Caring for our caregivers: How Michigan Medicine is rethinking employee safety

March 13, 2019  //  FOUND IN: Our Employees,

As thousands of hospitals and health care systems across the country celebrate National Patient Safety Awareness Week, Michigan Medicine is taking the opportunity to highlight employee safety, acknowledging the importance of protecting those who deliver care, as well as those who receive it.

“While this week is focused on increasing awareness and recognition around patient safety, we know there is an important link to employee safety,” said Sue Widmann, R.N., MSPH, interim associate hospital director and administrative director for C.S. Mott Children’s Hospital. “Our frontline patient caregivers can’t keep our patients safe if we don’t keep them safe, which makes employee safety an important component of patient safety. There is a lot of great work being done across our institution to improve employee safety and really reshape how we train our staff on safety.”

NAPPI training

Staff members are undergoing NAPPI training at C.S. Mott Children’s Hospital.

In 2017, Mott joined more than 100 children’s hospitals in a nationwide collaborative called Solutions for Patient Safety (SPS). The goal of SPS is to help children’s hospitals work together to reduce patient harm, ensuring patients receive safe, quality care.

As part of Mott’s participation, staff were asked to be part of a small coalition of hospitals piloting a program focused on addressing two aspects of employee safety: overexertion and patient behavioral events. Overexertion can lead to injuries due to moving things or people. Patient behavioral events can lead to injuries when patients act out either verbally and physically, potentially harming staff.

“We were one of only about five hospitals that sat down with SPS and scoped out an employee safety program,” said Nicole Figueroa, R.N., clinical nursing director in the Child and Adolescent Psychiatry unit. “Our work started with creating guidelines to help caregivers become aware of the patients that are at risk for agitation by screening pediatric patients for risk factors.”

The team also created guidelines for supporting family members who displayed signs of agitation.

“However, after implementing these guidelines, we quickly realized that very few bedside caregivers had training in handling agitation so that was where we decided to begin to focus on,” Figueroa said.

This work started out in 2017 as a pilot, involving four Mott units that provided Non-Abusive Psychological and Physical Intervention (NAPPI) training, provided by NAPPI International. This nationally-recognized training program focuses on de-escalation, self-protection and restraint training.

“Through this partnership, representatives from NAPPI trained two nurses from each of the pilot units,” said Figueroa. “Those nurses then trained other nurses and frontline staff. In total, we were able to train nearly 550 bedside caregivers in NAPPI, including nurses, unit hosts, nurse aids and techs.”

Following the training, Figueroa and her team reviewed post-survey results and noted a significant increase in confidence among caregivers.

“Feedback indicated that caregivers felt more empowered to identify and handle agitated patients and family members and felt more confident in their own abilities to handle the situation,” said Figueroa.

Due to the initial success, NAPPI training will be rolled out to all staff in Mott over the coming year. A committee has also been established to try and bring the training to other areas of Michigan Medicine, including UH/CVC.

Partnering with Security Services

DPSS recently hosted a multi- course training session covering active shooter events, large-scale civil unrest, hospital responses to an active assailant and more.

The Division of Public Safety and Security (DPSS) plays an important role in employee safety, but Brian Uridge, M.P.A., C.P.P., CHPA, director of security for Michigan Medicine, is looking to reshape that role by partnering with clinical staff.

“There is a common saying in law enforcement that describes how people react in stressful situations — ‘you do not rise to the occasion, you fall to the level of your training,’” said Uridge. “I want to take this principle and apply it to staff across the organization. In order for our frontline staff to feel confident in handling every situation they encounter, we need to provide the training to develop the necessary skills.”

As part of this effort, Uridge is looking to strengthen the relationship between security and clinical staff, creating a partnership that will eventually include joint training exercises.

“Our office is currently working to develop a training we’re calling SAVE, which stands for Situational Awareness for Violent Events,” said Uridge. “This training will be a live simulation in which we can run employees through various scenarios and give them tips on training on how best to approach each situation.”

SAVE training is a joint effort that will provide practical application on topics such as workplace violence prevention, intervention and response, situational awareness, crime prevention and in-home health care safety.

“Our goal is to equip employees with the skills they need to feel comfortable and safe in any situation,” said Uridge. “As the saying suggests they will ‘fall to the level of their training,’ it is our responsibility to make sure they have the proper training and skills to lean on. That’s what will keep everyone at Michigan Medicine as safe as possible.”