and we need to,
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  to truly realize the zero tolerance policy
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  that we have. And, and we're finally focused on that, making that a reality.
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  So we, we have zero tolerance for, uh,
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  aggression assaults, both verbal and physical and, and,
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  and try to prevent every preventable one. But if,
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  if an incident is unpreventable,
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  we need to make sure that we engage with, uh,
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  the teammates and engage with the patient and protect them, uh,
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  from another assault, protect the patient, and also help the,
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  the healthcare worker, our teammate to,
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  to recover from any kind of verbal or physical assault.
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  That really makes a lot of sense.
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  And I appreciate you taking us behind the scenes within how your organization is
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  growing and developing, um, these policies. From your perspective,
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  what have you done differently since this incident occurred? Um,
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  that that really is making a difference,
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  what it has worked well and what happens when there is, um,
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  an incident that, or,
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  or is the potential for an incident or somebody identifies some of the risk
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  factors that could lead to a, a violent incident? Um, how do you,
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  what, what comes next? What's the protocol.
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  Again? A a great question, Laura.
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  The challenge with workplace violence is how many sites this
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  problem has. In the early stages of, of my new role, we,
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  we work to, uh, identify, uh, different initiatives,
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  different problems with solutions that needed to be addressed. And,
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  uh, our initial list had over 80 different, uh,
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  things that we needed to, to learn about and, and come up with, with solutions.
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  So it's, it's exciting that there's, there's that many opportunities,
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  but also the importance of triaging, right?
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  The importance of putting priority on some and not others. And,
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  and fortunately we've been able to come up with, uh,
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  several solutions that are low or no cost,
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  and our teammates are really, uh, engaged.
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  They are yearning for the ability to feel safer and to,
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  to keep not only their patients safe, but also, uh, one another safe.
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  So the list is, is very, very long. Um, but we've had,
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  we've had great success because of,
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  of the teamwork that we have at Atrium Health Wake Forest Baptist.
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  That's great to hear. Now,
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  I'm wondering for organizations out there that are looking to strengthen their,
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  uh, workplace violence policies, looking to become a more safe place to work,
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  what is an investment that's worth making?
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  Especially right now when I know a lot of hospitals and health systems are
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  facing financial hardships. What is really important for them to step up and do,
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  um, to add the most value, po value possible to the health system.
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  That, uh, unfortunately doesn't have a cookie cutter answer? Uh, the,
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  the points where violence can enter into your healthcare system,
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  uh, varies from place to place. And in,
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  in my travels to multiple different healthcare systems, uh,
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  that's what we learned. The, the,
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  the way to generally answer that question that I,
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  I think is effective is to simply invest in,
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  in safety and to engage with this problem,
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  to acknowledge that it exists, to acknowledge that,
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  that it's become, uh, exponentially worse and,
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  and the, the return on investment for engaging in safety and leadership,
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  acknowledging that it occurs at the patient's bedside is,
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  is really beneficial for the overall feeling
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  that, um, all our teammates have and, and knowing that if,
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  if something were to happen, uh, even, even the threat of something happening,
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  that that leadership knows about it and leadership cares and their safety
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  matters to our, our leaders. That, and, and they, I mean, the patients,
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  uh, treating providers, the,
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  the patients' nurses right there at the bedside. So I would,
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  I would invest in, um,
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  taking the time and engaging in this problem and
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  assessing what the actual needs are for your healthcare
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  system.
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  That's such a great point and so valuable to understand on the ground level
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  where, uh,
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  the biggest risks are in where there might need to be extra support and
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  investment, um, you know, of either resources, time, energy,
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  or financial investments. Um, that makes a lot of sense. Now,
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  I'm wondering too, before we wrap up our conversation,
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  where do you see some of the best opportunities for growth in the future? Uh,
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  what, what are you optimistic about or,
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  or where do you see healthcare and especially safety headed?
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  Yeah, that's a, that's another great question. Uh, Laura, I, I,
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  I really think the future is bright. Um, it's,
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  it's it's time for us to, to really integrate a lot of the,
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  um, technology that we have, uh, inside of, of,
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  of our hospitals already and double down on, on some things, um,
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  like natural language processing and machine learning, uh,
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  to be able to improve the accuracy of reporting of
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  incidents.
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  We found that the number of incidents that are reported
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  in the reporting software that we have, the incident, uh,
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  software that we have is, is much less than, than what happens in reality.
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  And through natural language processing and machine learning,
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  we've been able to,
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  to look through the electronic medical record and identify additional
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  incidents of both verbal and physical assault that didn't make it into the
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  incident reporting software, but did make it into, uh, the, the medical record.
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  We've also seen that, um,
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  looking at some, some real time location system,
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  uh, hardware and software allows us to,
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  um, take technology and assist our,
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  the rest of our team to come to the aid of one of our teammates that, that,
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  that may need help. So, um, this,
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  this technology, this tool is, is able to, um,
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  have a simple button push that can be used to access help either before
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  or, uh, during an incident and a,
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  in an easy wearable type technology. Uh, and,
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  and we've seen at our facilities that, that,
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  that really just having that tool on their badge
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  allows them to feel, uh, so much safer. So if a,
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  if an incident were to occur, um, they,
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  they feel like they're connected directly to, uh, security and,
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  and that message does go to our security dispatch and they're able to, uh,
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  dispatch officers, uh, immediately to,
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  to know exactly where that teammate is without any information other than a
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  button push coming from, from our teammate. That being said,
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  we've also looked towards some, some simple technology.
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  Uh, in addition to having, uh, the advanced, uh,
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  badges that have the real time location systems, we also have, uh,
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  personal alarm screamers that, uh, you may have seen, um, that,
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  that when, when activated create a, a very high frequency, loud,
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  uh, alarm. And, and that also helps the, uh,
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  teammates around the incident to know that that help is needed and to be able to
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  locate where that incident is happening.
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  So these are just a couple of examples of, of what we've, uh,
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  looked to inside of information technology. Uh, we've also, uh,
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  looked at, uh, sitter logs and,
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  and how those sitter logs may be able to predict, uh, incidents,
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  uh,
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  use of screening tools that can be built into the electronic health record and,
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  and different, uh,
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  QR code driven surveys to be able to again,
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  improve the reporting that we see in our,
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  our facilities, just to make it easier for our, for our healthcare workers,
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  our teammates, to be able to report when,
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  when there are incidents of either verbal or physical, um,
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  assault.
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  That's great to hear. It seems like that would really make a big difference, um,
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  for the workers in,
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  in your teammates who are on the ground level every single day.
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  And I know during the pandemic there was a lot of different things happening
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  that potentially could have, um, increased some of these incidences,
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  some of the distrust in healthcare as well. Other, uh, challenges,
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  are there any trends that you're seeing overall that, um, are, are,
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  are bringing some of those, uh, that trust back into healthcare?
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  Is it still really, um, very much, you know,
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  a factor in how people are coming into the ED and in coming into the hospital in
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  general?
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  It certainly still is a factor, but, but what we've,
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  what we've seen is the importance of, of being consistent in,
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  in our approach, having clear, uh, boundaries that, that, uh,
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  cannot be crossed. There's, there's zero tolerance for
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  inappropriate aggressive behavior and to, to just kindly
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  and matter of fact, um, state that, that that is behavior that,
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  that we won't tolerate inside of our facilities, um, and engaging, uh,
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  when, when there's problems, um, the, the human tendency, uh,
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  for for many when, when there's, uh,
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  incidents of aggression is to walk away,
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  step out and not address the underlying, underlying problem.
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  And, and what we're finding that in,
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  in the world that we live in, uh, the, the,
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  a lot of aggression comes from miscommunication and a feeling that
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  the, the, the person isn't cared for. That, that, that the,
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  the, the issues that somebody's having, the,
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  that lack of comfort that somebody's having, uh, doesn't matter to other people.
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  So we found that by being honest, by engaging, being kind, being consistent,
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  um, and trying to assess, uh, why a patient is becoming, uh,
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  verbally or physically aggressive, we've been able to deescalate, uh,
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  a large number of,
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  of incidents that that previously developed into assault. But,
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  but here, um, with, with some very simple, uh, initiatives,
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  we've been able to prevent a large number of, of these assaults that.
• 16:59
  Absolutely. I really appreciate that.
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  And that's good to hear that you've been able to, uh,
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  prevent some of those along the way. Dr. Stra,
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  thank you so much for joining us on the podcast today.
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  This has been such an interesting and fascinating conversation,
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  so informative and I know helpful for all those listening today.
• 17:15
  I really appreciate your time and look forward to connecting with you again
• 17:18
  soon.
• 17:19
  Thanks, Laura.