Selected Podcast
Actions Taken to Address Workplace Safety in a Public Safety Net Health Care Organization
This podcast will review actions taken beyond the required federal, state and accreditation standards to address workplace violence (WPV) through the use of the ERM Risk Assessment and incorporation into system strategic initiatives. Incorporating trauma informed care principles for addressing patient behaviors and supporting impacted workforce members.
Featuring:
Karen is also active in the American Society for Healthcare Risk Managers (ASHRM) where she is currently serving a second term as a member of the ASHRM Board of Managers. She has been active as national teaching faculty for the ASHRM and IHI for each organization's certification courses. She has been active on the IHI Workforce Safety and Well Being Workgroup where is an Advisory lead. She is a HRET Patient Safety Leadership Fellow (2008) and graduate of the Harvard Consortium Sr. Patient Safety Executive Leadership Course. Karen received the DFW Great 100 Award for Nurses in 2017, the 2019 Healthcare Risk Management Leadership Award from ASHRM in October 2019 and the Presidential Citation Award for ASHRM in October 2021.
Karen Garvey, MPA/HCA, BSN, DFASHRM, CPHRM, CPPS
Karen Garvey serves as the Vice President for Safety & Clinical Risk Management for Parkland Health in Dallas, Texas. Reporting to the Chief Quality & Safety Officer, her current responsibilities include health system oversight of Regulatory & Accreditation, Patient Safety and Clinical Risk Management, Quality & Safety Education, implementation of High Reliability principles. She serves as the Executive Sponsor of the SPARKs (Supporting Parkland Staff) Peer Support Program and is the Chairperson for Workforce Safety Initiatives involving proactive and reactive strategies to decrease violence against the workforce. She serves on local, state, and national committees collaborating to collectively address this significant issue. She is often requested to speaks in forums about various levels of work to address the issue.Karen is also active in the American Society for Healthcare Risk Managers (ASHRM) where she is currently serving a second term as a member of the ASHRM Board of Managers. She has been active as national teaching faculty for the ASHRM and IHI for each organization's certification courses. She has been active on the IHI Workforce Safety and Well Being Workgroup where is an Advisory lead. She is a HRET Patient Safety Leadership Fellow (2008) and graduate of the Harvard Consortium Sr. Patient Safety Executive Leadership Course. Karen received the DFW Great 100 Award for Nurses in 2017, the 2019 Healthcare Risk Management Leadership Award from ASHRM in October 2019 and the Presidential Citation Award for ASHRM in October 2021.
Transcription:
Bill Klaproth (Host): Welcome to the ASHRM Podcast, made possible by the American Society for Healthcare Risk Management to support efforts to advance safe and trusted healthcare through enterprise risk management. You can visit ASHRM.org, that's A-S-H-R-M.org/membership, to learn more and to become an ASHRM member. On this podcast, we'll be discussing actions taken to address workplace safety in a public safety net healthcare organization. Our guest today is Karen Garvey, Vice President for Safety and Clinical Risk Management at Parkland Health in Dallas, Texas.
Karen, thank you for your time. We really appreciate it. I feel that all of the topics that we do on the ASHRM podcast are really important. But when it comes to workplace safety, I do feel that this is one of the more important topics that we can discuss. So again, thank you for your time. So, first off, what is our system doing to address the escalating aggression towards our workplace?
Karen Garvey: Thank you, Bill. It's great to be here today. And I really appreciate the time to be able to talk about this pretty serious subject. Workplace violence has been around for many, many decades. In fact, many folks on the line may have been subject to it themselves. But the COVID pandemic has really escalated and brought this to the public forum where people are now seeing the violence inflicted upon our healthcare workers. But not only our healthcare workers, we have seen this in the airline industry with disruptive passengers being kicked off of airplanes, we have seen road rage. We've seen it just general public.
But going back to what we're doing in our organization, being a safety net facility, we're the place where patients go when other healthcare organizations won't see them because of lack of insurance or being undocumented. We've taken a firmer stance within the last year or so to really kind of hold patients accountable to the responsibilities as well as supporting their patient rights. And part of the responsibility is how they communicate and they behave and they participate in their care.
We've seen some patients that have come through our organization 60 times in a two-month period of time, which is almost one per day, almost for the same things. And we know as risk management folks that those individuals who are frequent faces in our organization can certainly be high risk to our organization because we may miss something when they're truly coming in for something that is significant. But we've actually done a lot of work here on how we're focusing on our workforce, what are we doing as part of our values and part of our strategic plan? In that, our workforce needs to be healthy to come to work and feel safe in coming to work in order for them to actually provide better care for our patients.
So, part of that is really ensuring that our physical environment is safe for them to come in. We recently did a third-party risk assessment for all of our buildings where we have business offices, whether they're clinic buildings or whether they're back office. Recently, we're just now dealing very lengthy report. But realizing that that is also going to provide us information that may correlate with where we have known gaps in the organization. And I can tell you that recently that information, I believe, went to our board, to have insight to. So, we do keep this information out in front. We know that know where people are being hurt and trying to then action around what we're doing in those departments to better make them feel safe. We're not unlike any other organizations, that our main emergency department, our behavioral health areas are the highest of reported events and they truly are, which also mirrors national data.
Parkland Health has been cited recently in Becker's as being the busiest standalone ED in the nation and has been just prior to COVID and recently after COVID, where we're doing anywhere between 210,000 and 250,000 visits a year. And again, we are a standalone hospital where we can see up to 800 patients in 24 hours, it's always busy. That exhaustion of the staff, of people seeing the repeat offenders coming into the organization that may have opportunities, they may have medical issues, but they also have coexisting behavioral health issues too, and how do we equip them? Because not all of these patients are staying in the ED or behavioral health. If they have a coexisting medical condition or surgical condition, they're going to go out onto the floor and the units too. And those individuals don't always have the same level of de-escalation training, although we're starting to equip them more on those units because these folks are everywhere now.
Bill Klaproth (Host): You bring up some great points, Karen. And certainly, Parkland Health being the busiest standalone ED, I bet you do see a lot of aggression within your hallways and hospital rooms. It just seems like unfortunately bad behavior is cascading around the country. So being that you do see a lot of aggression, a lot of bad behavior, you know, workplace safety is critical for you. Can you tell us how has Parkland Health emphasized workplace safety as part of your strategic plan? How have you worked that in?
Karen Garvey: That's a great question. As part of our enterprise risk management committee, we do risk assessments across the health system and we do one every other year. And for the last three risk assessments, the last one which was done for 2023, workplace violence has shown up in the top 10 elements where we actually take that information and move it into the strategic priorities.
One of the strategic priorities is looking at the physical safety, psychological safety and emotional safety of our workforce. And I happen to lead that work stream with some other folks, where we do have an enterprise-wide workplace violence committee that's been in existence since 2015. But we also have identified and worked in focused areas of the ED and behavioral health and the correctional health settings. So, we also cover our county jail, which houses about 6,000 inmates, so it's like a city in itself. And then, we also have one that's focused on our ambulatory surgery center. So, we're also looking at focused areas. Because of things that have been brought forward, the ambulatory surgery center, as an example, houses our pain clinic. And if we go back to the summer of the unfortunate incident in Tulsa, Oklahoma, where that physician was killed, that was in a pain management type area. So, we want to be able to learn from others where things are happening across the country and we work with folks to enhance their security measures in those areas.
Additionally, because of the strategic priority, we've been able to hire a workforce safety manager who has been driving a lot of our processes of policy change with our legal folks and many frontline workers in the organization through focus groups. But trying to come out of the reactive mode, we're proactively identifying these patients. Because I think we're all trying to figure out what's the best method, and I don't think that there's one secret sauce. But if we know that a patient is coming a police cruiser, that's handcuffed, that has been in a fight, it's highly likely they're going to be identified as being a violent individual. So, we actually have implemented a screening process for them as they come through the emergency department. And if they screen positive, through what we call the stamp screening tool, then there is an area of the medical record that is highlighted so that when these patients then go up to the floor, the units, this information is communicated as part of the handoff. And then, there's a sign that goes on the door to alert other healthcare workers who may not access the medical record, that there's somebody of potential violence in that room. And 50% of our employees don't access the medical record. It's phlebotomy, it's the dietary aid that delivers trays, it's the EVS worker. So, there are several other individuals. If I go up to a unit and I go to a patient's room, I don't necessarily have been in that patient's medical record to validate what's going on with them.
So, there's a lot of other things. But that safety sign has been something that has been identified as one of the strategic actions to get implemented, so that we're actually alerting folks proactively that somebody may be violent in that room.
Bill Klaproth (Host): Yeah, that's a smart way to alert someone that's walking in, not knowing of this individual, that this person may be violent, so that's a really good idea.
Karen Garvey: Yeah. So, we looked at implementing aggression order sets for individuals. We also have developed one of the policies again with engaging our frontline. We had 19 different focus groups as we realigned policies within our organization of workplace violence and some of the disruptive behavior. But we created a new policy. It was called Preserving the Environment of Care. And what does does is it allows leaders and staff to escalate concerns of patient behavior even after they've tried to deescalate the patient. And we're seeing aggression in person verbally, physically; through the electronic messaging, through myChart as an example; through event reports, workplace violence reports, police reports. So, we actually collate a lot of this information when somebody brings a case forward to us, and we evaluate the case. So, we, as a public safety net institution, have changed our philosophy where we will not discharge anybody from the system. We have changed the philosophy in that we will discharge you if you don't abide by patient responsibilities, as I had mentioned, in being a participant in their care, but also being respectful to the individuals who are providing that care. We launched those policies in November. And every month, we send out behavior letters, giving them the expectations of how they are to behave. Some of them scoff at them, but some of them have taken it and said, "Okay. Yes, I have to behave in certain ways when I'm here. And it's not just if I'm in as an inpatient, it's anywhere in the organization." That if they go to the pharmacy, they need to be cordial there. If they're in the emergency room, they need to be cordial there. If they're walking the hallways and going to a clinic, they need to be cordial there.
If we are going to move to discharge, we actually have a committee that's been convened and I'm the chairperson. But it has individuals like legal, behavioral health, the person who actually creates the cases and then we allow the local unit to actually have their say for a couple of minutes, but then we go through the objective data. And we pull in our behavioral health folks because they do the trauma screening.
Behaviors that are exhibited are many times because of trauma that the individual has experienced over time, only we're evaluating that patient based on what we see in front of us, not based on history. What I have learned and have been educated on is that, yes, the behavior is being exhibited because of trauma, but it is not an excuse. So, we're working these cases to understand the global view of the individual, but not excusing their behavior because they have an ability in most cases to be able to conform to expectations.
Bill Klaproth (Host): Right. So, you're setting those expectations right up front. And I also like how you said you were trying to get out of the reactive mode and getting into more of a proactive mode, so you understand the threat before encountering the individual. So, you also mentioned learning from others as well to put these policies into place. Can you talk about engaging the frontline and middle management, how you engaged with them, listened to them to put this policy in place and the process development of that?
Karen Garvey: Yes, absolutely. So, we engage 19 different focus groups from across the health system, so whether it was in a clinic setting, inpatient setting, operations versus clinical, back office because certainly registrars who work in patient financial services may have interactions with patients that are not optimal. We had an opportunity last spring to go to our CMS folks because it was a high utilizer of our services and the patient kind of wanted to live here. So, we put together a timeline and again, being a safety net organization, we ran out opportunities and we needed help. We presented the case. The CMS folks gave us guidance back and we took that guidance and we went and implemented it. So, we actually reached out to them, letting them know that, "Yes, we are the safety net hospital, but we are often taking a stance on violence in our organization. And we would like to let you know that we are going to be terminating patients from our system if they are not abiding by the expectations and have an ability to do so." And they said, "You know what? We can't read your policy. We can't give you guidance, but we understand and go forth." We have since terminated three patients from our system.
Now, we give them plenty of warning. And the process is it goes through our Preserving the Environment of Care Committee to review. And ultimately, the outcome of that meeting is sent to our chief medical officer and chief nursing executive to actually weigh in. And the chief medical officer is actually the person who, if he supports it, he will write the discharge order, and he works with the physicians involved.
There's been lot more activity around just the behavioral letters and the cases that are coming forward, that we're going to have more work than we can handle, because we haven't done a really good job of enforcing the responsibility component along with the patient rights component. So, we're moving as quickly as we can, but we're also being very judicious and learning of how we actually approach the patients in a trauma-informed way, that the messaging is firm and well understood, but also taking into account the history that got them to be the way that they're behaving.
Bill Klaproth (Host): So as we wrap up, Karen, thank you so much for your time and sharing your story of what you're doing at Parkland Health. We really appreciate that. Is there anything else we should know? Anything else we left out? Anything you want to add when it comes to addressing workplace safety?
Karen Garvey: I think that the one thing is that it's so important to focus on our workforce, our employees, and really take care of them. They know that they're feeling protected and secure and know that people will support them. I think that they will go the extra mile and what they need to do to take care of our patients.
Bill Klaproth (Host): I think that is really well said. Make sure you focus on the workforce and make sure that they know that you are taking care of them and that they're feeling protected and secure and that people will support them. I think that's very well said and a good message for all of us. So, thank you so much, Karen. And we really appreciate your time today and all the good work that you're doing there at Parkland Health. So, thank you again. We appreciate it.
Karen Garvey: Thank you so much, Bill. I appreciate it.
Bill Klaproth (Host): And once again, that's Karen Garvey. And for more information, please visit jointcommission.org. The ASHRM Podcast has been made possible by the American Society for Healthcare Risk Management to support efforts to advance safe and trusted healthcare through enterprise risk management. You can visit ASHRM.org/membership to learn more and to become an ASHRM member. And if you found this podcast helpful, please share it on your social channels and check out the full podcast library for topics of interest to you. I'm Bill Klaproth. Thanks for listening.
And we'd like to thank health stream.
And we'd like to thank health stream for sponsoring this episode.
Welcome to the ashram podcast made possible by the American society for healthcare risk management. To support efforts to advance safe and trusted healthcare through enterprise risk management. You can visit Ash room.org. That's a S H R m.org/membership to learn more and to become an Ash firm member and we'd like to thank health stream for sponsoring this episode. I'm bill clapper, auth.
Bill Klaproth (Host): Welcome to the ASHRM Podcast, made possible by the American Society for Healthcare Risk Management to support efforts to advance safe and trusted healthcare through enterprise risk management. You can visit ASHRM.org, that's A-S-H-R-M.org/membership, to learn more and to become an ASHRM member. On this podcast, we'll be discussing actions taken to address workplace safety in a public safety net healthcare organization. Our guest today is Karen Garvey, Vice President for Safety and Clinical Risk Management at Parkland Health in Dallas, Texas.
Karen, thank you for your time. We really appreciate it. I feel that all of the topics that we do on the ASHRM podcast are really important. But when it comes to workplace safety, I do feel that this is one of the more important topics that we can discuss. So again, thank you for your time. So, first off, what is our system doing to address the escalating aggression towards our workplace?
Karen Garvey: Thank you, Bill. It's great to be here today. And I really appreciate the time to be able to talk about this pretty serious subject. Workplace violence has been around for many, many decades. In fact, many folks on the line may have been subject to it themselves. But the COVID pandemic has really escalated and brought this to the public forum where people are now seeing the violence inflicted upon our healthcare workers. But not only our healthcare workers, we have seen this in the airline industry with disruptive passengers being kicked off of airplanes, we have seen road rage. We've seen it just general public.
But going back to what we're doing in our organization, being a safety net facility, we're the place where patients go when other healthcare organizations won't see them because of lack of insurance or being undocumented. We've taken a firmer stance within the last year or so to really kind of hold patients accountable to the responsibilities as well as supporting their patient rights. And part of the responsibility is how they communicate and they behave and they participate in their care.
We've seen some patients that have come through our organization 60 times in a two-month period of time, which is almost one per day, almost for the same things. And we know as risk management folks that those individuals who are frequent faces in our organization can certainly be high risk to our organization because we may miss something when they're truly coming in for something that is significant. But we've actually done a lot of work here on how we're focusing on our workforce, what are we doing as part of our values and part of our strategic plan? In that, our workforce needs to be healthy to come to work and feel safe in coming to work in order for them to actually provide better care for our patients.
So, part of that is really ensuring that our physical environment is safe for them to come in. We recently did a third-party risk assessment for all of our buildings where we have business offices, whether they're clinic buildings or whether they're back office. Recently, we're just now dealing very lengthy report. But realizing that that is also going to provide us information that may correlate with where we have known gaps in the organization. And I can tell you that recently that information, I believe, went to our board, to have insight to. So, we do keep this information out in front. We know that know where people are being hurt and trying to then action around what we're doing in those departments to better make them feel safe. We're not unlike any other organizations, that our main emergency department, our behavioral health areas are the highest of reported events and they truly are, which also mirrors national data.
Parkland Health has been cited recently in Becker's as being the busiest standalone ED in the nation and has been just prior to COVID and recently after COVID, where we're doing anywhere between 210,000 and 250,000 visits a year. And again, we are a standalone hospital where we can see up to 800 patients in 24 hours, it's always busy. That exhaustion of the staff, of people seeing the repeat offenders coming into the organization that may have opportunities, they may have medical issues, but they also have coexisting behavioral health issues too, and how do we equip them? Because not all of these patients are staying in the ED or behavioral health. If they have a coexisting medical condition or surgical condition, they're going to go out onto the floor and the units too. And those individuals don't always have the same level of de-escalation training, although we're starting to equip them more on those units because these folks are everywhere now.
Bill Klaproth (Host): You bring up some great points, Karen. And certainly, Parkland Health being the busiest standalone ED, I bet you do see a lot of aggression within your hallways and hospital rooms. It just seems like unfortunately bad behavior is cascading around the country. So being that you do see a lot of aggression, a lot of bad behavior, you know, workplace safety is critical for you. Can you tell us how has Parkland Health emphasized workplace safety as part of your strategic plan? How have you worked that in?
Karen Garvey: That's a great question. As part of our enterprise risk management committee, we do risk assessments across the health system and we do one every other year. And for the last three risk assessments, the last one which was done for 2023, workplace violence has shown up in the top 10 elements where we actually take that information and move it into the strategic priorities.
One of the strategic priorities is looking at the physical safety, psychological safety and emotional safety of our workforce. And I happen to lead that work stream with some other folks, where we do have an enterprise-wide workplace violence committee that's been in existence since 2015. But we also have identified and worked in focused areas of the ED and behavioral health and the correctional health settings. So, we also cover our county jail, which houses about 6,000 inmates, so it's like a city in itself. And then, we also have one that's focused on our ambulatory surgery center. So, we're also looking at focused areas. Because of things that have been brought forward, the ambulatory surgery center, as an example, houses our pain clinic. And if we go back to the summer of the unfortunate incident in Tulsa, Oklahoma, where that physician was killed, that was in a pain management type area. So, we want to be able to learn from others where things are happening across the country and we work with folks to enhance their security measures in those areas.
Additionally, because of the strategic priority, we've been able to hire a workforce safety manager who has been driving a lot of our processes of policy change with our legal folks and many frontline workers in the organization through focus groups. But trying to come out of the reactive mode, we're proactively identifying these patients. Because I think we're all trying to figure out what's the best method, and I don't think that there's one secret sauce. But if we know that a patient is coming a police cruiser, that's handcuffed, that has been in a fight, it's highly likely they're going to be identified as being a violent individual. So, we actually have implemented a screening process for them as they come through the emergency department. And if they screen positive, through what we call the stamp screening tool, then there is an area of the medical record that is highlighted so that when these patients then go up to the floor, the units, this information is communicated as part of the handoff. And then, there's a sign that goes on the door to alert other healthcare workers who may not access the medical record, that there's somebody of potential violence in that room. And 50% of our employees don't access the medical record. It's phlebotomy, it's the dietary aid that delivers trays, it's the EVS worker. So, there are several other individuals. If I go up to a unit and I go to a patient's room, I don't necessarily have been in that patient's medical record to validate what's going on with them.
So, there's a lot of other things. But that safety sign has been something that has been identified as one of the strategic actions to get implemented, so that we're actually alerting folks proactively that somebody may be violent in that room.
Bill Klaproth (Host): Yeah, that's a smart way to alert someone that's walking in, not knowing of this individual, that this person may be violent, so that's a really good idea.
Karen Garvey: Yeah. So, we looked at implementing aggression order sets for individuals. We also have developed one of the policies again with engaging our frontline. We had 19 different focus groups as we realigned policies within our organization of workplace violence and some of the disruptive behavior. But we created a new policy. It was called Preserving the Environment of Care. And what does does is it allows leaders and staff to escalate concerns of patient behavior even after they've tried to deescalate the patient. And we're seeing aggression in person verbally, physically; through the electronic messaging, through myChart as an example; through event reports, workplace violence reports, police reports. So, we actually collate a lot of this information when somebody brings a case forward to us, and we evaluate the case. So, we, as a public safety net institution, have changed our philosophy where we will not discharge anybody from the system. We have changed the philosophy in that we will discharge you if you don't abide by patient responsibilities, as I had mentioned, in being a participant in their care, but also being respectful to the individuals who are providing that care. We launched those policies in November. And every month, we send out behavior letters, giving them the expectations of how they are to behave. Some of them scoff at them, but some of them have taken it and said, "Okay. Yes, I have to behave in certain ways when I'm here. And it's not just if I'm in as an inpatient, it's anywhere in the organization." That if they go to the pharmacy, they need to be cordial there. If they're in the emergency room, they need to be cordial there. If they're walking the hallways and going to a clinic, they need to be cordial there.
If we are going to move to discharge, we actually have a committee that's been convened and I'm the chairperson. But it has individuals like legal, behavioral health, the person who actually creates the cases and then we allow the local unit to actually have their say for a couple of minutes, but then we go through the objective data. And we pull in our behavioral health folks because they do the trauma screening.
Behaviors that are exhibited are many times because of trauma that the individual has experienced over time, only we're evaluating that patient based on what we see in front of us, not based on history. What I have learned and have been educated on is that, yes, the behavior is being exhibited because of trauma, but it is not an excuse. So, we're working these cases to understand the global view of the individual, but not excusing their behavior because they have an ability in most cases to be able to conform to expectations.
Bill Klaproth (Host): Right. So, you're setting those expectations right up front. And I also like how you said you were trying to get out of the reactive mode and getting into more of a proactive mode, so you understand the threat before encountering the individual. So, you also mentioned learning from others as well to put these policies into place. Can you talk about engaging the frontline and middle management, how you engaged with them, listened to them to put this policy in place and the process development of that?
Karen Garvey: Yes, absolutely. So, we engage 19 different focus groups from across the health system, so whether it was in a clinic setting, inpatient setting, operations versus clinical, back office because certainly registrars who work in patient financial services may have interactions with patients that are not optimal. We had an opportunity last spring to go to our CMS folks because it was a high utilizer of our services and the patient kind of wanted to live here. So, we put together a timeline and again, being a safety net organization, we ran out opportunities and we needed help. We presented the case. The CMS folks gave us guidance back and we took that guidance and we went and implemented it. So, we actually reached out to them, letting them know that, "Yes, we are the safety net hospital, but we are often taking a stance on violence in our organization. And we would like to let you know that we are going to be terminating patients from our system if they are not abiding by the expectations and have an ability to do so." And they said, "You know what? We can't read your policy. We can't give you guidance, but we understand and go forth." We have since terminated three patients from our system.
Now, we give them plenty of warning. And the process is it goes through our Preserving the Environment of Care Committee to review. And ultimately, the outcome of that meeting is sent to our chief medical officer and chief nursing executive to actually weigh in. And the chief medical officer is actually the person who, if he supports it, he will write the discharge order, and he works with the physicians involved.
There's been lot more activity around just the behavioral letters and the cases that are coming forward, that we're going to have more work than we can handle, because we haven't done a really good job of enforcing the responsibility component along with the patient rights component. So, we're moving as quickly as we can, but we're also being very judicious and learning of how we actually approach the patients in a trauma-informed way, that the messaging is firm and well understood, but also taking into account the history that got them to be the way that they're behaving.
Bill Klaproth (Host): So as we wrap up, Karen, thank you so much for your time and sharing your story of what you're doing at Parkland Health. We really appreciate that. Is there anything else we should know? Anything else we left out? Anything you want to add when it comes to addressing workplace safety?
Karen Garvey: I think that the one thing is that it's so important to focus on our workforce, our employees, and really take care of them. They know that they're feeling protected and secure and know that people will support them. I think that they will go the extra mile and what they need to do to take care of our patients.
Bill Klaproth (Host): I think that is really well said. Make sure you focus on the workforce and make sure that they know that you are taking care of them and that they're feeling protected and secure and that people will support them. I think that's very well said and a good message for all of us. So, thank you so much, Karen. And we really appreciate your time today and all the good work that you're doing there at Parkland Health. So, thank you again. We appreciate it.
Karen Garvey: Thank you so much, Bill. I appreciate it.
Bill Klaproth (Host): And once again, that's Karen Garvey. And for more information, please visit jointcommission.org. The ASHRM Podcast has been made possible by the American Society for Healthcare Risk Management to support efforts to advance safe and trusted healthcare through enterprise risk management. You can visit ASHRM.org/membership to learn more and to become an ASHRM member. And if you found this podcast helpful, please share it on your social channels and check out the full podcast library for topics of interest to you. I'm Bill Klaproth. Thanks for listening.
And we'd like to thank health stream.
And we'd like to thank health stream for sponsoring this episode.
Welcome to the ashram podcast made possible by the American society for healthcare risk management. To support efforts to advance safe and trusted healthcare through enterprise risk management. You can visit Ash room.org. That's a S H R m.org/membership to learn more and to become an Ash firm member and we'd like to thank health stream for sponsoring this episode. I'm bill clapper, auth.