While other healthcare organizations have seen staffing issues, HonorHealth has been able to focus on improving safety. Todd Larson has a background in law enforcement and the military and has been setting up communication and workplace safety for healthcare organizations.
Workplace safety is a top concern in the industry, with one of the highest instances of workforce violence. Learn about:
Todd Larson, Ed.D., MSL, FABC, Consultant | Workplace & Public Safety, HonorHealth
Janae Sharp, Founder, The Sharp Index
Janae Sharp: so I'm really looking forward to talking to you for Health Impact Live. We sit down with leaders to talk about current events, like what's going on in healthcare, what technology can do better. I'm Janae Sharp. We've met Do you wanna introduce yourself to the audience, cuz this'll be virtual?
Todd Larson: Sure, yeah. Todd Larson and I am currently, in a couple of roles, which my primary role is consulting and education across the country. And I also still work for Honor Health as a consultant in workplace and public safety and Honor Health is a medium sized healthcare organization in the Phoenix, Arizona area.
Janae Sharp: Awesome.
Yeah, I know that Honor Health people and you came highly recommended. No pressure . No pressure, no pressure. So, when people think about workplace safety, I think about like that healthcare has some of the highest workplace violence and is having massive staffing issues. Like we're seeing tons of nurse walkouts, we're seeing all this stuff, but I don't think I, I think our audience actually knows more about workplace safety than I probably do.
But I'd love to hear kind of what is top of mind for people right now. Like what is it that you're dealing with all the time?
Todd Larson: I think healthcare organizations I put it in sort of a bucket of three when we talk about workplace violence. First off, you have the patient. Mm-hmm. . Second, you have the, the family or the visitor or anyone else who may be there.
And third, you also have the staff member. So, , you're mixing all three, right? You, you have patient, you have caregiver, you have family members, somebody else who might be in the room, a visitor. So I use this term, it's actually very dynamic. If things were down to the simplest of caregiver and patient okay, that can have some complexities.
But when you start having all of these other dynamics uh, it gets very complex. So that's compounded with staffing. As you brought up the pandemic, PPE gear being on, can you even have a communication problem? So I think it's a multiplex problem, but I have spent the last several years focused on addressing this from the staff perspective.
Okay. We at Honor Health did a study and we found how a very high percentage, and I'm not gonna get into detailed math on this, on this podcast,
Janae Sharp: This isn't a math contest, but later,
Todd Larson: So let's just use like, you know, very high percentage very, very great majority, you know, three quarters plus were assaults or workplace violence incidents on staff that were predicated by a verbal.
Threat or a verbal announcement. Oh wow. Such as, you know, don't touch me, don't stick me with that. I'm, if you do this, I'm gonna kick you. I mean, patients giving a verbal warning. So I think really, and, and I'm gonna hit to the core of it like quickly, I think really is that caregivers are care. , whether you're a nurse, whether you're a physician I'll stick with sort of in a tech, let's say you have a tech of nurse, a physician, nurses being the, the bulk of the hands-on patient care.
You're a caregiver first. So commonly it's, you know, maybe you don't hear that comment. You're thinking about giving your dose of medication. You're thinking about giving a shot, you're thinking about doing a bed roll of the patient, you know, and so your primary condition is to. So it's care for the patient.
So I think that that compounds the Workplace Violence problem is that nurses and clinicians and staff are constantly thinking about care of the patient and don't always think about care of themselves. . And so what I think gets to the heart of it is we have to conduct training. You know, everybody out there wants to sell solutions for millions of dollars and this wearable or this device or that, and the things we did on our health get get down to just really working with staff training, staff recognition, hearing a comment, backing away, standing in the doorway, asking for someone else to come in the room and help you. You know, scoring systems, charting, all kinds of ways that you can preempt an event from happening.
That's the real way with workplace violence, right? Let's, let's create, prevent it from happen. or if it was to ever happen, it's a total surprise and it was nearly impossible to mitigate, so. Hmm. That, you know, I think that's at the core caregivers being caregivers and maybe retraining the mind to pick up on those verbal and or body cues.
Sometimes a, a straight up threat, don't touch me or I'm gonna hit you. Well then don't touch the patient at that time. So those types of things, that's what I, I, that's where I think we got to go with, with workplace violence and, and in many ways it doesn't involve spending millions of dollars. It's really, really something that any healthcare organization can get focused on today.
Janae Sharp: Right. That's an interesting point too. So in a prior life before I went to healthcare, a briefly was a teacher. And they tell you that the most powerful tool you have is always proximity. Like for a student who's struggling or for something and you don't really realize how important that is until you're like in a classroom full of second graders who are like doing tumbling
And they need, they need that grounding force. And also, I like what you said about listening to patients. It's not, it's hard though, because when you have that people, people come and ask and you're like, well, how is that scalable? Like if you're doing one-on-one training, is that scalable and it, how is that scalable when you're having turnover?
Like do you have to retrain staff that are coming for travel nursing? Like did Honor have to go through that or is that a different discussion?
Todd Larson: No, i, it is clearly part of the discussion, you know? Right. Whether it be traveling staff, whether it be turnover, those are always gonna come up. Right. I think the key that we, we think about with what we talked about, to start this off with training and knowledge and education is culture.
Culture trumps everything else. Culture. The foundation. So if, if that is your culture of safety and that is your culture of supporting your staff and you support your nurse or a clinician when they, you know, have a concern and they know their voice is heard and you provide the resources and training.
So I, I go back to the culture portion of it, that if that's your culture, that anybody who comes in sees that, that's your culture. and knows that it's part of your fabric. And I think it carries on, you know, the, the study and the, and the, and the training we did started back way back in 2018. Mm-hmm.
and we're still seeing decreases in workplace violence as opposed to the rest of the country that is seeing double digit increases. And that's not to say that technology doesn't help. I, I, you, you know, there are technology things that we can build out and do, but those to me are enhance. On the people. I think all too often people look to technology to be a solution versus technology should be looked at to be an enhancement or something that helps, helps to enhance things you're already doing, make things more efficient, create things.
We can't just, you know, every time you buy a solution doesn't necessarily get you there. So I'm a fan of technology, but technology built upon that layer of culture and.
Janae Sharp: Right. I like that. Also, congratulations on decreasing rates. That's a, that's a big deal.
Todd Larson: It's a, it's a huge deal. Yeah.
I'd love to hear more about your background.
How did you come to healthcare? Because you have an interesting story, like how you got there and why did you feel like it was a good place for
you? Yeah, you know, let me start with this. What I did not realize is that I've always been a healthcare. . So my story, I coming outta the military, I joined the Scottsdale Arizona Police Department where I worked for over 22 years.
Looking back on that career, once I was in healthcare, I realized the majority of my job was healthcare. Whether that's responding to accidents trauma, vehicle accidents, but then you think about it, behavioral. You know, drug abuse, alcohol abuse, domestic violence situations, personal injury counseling.
Wow. If you really think about it, what a, what much of what a police officer does is actual clinician type work. You're, you're helping people, whether it be with a disease, whether it be with drug addiction, whether it be with actual violence and. . So I came into healthcare because my last role at the police department involved being the director over the family advocacy center.
And that is a multidisciplinary building. Mm-hmm. , where you have law enforcement, you have counseling, you have medical, the forensic nurses and you have investigations as well as some other state agencies all within the same building. And so I, I developed a relationship. , the nurses that were caring for our patients coming into the family advocacy center, these are our domestic violence victims.
These are sexual assault victims. And so these nurses would care for these patients. And I developed a relationship with them and their, their leader. And one day he said, I'm gonna be leaving. I have to move to Washington, dc My wife's getting a promotion. You should put in for my jobyou'd be competitve.
So that started my journey into healthcare. I retired from law enforcement. I went into healthcare and had a wonderful time at Honor Health running the military partnership where we trained the military personnel mm-hmm. in trauma medicine from around the globe. As well as, you know, the other jobs that I had, their service lines involving.
Emergency management access control. And then, you know, one of the last projects I, I worked on and spent time working on was, was the creation and build out of the network operations center.
Janae Sharp: I wanna hear more about the network operations center. Like I know we, we, we have this foundation that humans matter most like, and it's, it's the human factors that matter and that technology.
I'm also a big fan of technology by the way. technology should enhance it. Technology should be an asset. How do you build out a command center? What is that ? Yeah. I mean, people probably know, but
Todd Larson: Yeah. Well, yeah. You know, it's interesting because I think there's dispatch centers, there's command centers and what we're really trying to do is enhance all of that into almost a complete fusion center or coordinated care center so that everything's all together. But how we initially did it is we focused on operations, things that are operation related. So for instance the first group to actually move into the network operations center, we had an, we had a building on one of our campuses.
Number one, I think it was crucially important to put it on a campus. , it should be on a medical campus, not a standalone building off, you know, not the old shiny building on the hill, right? It should be on a campus part of the fabric of the system. Number two, we focused on integrating services that can be part of the command and control feature together.
So the actual first team to move in was on the nursing operations and the clinical operations side. The transfer center and bed control and float pool and labor as well as transports, patient transports. So we moved sort of all that inside operations, whether it be staff patients, procedures, all of that moved in and they're in one portion of the command center, the other portion of the command center that they're about to move into.
By the way, tough to build a command center during a pandemic with supply chain shortages. I'm just, just gonna say that. So was it your favorite ? No. So the the other side of the command center is, is what I would call sometimes a traditional command center. You're going to have security and cameras.
And all, when I say technology, all the technology, right? So I'll, I'll give you an example. W we had a clinician who had an item stolen out of a locker and he came in to do a surgery and.
When we did the investigation, we found that the reason it had happened is that the back door had been propped open. So I'll give you an example of a command center. Had the command center been up and running the back door, propped open, after 20 seconds or 30 seconds, whatever, you set the timer, the alarm would go off, the camera would alert to the knock, the picture would come up on the screen and we could say, Hey, security, go check this door.
Why is it propped open? And within one, that that situation would've been remedied. Right? Right. And no one would've been able to walk in the back and said, so that's the traditional command center. You have cameras, you have security, you have alarms, whether it be temperature monitoring or refrigeration or, or med and gas, all those traditional things and dispatching security.
But where we're trying to go is the next level. So, so let me put this out there. When you think about healthcare, there's a couple of models out. There's the model of you're completely free and open, and then there's all the way to the model of you have metal detectors and there are hospitals out there that have metal detectors and armed personnel and sometimes police departments that, that are blocking a hospital down.
And, and I'm not judging either end of that. But a to go on one end, that's very labor intensive, very cost intensive, and you have to pay a lot of labor to. You know, high level security, if you think of it like a courthouse or some type of, of jail or something where you have these metal detectors and armed personnel.
And, but here's the thing, I, this is me saying is that really what patients want? Is that really what family want? Do they wanna have to go through metal detectors and arm guards when they come to visit their mother? No. So it's
Janae Sharp: a little, it's a little unsettling. You know?
Todd Larson: I, yes. And so, on the flip side, you know, how is it that I can order a package on a company like Amazon and from the moment I hit enter or purchase on my computer?
Until the moment it's at my door. I know everything about that package. I know where it's at, where it's scanned in, when it's gonna be here. I know everything about it. Now I want you to try to call your local hospital and say, I'm trying to get ahold of my grandma. I don't know what room she's in. You tell me how long that takes to, to actually get connected up to your grandmother's room.
So when I say network operations center, where we need to go, and this is where technology comes, is if we don't wanna be the, the hospital that's. Down, like, like going to a courtroom or prison, and we don't really wanna be foolish. Right? And we just completely, you know, open all our doors to everything. I think we have to look to technology.
So we think about how does the, how does a hotel in Las Vegas, like the Bellagio, how do they run hundreds of thousands of people a week through there, but yet when they have a fall, they can detect it in. They have cameras that can read the serial number on the bill that you're using at a, at a gaming table.
They can move people through effectively and safely all day long. So they do that with technology and they do that with training. It's the same with banks. You know, I had a career in law enforcement and banks are often. , you know, robbed or, or money taken, but you know, it's the highest, one of the highest solved crimes in, in the world.
Why? Because they focus on two things. They train their staff really well. Mm-hmm. on what to do, and they have great technology cameras and dive packs and things that are in the money, and then cameras to go with it. And they have charting on the doors and they have, have all these things that they put together so that you can walk into a.
and you don't have to go through metal detectors and feel like you're in a prison, but you can walk into a bank where there's all kinds of money, and yet you can walk in and out freely. And when they are a victim of a crime, it's one of the number one solved crimes in the world because of their commitment to people.
Culture, training and commitment to technology. So where the knock is going. Is to continue to build in those things. Can we build in registration? Could you, why can't you log in ahead of time to visit your mom, get a barcode or, or a QR code, come into the hospital, hit the QR code gate, opens, go through, you know, into the hospital.
We now know who you are. You're in the hospital, you're walking around. Combine that with cameras. Those cameras can identify, you know, an employee badge. They would know if you're an employee if you don't have a badge hanging on you. They would recognize you as a visitor. And I'm not talking about facial recognition that people get, you know, crazy about and don't want privacy.
I'm talking about just general things that can help us flow through and then we move forward into what we talked about earlier, all of those other operations things that can come in there, whether that's supply chain, whether that's the movement of patients. As we brought up in our current network operations center on the, on the clinical operations side, we have had community partners such as a.
And that come in now and physically want to work in that space with us so that they're integrated with us. We've been able to take queue times on patient transports from 12 to 14 in the queue time to zero, Wow. Cause of, of, of having this centralized network operation center approach. So I know we hit a lot of things there, Janae.
I'm sorry. That's a lot. It's a lot. I hit a lot. This is where healthcare needs to go. I, you know, coming out of a career and spending, you know, the last eight years in healthcare I thought, you know, government was behind yet then I come into healthcare and, and wow. So we need to, we need to get rolling because it's, it's, it's not acceptable to tell a patient's family that I could track the package into their patient.
quicker and faster than I could actually track clinical care going into that patient's room. Right.
Janae Sharp: And that's interesting too with all the supply chain issues that have kind of highlighted it. So I like the meme that they, that always goes around where it's like, U s ps, we don't know if this package exists.
delivered and then, then it's like Amazon. It'll be there at nine. And then it's like Facebook. You thought about buying this ,
Todd Larson: right? Right, right. And you just hit it all. How is it that in all of these other industries this stuff is happening yet in healthcare? It's, I, you know, I understand HIPAA and I understand all that, but in healthcare there's this cloak of, of, you know, paralysis by analysis and this, you know, bureaucratic slowdown versus we could, you know, and, and that's, I give so much credit to honor health and the amazing push that they have had with of, let's.
to be so efficient, and let's try to put all of these services together in a network operations center so that at the end of the day, we're giving the best care to our patients. Right. That's really why Honor Health is doing it. They really care about their patients, you know, and, and I get, you know, I, to me it matters, right?
I mean, you know, living in the Phoenix area, Scottsdale area, I've been a patient at these hospitals as well as, as working for them. So I see firsthand that the. is for the patient coming in. So I think you have to look at it from that aspect back to the, whether it's workplace violence or network operations center, if you put the patient at the center of what you're doing and you focus on integration, and you focus on bringing in these things together from a symbiotic relationship, then.
I say back to your point, we should take some of the best things Amazon's doing and Facebook is doing. Mm-hmm. and Gabriela, we should take their best things and bring them into healthcare. Right? Doesn't mean we need to replicate what they're doing, but we should take the best of the best. You know, and I, I've tried to do some of that.
We, we, we did a lot of that with our vaccine model. We did a lot of that with, with other models where how can we make things efficient and. By learning what others are doing. Right.
Janae Sharp: I love that. From a leadership perspective, what is it that makes the difference for them? Like you've worked with them, how do they get there For leaders that are watching,
Todd Larson: you know, so, you know, Having been, you know, a mid-level leader you know, at Honor Health as an associate vice president and, and now still there is an employee, but really in a consulting role.
And I, I have to back up. I have to say it really ties into what I saw in 30 years, right? So I had a 22 year career in law enforcement in the city of Scottsdale, of which honor Health has three hospital. So I, I was, you know, as you can imagine in law enforcement, I was in and out of these hospitals constantly for 22 years and then working there the last eight years.
So I'll, I'll go to this. I have seen a continuous and constant culture of care for 30 years. Wow. And that's, that's number one. Number two is that they focus on leadership That is both. From the organization, b from outside the organization. So they have a mixture, right? Mm-hmm. , but also that they focus on leadership that is there for the right reasons.
So if someone comes from another organization or if someone you know, comes up through the organization at the core, they have the same values, they have the same culture. . So I, I use that word culture. I think culture's incredibly important. So, when you look at you know, Todd LePort is the c e o of honor health.
He is, he is created and maintained really, because even prior to him great culture. So that's, that's number one. Number two is that the leaders that are in place are both a very good at what they do, meaning. , all of them, in my experience that I worked with were great practitioners and then moved into leadership roles over time.
So having done the task and then knowing the task, and now leading the task, I think is very important. Right. Because the staff trust them. So, back let me put this all together in why I think leadership. Yeah.
Janae Sharp: I was just gonna ask you. I was like, well, we're wrapping up, so how are we gonna,
Todd Larson: I think.
Greatest exhibit number one. I was once walking on the Osborne campus, which is one of the honor health hospitals, and I saw in front of me our C E O Todd LePort and he is walking down the sidewalk. I saw him greet someone on the sidewalk and provide directions. Then I see him stop because a piece of paper was on the ground, like in the rocks, and he picked it up and walked over to a garbage can and threw the piece of paper away.
And then he went into the hospital and met with, this is the c e o, right? He is, he is talking with patients, looking what entrance He's picking up a piece of garbage and putting it in a garbage can. Walking over to the, I mean, saying, Showing that he is all, there's, there's no talk there. That's actually who he is in the fabric of every little bit of this organization to, in the same day I was over in the emergency department in the trauma bay, and the trauma director was dressed very nice civilian clothes.
I, I don't know what she had, but some type of meeting where she was dressed very nice in civilian. and all of a sudden, you know, trauma is coming in, another trauma's coming in, it's a level one trauma center, incredibly busy, and she runs over to like the scrub machine gets a set of, of scrubs and immediately changes and she's over there, you know, j just in, in it.
Right. And so, and you could say that about, you know, the executive vice presidents, you could say that about the, you know, the, the chief financial officer, I don't care. where you go. Leadership is key and what the leadership does at that organization at Honor Health is, sets a culture all the time, and that culture is what's best for the patient and they live it, you know, it's, it's an amazing place and I think they, they do an amazing job for the community that's,
Janae Sharp: Well, I'm grateful that, that they are doing that and also that you're able to come share that story and share some of that expertise about how to, how to get there. I'm really looking forward to like the future of that and the future of having centralized command and better technology.
Todd Larson: Yeah. And, and, and also being open to more things that could go into centralization. Right. And more things that could be part of that, because I don't certainly have all the answers. And I think that we need to continue to reinvent. And I don't mean that from, you know, throw everything away that we've done in the past.
I mean, it. We need to reinvent constantly based upon our entities healthcare, based upon looking at what others are doing, based upon what everybody from, you know, staff all the way to the c e o, everybody in between. Let's, let's put all this together because somewhere in there at any given moment is a great way to do something that's probably, you know, better than, you know, better than the why.
We've always done it this way, so, right. Yeah, it's ex I think it's exciting. I think healthcare is on the verge of, of an explosion of efficiency. The next 10 years, how are we going to take all of these things coming at us, technology and ways and means and people, and change in telemedicine and all of these things that are coming at us and now integrate that out there.
I, it's really an exciting. .
Janae Sharp: Yeah, I love that. The vision of the explosion of efficiency. Well, thank you.