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.

I'm Bill Klaproth. On this podcast, another healthcare risk professional journey, as we talk with Josh Hyatt, Director Risk Education and Strategy at MedIQ, and an adjunct professor at Massachusetts College of Pharmacy and Health Sciences. Josh, welcome to the Podcast.

Josh Hyatt, DHS, MBE, MHL, DFASHRM, CPHRM, CPPS, HEC-C: Hey Bill, thanks for having me. Appreciate it.

Host: Yeah, great to talk with you. So Josh, let's start off by hearing about you. Tell us, how did you get into risk management?

Josh Hyatt, DHS, MBE, MHL, DFASHRM, CPHRM, CPPS, HEC-C: Oh goodness gracious. I got into risk probably in the mid 90s. It was about 94, 95. I was actually working in the mental health field and in that arena, I was able to start looking through different opportunities. And one came across my desk, which was this interesting field of risk management and quality and I didn't know anything about it.

So I was able to go and take some courses. It was like a one at one day on a Saturday for six months and got my initial licensure in Florida, which at the time was the only place that you did licensure. And that's kind of how I started moving into risk management and I loved it and stayed in it.

Host: So what intrigued you about risk management? What made you think, you know, that sounds interesting. I'm going to go and take this course.

Josh Hyatt, DHS, MBE, MHL, DFASHRM, CPHRM, CPPS, HEC-C: Yeah, it was kind of cool because it was covering topics that I didn't really know much about. I was, I had started kind of in the clinical inpatient psychiatric setting and then I moved into more of an administrative and operational role. And the curriculum was kind of what first caught my attention.

It was looking at things cause I didn't know what risk management was. I'd never heard of that term before. But it was looking at patient safety and it was looking around compliance and legal regulatory stuff. And these were kind of things in quality, these were things that were kind of interesting to me, but I didn't really know much about.

And so I felt this would be a great opportunity to go dive in and learn more about what all of that means.

Host: So did you stay in Florida then for a while, or did you look for work elsewhere?

Josh Hyatt, DHS, MBE, MHL, DFASHRM, CPHRM, CPPS, HEC-C: Both. I was in Florida for quite some time. I worked in risk for a while, but shortly after I became a risk manager, actually, I got a job as a surveyor for the state of Florida and I worked going into nursing homes and hospitals to survey them for compliance purposes. I was only about 24 when I got the job and the reason I got the job was actually because of my risk management certification.

There was a requirement at the time that hospitals had to have what were called code 15 surveys in Florida and in order to do those you had to be a risk manager. You had this license and they did not have a lot of applicants or any applicants other than me that had this licensure opportunity.

So I was able to get a really cool job and was able to apply my risk management skills then. I did some risk management in Texas. I moved to California. And then I did some risk management there and now I'm now in Massachusetts and I've done some risk management work here. So kind of bounce around.

Host: So you've kind of been all over. So tell me, what is it that you love about risk management?

Josh Hyatt, DHS, MBE, MHL, DFASHRM, CPHRM, CPPS, HEC-C: Well, one of the greatest things about risk is that no one day is the same. It's constantly changing and evolving and you're learning new things. And I think that's something that really resonates for me. Because you're dealing with people that are sometimes in crisis, sometimes it's a very complicated situation and they don't know how to think through it.

So it's something that evolves and changes, and every time you're faced with a scenario, it's never the same scenario twice. Because there's different pieces and different elements to it. So you have to really kind of think through things and understand it all kind of works together. So for me, I really kind of like that 50,000 foot view of healthcare, and it helps me also provide help to those that need it when they need it.

Host: Yeah, that's interesting. So then, in your opinion, what qualities make someone a good risk manager?

Josh Hyatt, DHS, MBE, MHL, DFASHRM, CPHRM, CPPS, HEC-C: You have to be nimble. That's the first thing. And you have to be a lifelong learner. I always told, my team members, you know, I said, when you walk in the door, you have a plan as to what your day is going to look like. And that never happens. And you have to be able to adjust to things and be open to learning new things.

So, those are kind of those qualities that I think are really important for risk managers to be able to really hold on to. And you also have to be a change maker. You have to be able to create environments where people feel safe talking to you and also, environments where you're able to be innovative and think through things in different and new ways.

As I said, situations are always unique, so it's best to be able to think through things innovatively and know that things are going to not always turn out the way you think they are or they should, but be able to create change and think through that with people.

Host: So Josh, you're very tenured in this career. What would your advice be to someone early on in their risk management career?

Josh Hyatt, DHS, MBE, MHL, DFASHRM, CPHRM, CPPS, HEC-C: Well, so what's interesting about risk management, and a lot of people ask me this, like, well, what does a risk manager do? What is a risk manager? And I tell them, I have no idea. I've been doing this long enough to know that a risk manager is not one thing. A risk manager is many things to many places in different circumstances.

And so, if you are going in with the idea that this is a thing, it's really not. And so risk managers often touch so many different areas and so many different aspects of healthcare and patient care, that it's hard to really nail down what it is. What you do in as a risk manager in one hospital, may be completely different than what you do as a risk manager in another hospital. And not all risk managers are clinicians. Some risk managers do finance, some do litigation, some do claims. So there's a broad brush of what risk management truly is. And for a new risk manager, finding what that means is really important because when you go into a new role as a risk manager, you are only a risk manager in that one place.

And what you're doing there may not translate over to other people. So keeping your mind open, learning about the field, learning about all the different principles and perspectives that come with it, really helps you grow as a professional. And it helps you think through kind of the different ways of approaching stuff because you may be thinking of something from a nursing perspective, if that's your primary position or your primary education is in nursing, but there are also legal elements. There are ethical elements. There are insurance elements. There are so many different pieces of the pie when you're dealing with just one situation, that it's really important to remember to be diversified in how you think through complex issues and that you're going to have a lot of people that you're going to need to address and talk to in different ways.

So, I would say as a new risk manager, just learn about the field. Learn about the breadth of the field. And get engaged with all of those other pieces and be collaborative. Because the worst thing that a risk manager can do is be in a silo. And think that their one way is the one way and the only way. And that is absolutely a recipe for disaster.

Host: Well, that's where the listening comes in, opening your mind, hearing other perspectives, viewpoints, what other people think. So, Josh, was there someone that made a difference in your career when you were coming up? Did you have a mentor that you learned from?

Josh Hyatt, DHS, MBE, MHL, DFASHRM, CPHRM, CPPS, HEC-C: That's a really great question. And I would say there's a lot. There's a lot of people that I learned from throughout my career. And because as a risk manager or in any profession, you're at different levels at different points, right? You start off as a novice and you become more of an expert and then you can kind of be in that subject matter expert level.

So where you are, I think, you will have different mentors in those different spaces. When I was first starting out in risk, my mentors really weren't risk managers. They were other people that were teaching me about health care and health systems like dieticians and nurses and physicians and environmental people.

They really taught me and mentored me through the stuff that I had no idea that I needed to know. And as I became a more seasoned risk manager and got into executive level positions, I had mentors at those levels that really taught me the importance of strategic thinking and how to get big projects and initiatives done.

So, and I have risk, you know, I'm considered now a subject matter expert. And I have people that I reach out to sometimes on a weekly, a monthly basis and just bounce ideas off of. Those are mentors for me. So I guess I can't say that there's one. There's been a lot and there are currently quite a few.

Host: And I would imagine at this stage there are people now that you are mentoring.

Josh Hyatt, DHS, MBE, MHL, DFASHRM, CPHRM, CPPS, HEC-C: I do my best. Yeah, I do. I work with a lot of risk managers and so, I would hope that some of them see me as a mentor. I've had students I teach one of the courses I've taught at the University is a doctoral class in patient safety and risk management. And I've actually had some of those students who are in ancillary professions like nursing and stuff, who have found that they love the class so much that they went into risk management or patient safety.

And in one case, she and I actually wrote a paper together that got published. So, I try to work with risk managers in a lot of different capacities. And I'm happy to mentor people. I'm open, always open to having people contact me and ask me questions. So.

Host: Yeah. And then, Josh, when and how did you first get involved with ASHRM?

Josh Hyatt, DHS, MBE, MHL, DFASHRM, CPHRM, CPPS, HEC-C: I got involved with ASHRM in the late 90s. That's when I took my CPHRM for the first time. And yes, the first time I did have to take it again because I let my certification lapse at a certain point, never do that. But yeah, so it was around then and I was in and out of kind of risk management as a profession.

I was doing different things like working as a surveyor or working in regulatory and accrediting compliance, but my fingers were always involved in risk in some way. About 2006, 7, I caught, basically went right back into risk management and have stayed in it consistently since then in different roles. But my initial work with ASHRM started, well, my initial engagement started in the late nineties.

Host: So that's a long time, a great relationship with ASHRM. So Josh, let me ask you this. Throughout your career, what's the biggest thing that you've learned being a risk manager?

Josh Hyatt, DHS, MBE, MHL, DFASHRM, CPHRM, CPPS, HEC-C: For me, the most important thing is humility because we, we all come to risk management from different paths and different approaches and different perspectives and different points of view. And I think humility is a skill that's really difficult for a risk manager sometimes to utilize because, and it's not because risk managers are by nature not humble, but what happens is people will come to you with concerns, questions, and they need answers.

And risk managers tend to be individuals who want to solve problems for people. And so we have to come at it strong. We have to give advice strong. That gives us credibility in our profession. It gives credibility for us as individual professionals, but we also need to be humble in that those responses, those approaches to the problem or, or, ways of solving a problem do come with a lot of our own internal bias, our own personal bias that comes from what we do and who we are, from our background.

So as risk is a second order profession, meaning that people start off in another field like nursing or what have you, and they end up in risk. And so, being humble and accepting that your perspective is valuable. It's important. It needs to be said. However, it also comes with a bias attached to it.

And to be open minded and have open conversations and then sit back and be self-reflective. Like, did I actually, give the best advice because there's a lot of trauma that comes with this kind of role. And I had a friend of mine who was a risk manager who actually said to me one time, she goes sometimes I feel crushed by the weight of my decisions or advice and it's because we want to do the right thing. We want to help people. We want to get to the right place, but we're not always going to be perfect. We're not always going to be right. And we have to have enough grace in ourselves and be humble with those that are around us to admit where we fall down and learn from that and move forward.

Host: Mm hmm. Great answer. I love that humble grace, humility. So, Josh, I'm just thinking, looking over the risk management profession, if you will, what are the biggest issues that are facing risk managers in health care, and how do we solve it?

Josh Hyatt, DHS, MBE, MHL, DFASHRM, CPHRM, CPPS, HEC-C: Well I can answer the first part. I'm not really sure I can answer the second as well. First, and this is my own bias, my own, my own belief, right, is culture. The culture in healthcare, it can be extraordinarily toxic. It's toxic to our coworkers.

It's toxic sometimes to our patients and it's toxic to ourselves as providers. There's no easy fix for that. There are lots of programs out there that are looking at culture, advancing culture, thinking ethically, those sorts of things, and they're all great, but it doesn't get sometimes to the heart of really what the problems are.

Because these are complex situations with complex personalities and complex motivating factors and they often times create a lot of problems. I think that's going to be the general problem for anybody in healthcare including the risk manager. There are other things like technology that we just don't understand. Things that we can't even predict, or what it's going to look like in two years, five years, and what we need to do today to preserve our institutions and protect our patients. Those are the two really big ones.

Host: Yeah, well said. A lot on your plate, and that problem solving will come in handy when dealing, as you say, with culture and technology. Certainly, two big issues for sure. Josh, this has been great learning about you and getting to know you a little bit better. As we wrap up, anything else you want to add about being a risk manager?

Josh Hyatt, DHS, MBE, MHL, DFASHRM, CPHRM, CPPS, HEC-C: No, I really appreciate the opportunity and the platform to talk about this profession that I love and have been involved with for most of my, well, all of my professional life. And I encourage those that are interested or are new in the field to keep learning more. You know, ASHRM has got tons of resources to go to.

There are boards that you can go to and ask questions and learn from and even find mentors on that are on the ASHRM site. So, go to the local ASHRM groups and meet people in your area and go to the conferences because it's, you have a wealth of opportunity to learn. Just keep learning. Don't get afraid. Don't back out. Just keep moving forward.

Host: Great advice for all of us. Just keep moving forward. Josh, thanks again. Really been great talking with you.

Josh Hyatt, DHS, MBE, MHL, DFASHRM, CPHRM, CPPS, HEC-C: I really appreciate it. Thanks so much, Bill.

Host: And once again, that is Josh Hyatt, and the ASHRM podcast was 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.

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