1 00:00:01,919 --> 00:00:04,500 This is where health care leadership comes together. 2 00:00:04,639 --> 00:00:07,759 Becker's sixteenth annual meeting brings more than 3,500 3 00:00:07,759 --> 00:00:10,880 hospital and health system executives and nearly 800 4 00:00:10,880 --> 00:00:14,259 speakers to Chicago, April 13 through the sixteenth. 5 00:00:14,714 --> 00:00:17,355 This year's event includes keynote conversations with Dallas 6 00:00:17,355 --> 00:00:20,315 Cowboys legend Troy Aikman and former president George 7 00:00:20,315 --> 00:00:22,954 w Bush. For the agenda and event details, 8 00:00:22,954 --> 00:00:25,275 visit beckershospitalreview.com 9 00:00:25,275 --> 00:00:26,875 and click on the events tab in the 10 00:00:26,875 --> 00:00:29,595 upper right. We're looking forward to hosting you 11 00:00:29,595 --> 00:00:30,335 in Chicago. 12 00:00:32,049 --> 00:00:32,869 This is 13 00:00:33,170 --> 00:00:36,310 Scott Becker with the Beckers Health Care podcast. 14 00:00:36,690 --> 00:00:38,369 I I'm thrilled today to be joined to 15 00:00:38,369 --> 00:00:39,670 be a brilliant leader. 16 00:00:40,049 --> 00:00:42,310 We're joined today by Brian Urich. 17 00:00:42,770 --> 00:00:44,630 Brian's with Michigan Medicine, 18 00:00:45,085 --> 00:00:46,445 and he's gonna tell us a little bit 19 00:00:46,445 --> 00:00:48,225 what he does. He's got a a fascinating 20 00:00:48,284 --> 00:00:51,344 financing career there. He's the senior director, 21 00:00:51,884 --> 00:00:54,145 the Department of Public Safety and Security, 22 00:00:54,524 --> 00:00:56,445 which in health care has become more and 23 00:00:56,445 --> 00:00:58,465 more important on so many levels. 24 00:00:58,950 --> 00:01:01,189 Brian, can you take a moment to introduce 25 00:01:01,189 --> 00:01:03,189 yourself? And and I'm gonna ask you a 26 00:01:03,189 --> 00:01:05,349 lot today about how you ended up in 27 00:01:05,349 --> 00:01:07,269 the world in the area that you're in. 28 00:01:07,510 --> 00:01:08,869 I'll try not to ask you too much 29 00:01:08,869 --> 00:01:10,010 about Michigan football, 30 00:01:10,549 --> 00:01:12,069 but we will talk to you about your 31 00:01:12,069 --> 00:01:14,484 career and your life and and FBI and 32 00:01:14,484 --> 00:01:17,125 everything else. Brian, take a moment and introduce 33 00:01:17,125 --> 00:01:17,625 yourself. 34 00:01:18,084 --> 00:01:19,525 Well, Scott, first of all, thank you for 35 00:01:19,525 --> 00:01:21,864 having me. This is, an incredible opportunity. 36 00:01:22,564 --> 00:01:24,484 So happy to be here. As you said, 37 00:01:24,484 --> 00:01:26,004 my name is Brian Uriage, and I'm a 38 00:01:26,004 --> 00:01:28,700 senior director of public safety and security at, 39 00:01:29,019 --> 00:01:30,319 U of M Health System. 40 00:01:30,780 --> 00:01:31,280 And 41 00:01:31,579 --> 00:01:34,319 it's an incredible system. We see 42 00:01:34,700 --> 00:01:36,159 over 3,000,000 43 00:01:36,299 --> 00:01:39,280 patients per year just at our Anarbor location. 44 00:01:39,659 --> 00:01:41,819 That does not include our different locations throughout 45 00:01:41,819 --> 00:01:43,935 the state of Michigan. And we have about 46 00:01:43,995 --> 00:01:45,135 40,000 47 00:01:45,435 --> 00:01:46,415 employees overall. 48 00:01:47,115 --> 00:01:49,195 And on our team, we have a little 49 00:01:49,195 --> 00:01:49,594 over, 50 00:01:50,155 --> 00:01:51,055 300 51 00:01:51,275 --> 00:01:52,094 team members, 52 00:01:52,395 --> 00:01:55,995 and they are a combination of dedicated police 53 00:01:55,995 --> 00:01:56,495 officers, 54 00:01:57,329 --> 00:01:59,509 dedicated threat assessment investigators, 55 00:01:59,810 --> 00:02:00,869 security officers, 56 00:02:01,409 --> 00:02:03,509 k nine teams, and guest services. 57 00:02:03,810 --> 00:02:05,909 And all of that works together. 58 00:02:06,289 --> 00:02:08,049 And we like to say we have a 59 00:02:08,049 --> 00:02:09,349 a focus of trust, 60 00:02:09,729 --> 00:02:12,104 training, training, and technology to make sure that 61 00:02:12,104 --> 00:02:13,884 that our team members are safe. 62 00:02:14,824 --> 00:02:16,205 And talk a little bit about 63 00:02:16,584 --> 00:02:18,844 public safety in hospitals and health systems. 64 00:02:19,224 --> 00:02:21,324 If you went back twenty years ago, 65 00:02:21,705 --> 00:02:24,125 this seems like a very minor concern. 66 00:02:24,620 --> 00:02:27,039 You might have a security guy around, 67 00:02:28,060 --> 00:02:30,159 often was an older, nice gentleman, 68 00:02:30,620 --> 00:02:31,739 you know, and and I don't mean to 69 00:02:31,739 --> 00:02:32,239 stereotype, 70 00:02:33,259 --> 00:02:34,719 just sort of hanging around. 71 00:02:35,419 --> 00:02:38,219 And security at health systems has moved from 72 00:02:38,219 --> 00:02:38,719 that 73 00:02:39,444 --> 00:02:42,724 to being like a serious, serious, and very 74 00:02:42,724 --> 00:02:43,224 important, 75 00:02:44,805 --> 00:02:47,764 and and not scary, but there's lots of 76 00:02:47,764 --> 00:02:49,944 challenges in safety at health systems. 77 00:02:50,245 --> 00:02:52,564 You know, you hear often about an incident 78 00:02:52,564 --> 00:02:53,544 at a health system, 79 00:02:54,599 --> 00:02:56,300 a nurse shot, a patient 80 00:02:56,599 --> 00:02:59,560 knifed, so many different things. Tell me that 81 00:02:59,560 --> 00:03:01,639 evolution of what health system public safety has 82 00:03:01,639 --> 00:03:02,939 has become over the years. 83 00:03:03,479 --> 00:03:03,979 Well, 84 00:03:04,360 --> 00:03:05,180 great point. 85 00:03:05,639 --> 00:03:07,694 People don't and for the most part, the 86 00:03:07,694 --> 00:03:09,875 the rest of the world does not understand 87 00:03:09,935 --> 00:03:11,394 what's happening in health care. 88 00:03:11,694 --> 00:03:14,254 So we know that right now, Scott, seventy 89 00:03:14,254 --> 00:03:14,995 two percent 90 00:03:15,375 --> 00:03:18,414 of all violence in any workplace occurs in 91 00:03:18,414 --> 00:03:20,435 a health care setting. Seventy two percent. 92 00:03:20,810 --> 00:03:22,650 And we know that according to Press Ganey, 93 00:03:22,650 --> 00:03:23,949 two nurses are assaulted 94 00:03:24,409 --> 00:03:27,229 every single hour, twenty four hours a day. 95 00:03:27,289 --> 00:03:27,789 Yet, 96 00:03:28,250 --> 00:03:30,569 all of those statistics I just talked about 97 00:03:30,569 --> 00:03:32,269 are actually very much underreported 98 00:03:32,569 --> 00:03:34,650 because we know that only twenty six percent 99 00:03:34,650 --> 00:03:35,598 of nurses who are physically assaulted ever report 100 00:03:35,598 --> 00:03:35,689 the fact that they're assaulted. So the numbers 101 00:03:35,689 --> 00:03:36,509 are are 102 00:03:36,944 --> 00:03:39,444 assaulted ever report the fact that they're assaulted. 103 00:03:39,665 --> 00:03:42,224 So the numbers are are are very, very 104 00:03:42,224 --> 00:03:44,965 low compared to what is actually occurring. 105 00:03:45,985 --> 00:03:47,504 And I like to use the example in 106 00:03:47,504 --> 00:03:48,884 in 2019, 107 00:03:49,185 --> 00:03:52,250 there were one hundred and forty nine documented 108 00:03:52,389 --> 00:03:52,889 cases 109 00:03:53,349 --> 00:03:56,250 of people becoming angry and assaulted on airplanes. 110 00:03:56,709 --> 00:03:58,569 Fast forward to 2021, 111 00:03:58,949 --> 00:04:01,849 COVID starting to end. We had two thousand 112 00:04:01,909 --> 00:04:04,169 five hundred documented cases 113 00:04:04,555 --> 00:04:07,055 of people assaulting people on airlines. 114 00:04:07,355 --> 00:04:09,375 And all that's just an example of 115 00:04:10,395 --> 00:04:13,435 our society has changed, and all of those 116 00:04:13,435 --> 00:04:13,935 people 117 00:04:14,555 --> 00:04:16,875 need health care. And we know that according 118 00:04:16,875 --> 00:04:17,935 to the joint commission, 119 00:04:18,439 --> 00:04:21,959 that crowded waiting rooms and long waits for 120 00:04:21,959 --> 00:04:22,459 care 121 00:04:22,919 --> 00:04:24,939 are two of the driving factors 122 00:04:25,560 --> 00:04:28,279 in what's causing health care violence, and we 123 00:04:28,279 --> 00:04:31,079 know that every health system throughout the entire 124 00:04:31,079 --> 00:04:34,294 United States has crowded waiting rooms and long 125 00:04:34,294 --> 00:04:36,454 waits for care. So that's just a quick 126 00:04:36,454 --> 00:04:38,694 snapshot into what we're dealing with today, and 127 00:04:38,694 --> 00:04:40,774 that's what you see the change. And and 128 00:04:40,774 --> 00:04:41,594 take a second, 129 00:04:42,294 --> 00:04:44,314 Brian. This concept that on airplanes, 130 00:04:44,935 --> 00:04:46,935 we've got triple the amount of incidents from 131 00:04:46,935 --> 00:04:47,435 before. 132 00:04:47,894 --> 00:04:48,875 In health systems, 133 00:04:49,220 --> 00:04:51,300 probably 10 times the amount of incidents from 134 00:04:51,300 --> 00:04:52,280 twenty years ago. 135 00:04:53,300 --> 00:04:55,460 Is that a problem with society, or what 136 00:04:55,460 --> 00:04:57,379 drives that? And I know that's deeper than 137 00:04:57,379 --> 00:04:58,199 this discussion, 138 00:04:58,740 --> 00:05:00,660 but but why is that? What what has 139 00:05:00,660 --> 00:05:02,180 gone wrong that we have so much of 140 00:05:02,180 --> 00:05:04,664 that going on? Well, that's a great question. 141 00:05:04,664 --> 00:05:06,504 And I I don't know, like, that I 142 00:05:06,504 --> 00:05:08,584 can speak to the actually, what's happening in 143 00:05:08,584 --> 00:05:11,404 our society. I can tell you between 2011 144 00:05:11,944 --> 00:05:13,144 and 2018, 145 00:05:13,144 --> 00:05:16,044 this is before COVID, we saw a sixty 146 00:05:16,185 --> 00:05:16,925 eight percent 147 00:05:17,410 --> 00:05:17,910 increase 148 00:05:18,290 --> 00:05:21,330 in violence in healthcare. And that's before the 149 00:05:21,330 --> 00:05:24,770 exacerbating factor of COVID. So, yes, things that 150 00:05:24,770 --> 00:05:25,430 are happening. 151 00:05:25,970 --> 00:05:27,430 We have to realize that 152 00:05:28,210 --> 00:05:28,710 every 153 00:05:29,089 --> 00:05:31,110 hospital system is a community, 154 00:05:31,544 --> 00:05:33,324 and every floor is a neighborhood. 155 00:05:33,625 --> 00:05:36,024 Everything that you see happen out in the 156 00:05:36,024 --> 00:05:37,865 community and where I don't care where where 157 00:05:37,865 --> 00:05:40,584 you live or it's it's the same in 158 00:05:40,584 --> 00:05:42,685 health care. The only difference is our communities 159 00:05:42,745 --> 00:05:44,504 go straight up in the air. They have 160 00:05:44,504 --> 00:05:45,805 10 or 15 floors. 161 00:05:46,319 --> 00:05:48,879 But the same principles that we use to 162 00:05:48,879 --> 00:05:52,180 help combat crime and violence in the community, 163 00:05:52,399 --> 00:05:54,319 those are the same principles that we have 164 00:05:54,319 --> 00:05:55,699 to apply in health care. 165 00:05:56,479 --> 00:05:58,079 Thank you. And talk a little bit about 166 00:05:58,079 --> 00:05:59,860 your career in public safety. 167 00:06:00,705 --> 00:06:02,705 I I know that you're at Michigan Medicine 168 00:06:02,705 --> 00:06:05,024 now. At some point, you spent time in 169 00:06:05,024 --> 00:06:07,205 Kalamazoo, one of the great cities in America, 170 00:06:07,264 --> 00:06:07,764 maybe 171 00:06:08,464 --> 00:06:10,785 underrated great city in America. But but talk 172 00:06:10,785 --> 00:06:12,384 a little bit about your career and how 173 00:06:12,384 --> 00:06:13,824 you ended up in public safety and a 174 00:06:13,824 --> 00:06:14,884 little bit of your background. 175 00:06:15,479 --> 00:06:18,779 Well, I got really lucky. So, my entire 176 00:06:18,839 --> 00:06:21,079 life, I wanted to be a police officer 177 00:06:21,079 --> 00:06:21,899 or a firefighter. 178 00:06:22,279 --> 00:06:23,579 So I went to college, 179 00:06:23,959 --> 00:06:25,879 and one day I found out there's this 180 00:06:25,879 --> 00:06:27,579 incredible place called Kalamazoo. 181 00:06:27,904 --> 00:06:28,965 That's the largest 182 00:06:29,345 --> 00:06:32,625 fully integrated police, fire, and medical EMS department 183 00:06:32,625 --> 00:06:33,764 in The United States. 184 00:06:34,145 --> 00:06:36,064 So I applied and I thought I will 185 00:06:36,064 --> 00:06:38,305 never get in. Sure enough, I was lucky 186 00:06:38,305 --> 00:06:41,125 enough to get in. I spent a twenty 187 00:06:41,185 --> 00:06:42,564 five year career 188 00:06:43,029 --> 00:06:45,829 at Kalamazoo, and I retired as their assistant 189 00:06:45,829 --> 00:06:46,329 chief. 190 00:06:46,790 --> 00:06:48,310 And I remember one day, and I had 191 00:06:48,310 --> 00:06:49,750 about ten years in, I was at a 192 00:06:49,750 --> 00:06:50,729 community meeting, 193 00:06:51,110 --> 00:06:51,610 and 194 00:06:52,069 --> 00:06:54,310 a lady was talking about the crack cocaine 195 00:06:54,310 --> 00:06:56,949 problem. And it was it was my moment. 196 00:06:56,949 --> 00:06:58,490 I realized, wait a second. 197 00:06:59,024 --> 00:07:01,425 I she knows that we are not gonna 198 00:07:01,425 --> 00:07:03,665 be able to stop crack cocaine. But what 199 00:07:03,665 --> 00:07:06,384 she wants to know is that, can she 200 00:07:06,384 --> 00:07:07,285 have a relationship 201 00:07:07,665 --> 00:07:09,665 and trust us to know that we're on 202 00:07:09,665 --> 00:07:10,644 the same team 203 00:07:10,944 --> 00:07:13,680 and that we're working together to try to 204 00:07:13,680 --> 00:07:14,660 solve problems. 205 00:07:15,039 --> 00:07:16,959 So when I retired from Kalamazoo and I 206 00:07:16,959 --> 00:07:19,279 got into health care, I realized, wait a 207 00:07:19,279 --> 00:07:21,939 second. This that those same principles of trust 208 00:07:22,240 --> 00:07:23,379 and training technology, 209 00:07:23,759 --> 00:07:25,060 all of those apply 210 00:07:25,519 --> 00:07:26,579 in health care. 211 00:07:27,564 --> 00:07:29,964 And talk for a second, Brian. What's the 212 00:07:29,964 --> 00:07:32,444 most interesting thing that you see currently in 213 00:07:32,444 --> 00:07:34,605 health care and public safety when when you 214 00:07:34,605 --> 00:07:36,544 look at the overlap of those two areas? 215 00:07:37,404 --> 00:07:37,904 Well, 216 00:07:38,524 --> 00:07:40,444 probably the biggest thing is first of all, 217 00:07:40,444 --> 00:07:41,220 you have to understand 218 00:07:41,939 --> 00:07:44,420 the the key principle is we've gotta make 219 00:07:44,420 --> 00:07:46,980 sure that our patients, staff, and visitors are 220 00:07:46,980 --> 00:07:47,480 safe. 221 00:07:48,180 --> 00:07:50,019 But just as importantly, we need to make 222 00:07:50,019 --> 00:07:52,180 sure that they feel safe. And if they 223 00:07:52,180 --> 00:07:54,615 don't feel safe, we've not accomplished our mission. 224 00:07:54,854 --> 00:07:56,615 And for those of the that that will 225 00:07:56,615 --> 00:07:58,055 listen to this, that are old enough to 226 00:07:58,055 --> 00:07:59,354 remember the movie Gladiator, 227 00:07:59,974 --> 00:08:02,714 there's a portion of Gladiator with Russell Crowe 228 00:08:03,014 --> 00:08:06,055 where the head gladiator is talking about, you 229 00:08:06,055 --> 00:08:08,214 know, I wasn't the best gladiator because I 230 00:08:08,214 --> 00:08:09,354 was the best swordsman. 231 00:08:09,699 --> 00:08:11,860 I was the best gladiator because the crowd 232 00:08:11,860 --> 00:08:13,779 loved me. If you wanna be the best, 233 00:08:13,779 --> 00:08:15,860 win the crowd. And I show that video 234 00:08:15,860 --> 00:08:17,800 to my staff, and I always talk about 235 00:08:17,860 --> 00:08:21,060 win the crowd. So the biggest issue facing 236 00:08:21,060 --> 00:08:23,625 facing health care security is understanding that 237 00:08:24,105 --> 00:08:25,644 we have to use nontraditional 238 00:08:26,185 --> 00:08:28,904 public safety outreach. We have to focus on 239 00:08:28,904 --> 00:08:29,404 relationships. 240 00:08:30,105 --> 00:08:32,524 We have to focus on building that trust 241 00:08:32,825 --> 00:08:35,065 so that we can make sure people feel 242 00:08:35,065 --> 00:08:36,284 safe because emotion 243 00:08:36,664 --> 00:08:38,524 will always trump data. 244 00:08:38,919 --> 00:08:40,840 People will see something on the news, and 245 00:08:40,840 --> 00:08:42,519 even though it's a rare event, that's the 246 00:08:42,519 --> 00:08:43,980 only reason it's on the news, 247 00:08:44,440 --> 00:08:46,679 they will equate that, well, that's gonna happen 248 00:08:46,679 --> 00:08:48,840 in my hospital. So we have to understand 249 00:08:48,840 --> 00:08:51,259 that focusing on that relationship based 250 00:08:51,705 --> 00:08:55,165 public safety outreach is the number one key 251 00:08:55,305 --> 00:08:56,764 to keeping people safe. 252 00:08:57,865 --> 00:09:00,024 Thank you. No. I I I love that 253 00:09:00,024 --> 00:09:00,524 perspective. 254 00:09:01,625 --> 00:09:04,105 And how does that work in process in 255 00:09:04,105 --> 00:09:06,425 trying to defend and keep safe a large 256 00:09:06,425 --> 00:09:07,165 health system? 257 00:09:07,519 --> 00:09:09,919 How does that work in process in in 258 00:09:09,919 --> 00:09:11,759 in in in in in in how many 259 00:09:11,759 --> 00:09:13,759 people work in public safety at a system 260 00:09:13,759 --> 00:09:15,059 like Michigan Medicine? 261 00:09:15,679 --> 00:09:17,840 Well, we know the vast majority of hospitals 262 00:09:17,840 --> 00:09:20,399 in the nation are critical access hospitals. They 263 00:09:20,399 --> 00:09:21,779 don't have those resources. 264 00:09:22,264 --> 00:09:24,024 So the most I always tell people the 265 00:09:24,024 --> 00:09:24,924 most effective 266 00:09:25,465 --> 00:09:27,784 tool that you have is what's between your 267 00:09:27,784 --> 00:09:28,284 ears. 268 00:09:29,304 --> 00:09:31,465 It's your it's your mind. And so having 269 00:09:31,465 --> 00:09:35,065 a trained and engaged staff that has training 270 00:09:35,065 --> 00:09:37,970 in situational awareness, understands personal safety, 271 00:09:38,350 --> 00:09:39,570 that is engaged 272 00:09:40,029 --> 00:09:43,070 and works with their security teams. That's the 273 00:09:43,070 --> 00:09:44,690 most important thing, 274 00:09:45,230 --> 00:09:46,929 that that we can do, 275 00:09:47,389 --> 00:09:50,049 to help keep peep people safe right now. 276 00:09:51,004 --> 00:09:52,945 Thank you. And and when you look at 277 00:09:53,325 --> 00:09:55,825 the future of public safety and health systems, 278 00:09:56,205 --> 00:09:57,965 what are things that people should be thinking 279 00:09:57,965 --> 00:09:59,965 about? What what are what changes do you 280 00:09:59,965 --> 00:10:01,804 see? What is there more and more use 281 00:10:01,804 --> 00:10:02,384 of technology? 282 00:10:03,100 --> 00:10:05,019 But the technology only goes so far on 283 00:10:05,019 --> 00:10:06,940 monitoring everything. You still need people on the 284 00:10:06,940 --> 00:10:08,860 ground to see things and develop relationships. Right? 285 00:10:08,860 --> 00:10:10,779 What's what's this mix of where technology fits 286 00:10:10,779 --> 00:10:11,759 into public safety? 287 00:10:12,139 --> 00:10:13,980 What you absolutely do, and you you know, 288 00:10:13,980 --> 00:10:15,259 I didn't really do a good job of 289 00:10:15,259 --> 00:10:17,019 answering that first question when you talked about 290 00:10:17,019 --> 00:10:18,059 process. So let's 291 00:10:19,014 --> 00:10:21,095 you're absolutely right. Technology is key. Right now, 292 00:10:21,095 --> 00:10:23,654 we have cameras with analytics. They can they 293 00:10:23,654 --> 00:10:26,615 can capture exposed firearms. They can capture people 294 00:10:26,615 --> 00:10:29,115 who are loitering. They can capture physical fights. 295 00:10:29,334 --> 00:10:31,995 But nothing will ever be able to replace 296 00:10:32,054 --> 00:10:33,690 that human touch. So So what do we 297 00:10:33,690 --> 00:10:36,490 do about about process? So let's talk about 298 00:10:36,490 --> 00:10:37,230 that. We 299 00:10:37,769 --> 00:10:39,690 we know that what we do is we 300 00:10:39,690 --> 00:10:42,649 ask our staff every day, do two simple 301 00:10:42,649 --> 00:10:44,889 things. Number one, go meet a staff member 302 00:10:44,889 --> 00:10:46,889 that you've never met and engage them in 303 00:10:46,889 --> 00:10:49,465 a two minute conversation about nothing. Talk about 304 00:10:49,465 --> 00:10:51,065 where they're from. Talk about what the weather's 305 00:10:51,065 --> 00:10:52,684 like there. Talk about their background. 306 00:10:53,144 --> 00:10:54,985 And then two, go meet a patient or 307 00:10:54,985 --> 00:10:57,225 a visitor that you've never met and simply 308 00:10:57,225 --> 00:10:58,445 engage them in a conversation 309 00:10:59,144 --> 00:11:01,725 about where they're from. Reduce their anxiety. 310 00:11:02,429 --> 00:11:04,589 If you've ever read the book, If Disney 311 00:11:04,589 --> 00:11:06,269 Ran Your Hospital Nine and a Half, Think 312 00:11:06,269 --> 00:11:07,089 You Do Differently, 313 00:11:07,470 --> 00:11:09,950 incredible book. And it talks about the number 314 00:11:09,950 --> 00:11:11,570 one patient need is assurance. 315 00:11:12,350 --> 00:11:14,990 We've gotta get our staff out and understand 316 00:11:14,990 --> 00:11:16,289 that we've gotta reduce 317 00:11:16,615 --> 00:11:19,115 that level of anxiety. So let's focus on 318 00:11:19,654 --> 00:11:21,335 one of the biggest things in health care 319 00:11:21,335 --> 00:11:22,875 now is behavioral 320 00:11:23,254 --> 00:11:25,274 threat assessment and management. 321 00:11:25,654 --> 00:11:27,735 We all know about the tragedy that happened 322 00:11:27,735 --> 00:11:28,475 to the UnitedHealthcare 323 00:11:28,934 --> 00:11:29,434 CEO. 324 00:11:29,949 --> 00:11:32,129 Well, that person who committed that atrocity, 325 00:11:32,589 --> 00:11:34,750 that person was on what was on what's 326 00:11:34,750 --> 00:11:37,730 called a pathway to intended violence. 327 00:11:38,190 --> 00:11:40,269 So now what I always recommend is you 328 00:11:40,269 --> 00:11:42,129 need to have a multidisciplinary 329 00:11:43,070 --> 00:11:47,245 behavioral threat assessment team who focuses on people 330 00:11:47,245 --> 00:11:50,465 who could be on a pathway to intended 331 00:11:51,004 --> 00:11:54,304 violence. People who are giving pre incident indicators 332 00:11:54,605 --> 00:11:56,865 or they're exhibiting behaviors of concern 333 00:11:57,330 --> 00:11:58,930 Because we know, and this is a horrible 334 00:11:58,930 --> 00:12:01,809 statistic, that fifty four percent of all active 335 00:12:01,809 --> 00:12:04,870 shooters start with what? They start with domestic 336 00:12:05,250 --> 00:12:07,090 violence. And we know when we look at 337 00:12:07,090 --> 00:12:09,830 the other parts, it's an adverse employment action. 338 00:12:09,970 --> 00:12:11,889 And we know that the vast majority of 339 00:12:11,889 --> 00:12:13,384 times, they will exhibit 340 00:12:13,685 --> 00:12:16,725 pre incident indicators. And I'll never forget, I 341 00:12:16,725 --> 00:12:18,965 was talking about this in front of about 342 00:12:18,965 --> 00:12:20,985 40 nurses. I was explaining 343 00:12:21,445 --> 00:12:24,245 behaviors of concern. And Scott, there was a 344 00:12:24,245 --> 00:12:26,009 nurse in the back and she was crying. 345 00:12:26,570 --> 00:12:28,570 And her manager was rubbing her back, and 346 00:12:28,570 --> 00:12:30,190 I I walked up at the end of 347 00:12:30,330 --> 00:12:32,570 the presentation. And I said, you know, was 348 00:12:32,570 --> 00:12:35,610 the presentation that bad? And her manager said 349 00:12:35,610 --> 00:12:36,110 no. 350 00:12:36,730 --> 00:12:39,210 The problem is that her husband, her soon 351 00:12:39,210 --> 00:12:40,990 to be ex husband, is exhibiting 352 00:12:42,044 --> 00:12:44,205 everything you're talking about, every one of those 353 00:12:44,205 --> 00:12:47,105 pre incident indicators, and she's scared to death. 354 00:12:47,325 --> 00:12:49,004 Now let's think about that for a minute. 355 00:12:49,004 --> 00:12:50,304 That's a horrible tragedy. 356 00:12:50,764 --> 00:12:53,804 And is that nurse able to deliver good 357 00:12:53,804 --> 00:12:57,110 patient care? Absolutely not. She is not. So 358 00:12:57,110 --> 00:13:00,230 our job is to identify those behaviors of 359 00:13:00,230 --> 00:13:03,190 concern, but that would not start unless we 360 00:13:03,190 --> 00:13:05,350 build relationships with our staff so they can 361 00:13:05,350 --> 00:13:08,309 trust us. And it starts with that non 362 00:13:08,309 --> 00:13:09,769 traditional public safety, 363 00:13:10,164 --> 00:13:12,485 which goes to that process you talked about, 364 00:13:12,485 --> 00:13:14,745 which then goes to those pre incident indicators, 365 00:13:14,884 --> 00:13:18,004 which lets us disrupt that pathway to intended 366 00:13:18,004 --> 00:13:19,785 violence. It's all interrelated. 367 00:13:21,445 --> 00:13:23,285 Thank you so much. And and talk about 368 00:13:23,285 --> 00:13:25,065 this. Like, from your perspective, 369 00:13:25,899 --> 00:13:26,799 having that intelligence, 370 00:13:27,500 --> 00:13:28,639 whether it's on a 371 00:13:29,100 --> 00:13:32,059 patient who's got trouble or an employee who's 372 00:13:32,059 --> 00:13:34,059 got trouble or anybody who comes in the 373 00:13:34,059 --> 00:13:37,100 hospital that has trouble, how challenging is it 374 00:13:37,100 --> 00:13:38,959 to access some of that information 375 00:13:39,575 --> 00:13:41,654 that must be so out there in an 376 00:13:41,654 --> 00:13:42,714 AI world, 377 00:13:43,495 --> 00:13:45,414 but there must be privacy issues in how 378 00:13:45,414 --> 00:13:47,815 you access it? Because, like, you talked about 379 00:13:47,815 --> 00:13:50,075 the shooter of the United CEO, 380 00:13:50,695 --> 00:13:52,534 and people knew he was on the pathway 381 00:13:52,534 --> 00:13:53,735 to violence. He as much said he was 382 00:13:53,735 --> 00:13:55,409 on a pathway to violence, but trying to 383 00:13:55,409 --> 00:13:57,269 connect dots is so hard. 384 00:13:57,730 --> 00:13:58,789 Do we get to 385 00:13:59,169 --> 00:13:59,669 spot 386 00:14:00,049 --> 00:14:02,210 where it's easier to utilize different types of 387 00:14:02,210 --> 00:14:03,809 data to get a better sense of where 388 00:14:03,809 --> 00:14:04,789 we could have problems? 389 00:14:05,570 --> 00:14:08,575 Well, very good points because, obviously, we run 390 00:14:08,575 --> 00:14:10,335 it we run into all sorts of barriers 391 00:14:10,335 --> 00:14:14,174 because there's obviously law enforcement sensitive data that 392 00:14:14,174 --> 00:14:16,754 may not be easily easily accessible 393 00:14:18,335 --> 00:14:20,575 by people who were not actually in law 394 00:14:20,575 --> 00:14:21,075 enforcement. 395 00:14:21,450 --> 00:14:23,769 That's a key component right there, and that's 396 00:14:23,769 --> 00:14:26,490 why I always recommend to the critical access 397 00:14:26,490 --> 00:14:26,990 hospitals, 398 00:14:27,610 --> 00:14:29,149 build that relationship 399 00:14:29,610 --> 00:14:31,870 with your local police department, 400 00:14:32,250 --> 00:14:34,429 have them in when times are good, 401 00:14:34,889 --> 00:14:36,884 have them sit down for coffee so that 402 00:14:36,965 --> 00:14:39,044 in the event there's a critical incident, I 403 00:14:39,044 --> 00:14:41,625 can call police officer Scott up and say, 404 00:14:41,764 --> 00:14:44,085 Scott, I have a problem. I I have 405 00:14:44,085 --> 00:14:46,424 a person who's exhibiting behaviors of concern. 406 00:14:46,804 --> 00:14:49,285 Can you come over and help me? And 407 00:14:49,285 --> 00:14:50,009 that is 408 00:14:50,330 --> 00:14:52,669 key. And then the second key is understanding, 409 00:14:53,129 --> 00:14:55,769 and this is really, taking making headway now 410 00:14:55,769 --> 00:14:57,950 in The United States. It's a trauma 411 00:14:58,330 --> 00:14:58,830 informed 412 00:14:59,450 --> 00:15:00,910 care approach. Meaning, 413 00:15:01,370 --> 00:15:04,845 I need to understand what is Scott's background? 414 00:15:05,465 --> 00:15:08,184 What trauma has he been exposed to? Because 415 00:15:08,184 --> 00:15:10,365 the last thing I wanna do is retraumatize 416 00:15:10,904 --> 00:15:12,925 Scott. So if I can respectfully 417 00:15:13,305 --> 00:15:15,785 understand what is your background? What is it 418 00:15:15,865 --> 00:15:18,299 what have you experienced, and how can I 419 00:15:18,299 --> 00:15:20,559 relate to that, and how can I adjust 420 00:15:20,620 --> 00:15:21,360 my care 421 00:15:21,740 --> 00:15:22,879 to more respectfully 422 00:15:23,419 --> 00:15:25,839 support you and your family 423 00:15:26,139 --> 00:15:27,120 and understand 424 00:15:27,580 --> 00:15:29,519 what differences we may have? 425 00:15:29,865 --> 00:15:31,625 That way, I can make sure I don't 426 00:15:31,625 --> 00:15:32,125 retraumatize 427 00:15:32,504 --> 00:15:33,965 you and perhaps 428 00:15:34,345 --> 00:15:36,985 not cause you to escalate into some type 429 00:15:36,985 --> 00:15:37,644 of violence. 430 00:15:38,825 --> 00:15:41,144 Thank you. When you look at this year 431 00:15:41,144 --> 00:15:42,044 coming up, 432 00:15:42,579 --> 00:15:45,720 what's the biggest priority this year in 2026? 433 00:15:46,980 --> 00:15:49,700 Our big our biggest focus at Michigan Medicine 434 00:15:49,700 --> 00:15:52,820 is is really threefold. Number one, building our 435 00:15:52,820 --> 00:15:55,894 behavioral threat assessment and management teams 436 00:15:56,274 --> 00:15:57,575 at all of our hospitals 437 00:15:58,034 --> 00:15:59,174 using that multidisciplinary 438 00:15:59,955 --> 00:16:00,455 approach 439 00:16:00,835 --> 00:16:01,575 to help 440 00:16:02,034 --> 00:16:04,195 support people who may be on a pathway 441 00:16:04,195 --> 00:16:07,394 to an intended violence. That's number one. Number 442 00:16:07,394 --> 00:16:07,894 two 443 00:16:08,269 --> 00:16:09,809 is developing training 444 00:16:10,190 --> 00:16:11,009 in collaboration 445 00:16:11,389 --> 00:16:13,330 with our nurse educators 446 00:16:13,710 --> 00:16:16,750 that reduces both risk and anxiety of our 447 00:16:16,750 --> 00:16:18,910 staff. And I always tell people, you can 448 00:16:18,910 --> 00:16:20,290 build it in house. 449 00:16:20,669 --> 00:16:22,269 All you need is two things. You need 450 00:16:22,269 --> 00:16:23,410 people who care 451 00:16:23,714 --> 00:16:25,875 and people who are creative. And I guarantee 452 00:16:25,875 --> 00:16:27,875 you, I don't care what hospital you go 453 00:16:27,875 --> 00:16:30,434 to in The US, there's somebody out there 454 00:16:30,434 --> 00:16:33,794 that is very caring and very creative. Otherwise, 455 00:16:33,794 --> 00:16:35,014 they would not be in healthcare. 456 00:16:35,394 --> 00:16:36,294 And then finally, 457 00:16:36,870 --> 00:16:41,110 using technology that actually reduces risk. And that 458 00:16:41,110 --> 00:16:43,850 people talk about weapons detection or metal detectors. 459 00:16:44,230 --> 00:16:47,029 Yep. They they do have benefit, but there's 460 00:16:47,029 --> 00:16:49,210 other technology like we talked about before. 461 00:16:49,654 --> 00:16:50,875 Cameras with analytics 462 00:16:51,335 --> 00:16:52,794 that can focus on identifying 463 00:16:53,174 --> 00:16:55,434 that threat level, making sure that we have 464 00:16:55,735 --> 00:16:56,715 access control 465 00:16:57,174 --> 00:16:59,894 so that there's an on stage and an 466 00:16:59,894 --> 00:17:03,279 off stage presence, meaning your waiting room where 467 00:17:03,279 --> 00:17:05,539 it's on stage, but there's access control 468 00:17:05,920 --> 00:17:08,160 to get back to your clinical areas because 469 00:17:08,160 --> 00:17:10,559 that's your offstage area. So those are really 470 00:17:10,559 --> 00:17:13,299 our three areas that we're focused on. 471 00:17:15,599 --> 00:17:17,680 Fantastic. And and just one more question for 472 00:17:17,680 --> 00:17:20,075 you, Brian. You've had this great leadership career. 473 00:17:20,075 --> 00:17:21,514 We'll ask you first, I'll ask you the 474 00:17:21,514 --> 00:17:23,694 the tough question. The tough question is this. 475 00:17:24,954 --> 00:17:27,534 Have you become a University of Michigan fan? 476 00:17:27,754 --> 00:17:29,674 Were you always a University of Michigan fan, 477 00:17:29,674 --> 00:17:30,575 or do you 478 00:17:31,034 --> 00:17:32,880 avoid that like like the plague? 479 00:17:33,759 --> 00:17:35,440 Well, I will tell you this. So my 480 00:17:35,440 --> 00:17:38,000 wife's from Michigan State University, graduated from there, 481 00:17:38,000 --> 00:17:39,839 so I can't even talk about it. I 482 00:17:39,839 --> 00:17:40,980 can just tell you this. 483 00:17:41,359 --> 00:17:43,440 I was never, nor would I ever be 484 00:17:43,440 --> 00:17:45,440 smart enough to get into the University of 485 00:17:45,440 --> 00:17:47,954 Michigan. In fact, my claim to fame is 486 00:17:48,194 --> 00:17:50,674 every meeting that I go to at the 487 00:17:50,674 --> 00:17:52,214 University of Michigan Health System, 488 00:17:52,674 --> 00:17:54,934 they are some of the smartest people 489 00:17:55,315 --> 00:17:57,474 I have ever met in my life. And 490 00:17:57,474 --> 00:17:59,554 I can honestly say that I am always 491 00:17:59,554 --> 00:18:01,634 the dumbest guy in the room, and I'm 492 00:18:01,634 --> 00:18:03,000 just honored to be there. 493 00:18:03,559 --> 00:18:05,240 Well, you're you're you're a good man and 494 00:18:05,240 --> 00:18:08,039 no no better put than saying it somewhat 495 00:18:08,039 --> 00:18:10,279 like that, especially with the wife who's a 496 00:18:10,279 --> 00:18:12,700 Spartan and you're a Western Michigan guy. 497 00:18:13,000 --> 00:18:14,700 We get it. Well stated. 498 00:18:15,720 --> 00:18:18,539 Last question. You've had this great leadership career 499 00:18:18,944 --> 00:18:21,345 regardless of that tremendous humility even though you're 500 00:18:21,345 --> 00:18:22,884 really bright and just fantastic. 501 00:18:23,345 --> 00:18:25,184 Talk for a second about any advice you 502 00:18:25,184 --> 00:18:27,424 would give to emerging leaders generally on the 503 00:18:27,424 --> 00:18:28,565 public safety field. 504 00:18:29,265 --> 00:18:31,184 Yes. Absolutely. And I'm gonna give you a 505 00:18:31,184 --> 00:18:31,924 quick story. 506 00:18:32,384 --> 00:18:33,204 My first 507 00:18:33,585 --> 00:18:36,860 day as a sergeant in Kalamazoo Public Safety, 508 00:18:37,160 --> 00:18:39,100 my first time ever being alone, 509 00:18:39,559 --> 00:18:40,940 my first call 510 00:18:41,240 --> 00:18:43,799 was a garage that was on fire attached 511 00:18:43,799 --> 00:18:44,539 to a house. 512 00:18:44,840 --> 00:18:46,680 I was the first one there, Scott. I 513 00:18:46,680 --> 00:18:49,275 was scared to death. There were flames everywhere. 514 00:18:49,275 --> 00:18:51,355 It was starting to burn the house and 515 00:18:51,355 --> 00:18:52,974 the garage was fully involved 516 00:18:53,434 --> 00:18:55,755 and the fire truck pulled up and I 517 00:18:55,755 --> 00:18:57,755 was in charge of the person on the 518 00:18:57,755 --> 00:18:59,434 fire truck, but he knew more. He'd been 519 00:18:59,434 --> 00:19:01,134 there longer. He was more experienced. 520 00:19:01,509 --> 00:19:02,789 And I looked at him, and his name 521 00:19:02,789 --> 00:19:04,250 was Dave Toth. I said, Dave. 522 00:19:04,710 --> 00:19:07,349 I said, we need to connect to the 523 00:19:07,349 --> 00:19:09,750 fire hydrant to get more water. He said, 524 00:19:09,750 --> 00:19:10,250 Brian, 525 00:19:10,710 --> 00:19:13,029 that is the wrong decision. We need to 526 00:19:13,029 --> 00:19:14,390 put on our gear. We need to climb 527 00:19:14,390 --> 00:19:16,150 in the living room to stop the fire 528 00:19:16,150 --> 00:19:18,845 from getting into the into the house. So 529 00:19:18,845 --> 00:19:20,444 I said, you know what? That's a lot 530 00:19:20,444 --> 00:19:22,444 better idea. So we did it, and we 531 00:19:22,444 --> 00:19:23,424 saved the house. 532 00:19:23,804 --> 00:19:25,744 And I walked away. I was mortified. 533 00:19:26,684 --> 00:19:28,764 I was like, my first day, my first 534 00:19:28,764 --> 00:19:31,105 decision, my first call, and it was wrong. 535 00:19:31,244 --> 00:19:33,184 But, Scott, what I learned from that 536 00:19:33,509 --> 00:19:35,369 is three things. Number one, 537 00:19:36,150 --> 00:19:37,289 create a culture 538 00:19:37,750 --> 00:19:41,049 where your staff feel free to disagree. 539 00:19:41,509 --> 00:19:44,490 Number two, always ask for help. 540 00:19:44,869 --> 00:19:47,589 Always ask for advice. And number three, always 541 00:19:47,589 --> 00:19:48,089 remember 542 00:19:48,525 --> 00:19:51,585 the next person on scene of any situation, 543 00:19:52,205 --> 00:19:53,424 any critical incident 544 00:19:53,884 --> 00:19:56,445 always has a better idea because they don't 545 00:19:56,445 --> 00:19:59,184 have tunnel vision. And that's my leadership advice. 546 00:20:00,125 --> 00:20:01,184 That is literally 547 00:20:01,619 --> 00:20:02,119 brilliant. 548 00:20:02,660 --> 00:20:05,640 Brian, I love that. Again, we're fortunate today 549 00:20:06,019 --> 00:20:08,359 to to get to visit with Brian Urich, 550 00:20:08,819 --> 00:20:11,460 department of public safety at the University of 551 00:20:11,460 --> 00:20:11,960 Michigan. 552 00:20:12,980 --> 00:20:13,480 Brian, 553 00:20:14,019 --> 00:20:15,940 remind me of the exact title for our 554 00:20:15,940 --> 00:20:17,355 audience, if you don't mind. 555 00:20:18,394 --> 00:20:20,714 I'm the senior director for public safety and 556 00:20:20,714 --> 00:20:21,214 security 557 00:20:21,674 --> 00:20:23,535 for University of Michigan 558 00:20:23,914 --> 00:20:24,654 health system. 559 00:20:25,434 --> 00:20:27,835 Fantastic. It is really a pleasure to visit 560 00:20:27,835 --> 00:20:28,474 with you. 561 00:20:28,954 --> 00:20:32,335 You've also got several educational degrees and certificates. 562 00:20:32,720 --> 00:20:34,099 You're a lifelong learner, 563 00:20:34,480 --> 00:20:37,599 constant improvement person. Brian, fantastic to visit with 564 00:20:37,599 --> 00:20:40,079 you today on the Becker's Healthcare podcast. Thank 565 00:20:40,079 --> 00:20:42,420 you so much for joining us. Thank you.