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Becker’s Healthcare Podcast
Public Safety, Trust, and Violence Prevention in Healthcare Settings with Brian Uridge
00:20:46
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- [00:02]
A
This is where healthcare leadership comes together. Becker's 16th annual meeting brings more than 3,500 hospital and health system executives and nearly 800 speakers to Chicago, April 13th through the 16th. This year's event includes keynote conversations with Dallas Cowboys legend Troy Aikman and former President George W. Bush. For the agenda and event details, visit Beckershospitalreview.com and click on the Events tab in the upper right, click. We're looking forward to hosting you in Chicago.
- [00:32]
B
This is Scott Becker with the Becker's Healthcare Podcast. I'm thrilled today to be joined to be a brilliant leader. We're joined today by Brian Uridge. Brian's with Michigan Medicine, and he's going to tell us a little bit what he does. He's got a fascinating fantasy career there. He's the senior director, the Department of Public Safety and Security, which in healthcare has become more and more important on so many levels. And Brian, can you take a moment to introduce yourself? And I'm going to ask you a lot today about how you ended up in the world in the area that you're in. I'll try not to ask you too much about Michigan football, but we will talk to you about your career and your life and fei and everything else. Brian, take a moment and introduce yourself.
- [01:18]
C
Well, Scott, first of all, thank you for having me. This is an incredible opportunity. So happy to be here, as you said. My name is Brian Uridge, and I'm a senior director of Public safety and security at U of M Health System. And it's an incredible system. We see over 3 million patients per year just at our Ann Arbor location. That does not include our different locations throughout the state of Michigan. And we have about 40,000 employees overall. And on our team, we have a little over 300 team members. And they are a combination of dedicated police officers, dedicated threat assessment investigators, security officers, canine teams, and guest services. And all of that works together. And we like to say we have a focus of trust, training and technology to make sure that our team members are safe and talk a little bit.
- [02:16]
B
About public safety in hospitals and health systems. If you went back 20 years ago, this seems like a very minor concern. You might have a security guy around, often was an older, nice gentleman. And I don't mean to stereotype, just sort of hanging around. Insecurity at health systems has moved from that to being like a serious, serious and very important and not scary. But there's lots of challenges in safety at health systems. You hear often about an incident at a health system. A nurse shot a patient Knifed so many different things. Tell me that evolution of what health system public safety has become over the years.
- [03:03]
C
Well, great point. People don't. And for the most part, the rest of the world does not understand what's happening in healthcare. So we know that right now, Scott, 72% of all violence in any workplace occurs in a healthcare setting. 72%. And we know that according to Press Ganey, two nurses are assaulted every single hour, 24 hours a day. Yet all of those statistics I just talked about are actually very much underreported because we know that only 26% of nurses who are physically assaulted ever report the fact that they're assaulted. So the numbers are are very, very low compared to what is actually occurring. And I like to use the example in 2019, there were 149 documented cases of people becoming angry and assaultive on airplanes. Fast forward to 2021, Covid starting to end. We had 2,500 documented cases of people assaulting people on airlines. And all that's just an example of our society has changed. And all of those people need health care. And we know that, according to the Joint Commission, that crowded waiting rooms and long waits for care are two of the driving factors in what's causing health care violence. And we know that every health system throughout the entire United States has crowded waiting rooms and long waits for care. So that's just a quick snapshot into what we're dealing with today. And that's what you see the change.
- [04:40]
B
And take a second yet, Brian, this concept that on airplanes we've got triple the amount of incidents from before in health systems, probably 10 times the amount of incidents from 20 years ago. Is that a problem with society or what drives that? And I know that's deeper than this discussion, but why is that? What has gone wrong that we have so much of that going on?
- [05:03]
C
Well, that's a great question. And I don't know that I can speak to the actually what's happening in our society. I can tell you between 2011 and 2018, this is before COVID we saw a 68% increase in violence in health care. And that's before the exacerbating factor of COVID So, yes, things that are happening, we have to realize that every hospital system is a community and every floor is a neighborhood. Everything that you see happen out in the community and where I don't care where you live or it's the same in healthcare. The only difference is our communities go straight up in the air. They have 10 or 15 floors, but the Same principles that we use to help combat crime and violence in the community. Those are the same principles that we have to apply in healthcare.
- [05:57]
B
Thank you. And talk a bit about your career in public safety. I know that you're at Michigan Medicine now. At some point you spent time in Kalamazoo, one of the great cities in America. Maybe underrated, great city in America. But talk a little bit about your career and how you ended up in public safety and a little bit your background.
- [06:15]
C
Well, I got really lucky. So my entire life I wanted to be a police officer or a firefighter. So I went to college and one day I found out there's this incredible place called Kalamazoo that's the largest fully integrated police, fire and medical EMS department in the United States. So I applied and I thought, I will never get in. Sure enough, I was lucky enough to get in. I spent a 25 year career at Kalamazoo and I retired as their assistant chief. And I remember one day and I had about 10 years in, I was at a community meeting and a lady was talking about the crack cocaine problem. And it was my aha moment. I realized, wait a second, she knows that we are not going to be able to stop crack cocaine. But what she wants to know is that can she have a relationship and trust us to know that we are on the same team and that we are working together to try to solve problems. So when I retired from Kalamazoo and I got into healthcare, I realized, wait a second, those same principles of trust and, and training and technology, all of those apply in healthcare.
- [07:28]
B
And talk for a second, Brian. What's the most interesting thing that you see currently in healthcare and public safety when you look at the overlap of those two areas?
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C
Well, probably the biggest thing is, first of all, you have to understand the key principle is we've got to make sure that our patient, staff and visitors are safe. But just as importantly, we need to make sure that they feel safe. And if they don't feel safe, we've not accomplished our mission. And for those of that will listen to this that are old enough to remember the movie Gladiator, there's a portion of Gladiator with Russell Crowe where the head gladiator is talking about, I wasn't the best gladiator because I was the best swordsman. I was the best gladiator because the crowd loved me. If you want to be the best, win the crowd. And I show that video to my staff and I always talk about what win the crowd. So the biggest issue facing facing health care Security is understanding that we have to use non traditional public safety outreach. We have to focus on relationships. We have to focus on building that trust so that we can make sure people feel safe. Because emotion will always trump data. People will see something on the news and even though it's a rare event, that's the only reason it's on the news. They will equate that. Well, that's going to happen in my hospital. So we have to understand that focusing on that relationship based public safety outreach is the number one key to keeping people safe.
- [08:58]
B
Thank you. No, I love that perspective. And how does that work in process in trying to defend and keep safe a large health system? How does it work in process? And how many people work in public safety at a system like Michigan Medicine?
- [09:16]
C
Well, we know the vast majority of hospitals in the nation are critical access hospitals. They don't have those resources. So the most, I always tell people the most effective tool that you have is what's between your ears. It's your mind. And so having a trained and engaged staff that has training and situational awareness, understands personal safety, that is engaged and works with their security teams, that's the most important thing that we can do to help keep people safe right now.
- [09:51]
B
Thank you. When you look at the future of public safety and health systems, what are things that people should be thinking about? What changes do you see? Is there more and more use of technology? But the technology only goes so far in monitoring everything. You still need people on the ground to see things and develop relationships. What's this mix of where technology fits into public safety?
- [10:12]
C
Well, you absolutely do. And yet, you know, I didn't really do a good job of answering that first question when you talked about process. So let's. You're absolutely right. Technology is key. Right now we have cameras with analytics. They can, they can capture exposed firearms, they can capture people who are loitering, they can capture physical fights, but nothing will ever be able to replace that human touch. So what do we do about process? So let's talk about that. We, we know that what we do is we ask our staff every day, do two simple things. Number one, go meet a staff member that you've never met and engage them in a two minute conversation about nothing. Talk about where they're from, talk about what the weather's like there, talk about their background. And then two, go meet a patient or visitor that you've never met and simply engage them in a conversation about where they're from. Reduce their anxiety. If you've ever read the book you if Disney ran your hospital nine and a half things you do differently. Incredible book. And it talks about the number one patient need is assurance. We've got to get our staff out and understand that we've got to reduce that level of anxiety. So let's focus on one of the biggest things in healthcare now is behavioral threat assessment and management. We all know about the tragedy that happened to the UnitedHealthcare CEO. Well, that person who committed that atrocity, that person was on what's called a pathway to intended violence. So now what I always recommend is you need to have a multidisciplinary behavioral threat assessment team who focuses on people who could be on a pathway to intended violence. People who are giving pre incident indicators or they're exhibiting behaviors of concern. Because we know, and this is a horrible statistic that 54% of all active shooters start with what they start with domestic violence. And we know when we look at the other parts it's an adverse employment action. And we know that the vast majority of times they will exhibit pre incident indicators. And I'll never forget I was talking about this in front of about 40 nurses. I was explaining behaviors of concern and Scott, there was a nurse in the back and she was crying and her manager was rubbing her back. And I walked up at the end of the presentation and I said, you know, was the presentation that bad? And her manager said no. The problem is that her husband or soon to be ex husband is exhibiting everything you're talking about every one of those pre incident indicators and she's scared to death. Now let's think about that for a minute. That's a horrible tragedy. And is that nurse able to to deliver good patient care? Absolutely not. She is not. So our job is to identify those behaviors of concern. But that would not start unless we build relationships with our staff so they can trust us. And it starts with that non traditional public safety which goes to that process you talked about, which then goes to those pre incident indicators which lets us disrupt that pathway to intended violence. It's all interrelated.
- [13:22]
B
Thank you so much. And talk about this like from your perspective, having that intelligence, whether it's on a patient who's got trouble or an employee who's got trouble or anybody that comes in the hospital has trouble. How challenging is it to access some of that information? That must be so out there in an AI world. But there must be privacy issues in how you access it. You because like you talked about the shooter of the United CEO and people knew he was on a pathway to Violence. He as much said he was on a pathway to violence, but trying to connect dots is so hard. Do we get to a spot where it's easier to utilize different types of data to get a better sense of where we could have problems?
- [14:06]
C
Well, very good points, because obviously we run into all sorts of barriers because there's obviously law enforcement sensitive data that may not be easily, easily accessible by people who are not actually in law enforcement. That's a key component right there. And that's why I always recommend to the critical access hospitals, build that relationship with your local police department. Have them in when times are good, have them sit down for coffee so that in the event there's a critical incident, I can call police officer Scott up and say, scott, I have a problem. I have a person who's exhibiting behaviors of concern. Can you come over and help me? And that is key. And then the second key is understanding. And this is really taking, making headway now in the United States. It's a trauma informed care approach, meaning I need to understand what is Scott's background, what trauma has he been exposed to? Because the last thing I want to do is re traumatize Scott. So if I can respectfully understand what is your background, what have you experienced and how can I relate to that, and how can I adjust my care to more respectfully support you and your family and understand what differences we may have. That way I can make sure I don't re traumatize you and, and perhaps not cause you to escalate into some type of violence.
- [15:39]
B
Thank you. When you look at this year coming up, what's the biggest priority this year? In 2026, our big, our biggest focus.
- [15:49]
C
At Michigan Medicine is, is really threefold. Number one, building our behavioral threat assessment and management teams at all of our hospitals, using that multidisciplinary approach to help support people who may be on a pathway to an intended violence. That's number one. Number two is developing training in collaboration with our nurse educators that reduces both risk and anxiety of our staff. And I always tell people, you can build it in house. All you need is two things. You need people who care and people who are creative. And I guarantee you, I don't care what hospital you go to in the US there's somebody out there that is very caring and very creative, otherwise they would not be in healthcare. And then finally, using technology that actually reduces risk, and that's. People talk about weapons detection or metal detectors. Yeah, they do have benefit. But there's other technology like we talked about before, cameras with analytics that can focus on identifying that threat level, making sure that we have access control so that there's an on stage and an off stage presence, meaning your waiting room where it's on stage, but there's access control to get back to your clinical areas because that's your off stage area. So those are really our three areas that we're focused on.
- [17:15]
B
Fantastic. And just one more question for you, Brian. You've had this great leadership career. Well, ask you first. I'll ask you the tough question. The tough question is this. Have you become a University of Michigan fan? Were you always a University of Michigan fan or do you avoid that like the plague?
- [17:34]
C
Well, I will tell you this. So my wife's from Michigan State University, graduated from there. So I can't even talk about it. I can just tell you this. I was never nor would I ever be smart enough to get into the University of Michigan. In fact, my claim to fame is every meeting that I go to at Michigan University of Michigan Health System. They are some of the smartest people I have ever met in my life. And I can honestly say that I am always the dumbest guy in the room and I'm just honored to be there.
- [18:04]
B
Well, you're a good man and no better put than saying it somewhat like that, especially with a wife who's a Spartan and you're a Western Michigan guy. We get it. Well stated. Last question. You've had this great leadership career, regardless of that, tremendous humility, even though you're really bright and just fantastic. Talk for a second about any advice you would give to emerging leaders generally or in the public safety field.
- [18:29]
C
Yes, absolutely. And I'm going to give you a quick story. My first day as a sergeant in Kalamazoo Public safety. My first time ever being alone. My first call was a garage that was on fire attached to a house. I was the first one there. Scott, I was scared to death. There were flames everywhere that was starting to burn the house. And the garage was fully involved. And the fire truck pulled up and I was in charge of the person on the fire truck. But he knew more. He had been there longer. He was more experienced. I looked at him and his name was Dave Toff. I said, Dave, I said, we need to connect to the fire hydrant to get more water. He said, brian, that is the wrong decision. We need to put on our gear. We need to climb in the living room to stop the fire from getting into the, into the house. So I said, you know what? That's a lot better idea. So we did it. We saved the house and I walked away. I was mortified. I was like, my first day, my first decision, my first call. And it was wrong. But, Scott, what I learned from that is three things. Number one, create a culture where, where your staff feel free to disagree. Number two, always ask for help, always ask for advice. And number three, always remember the next person on scene of any situation, any critical incident, always has a better idea because they don't have tunnel vision. And that's my leadership advice.
- [20:00]
B
That is literally brilliant, Brian. I love that. Again, we're fortunate today to get to visit with Brian Uridge, Department of Public Safety at the University of Michigan. Brian, remind me of the exact title for our audience, if you don't mind.
- [20:18]
C
I'm the Senior Director for Public Safety and Security for University of Michigan Health System.
- [20:25]
B
Fantastic. It is really a pleasure to visit with you. You've also got several educational degrees and certificates. You're a lifelong learner, constant improvement person. Brian, fantastic to visit with you today on the Becker's Healthcare Podcast. Thank you so much for joining us.
- [20:42]
C
Thank you.