How HealthPartners Built a Culture of Simulation Excellence

What happens when simulation breaks free from hospital walls and becomes embedded throughout an entire healthcare system? Ryan Aga and Don Brock reveal the remarkable transformation at Health Partners, where simulation has evolved from a training method into a life-saving force reaching 14,000 learners annually across eight hospitals, countless clinics, and even rural communities.

Their story unfolds through powerful examples of lives saved, including a cardiac arrest patient given just a 5% chance of survival who later thanked the simulation-trained team for allowing him to witness his grandson's birth. This isn't just about clinical skills—it's about creating a culture where simulation becomes woven into the organizational fabric, with their CEO personally sharing simulation success stories with hundreds of leaders.

Behind the numbers lies a deeply human approach. Don, a retired Air Force flight nurse turned simulation operations manager, brings mechanical precision to Ryan's visionary leadership. Together, they've built a program that reaches every corner of their system, from dental clinics to primary care offices now handling patients with acuity levels previously seen only in emergency departments. They're even building the future healthcare workforce through extensive youth programs in local schools.

The President's Award-winning team doesn't shy away from healthcare's harsh realities—the lingering trauma of the pandemic, financial constraints, and the sobering statistic that 250,000 Americans die annually from preventable medical errors. Their response? A fierce tenacity to improve, an openness to diverse perspectives (including hiring a biomedical engineer to bring fresh insights), and a deep commitment to supporting each other through healthcare's most challenging era.

Whether you're just beginning your simulation journey or looking to scale your existing program, this conversation offers both inspiration and practical wisdom from pioneers who've made simulation an essential, system-wide force for saving lives. Connect with Ryan and Don on LinkedIn to continue the conversation about transforming healthcare through simulation.

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Transcript

Introduction and Welcome

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The views and opinions expressed in this program are those of the speakers and do not necessarily reflect the opinions or positions of anyone at Innovative Sim Solutions or our sponsors.

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Welcome to The Sim Cafe, a podcast produced by the team at Innovative Sim Solutions, edited by Shelly Houser. Join our host Deb Tauber and co-host Jerrod Jeffries as they sit down with subject matter experts from across the globe to reimagine clinical education and the use of simulation. So pour yourself a cup of relaxation, sit back, tune in and learn something new from The Sim Cafe.

Deb Tauber 1:39

Welcome to another episode of The Sim Cafe. Today, Jerrod and I are here with Ryan, ga and Don Brock from Health Partners. So welcome, and I'll just give a little brief introduction. Ryan is the System Director of Clinical Simulation and Health Partners, which is a non-profit healthcare provider and health insurance company based in Bloomington, minnesota. In this role, he leads initiatives to enhance patient care through innovative simulation technologies and fosters a culture of continuous improvement within the organization. Thank you, ryan, and Don is an experienced healthcare professional currently serving as operations manager at Health Partners and throughout his career Don's had various roles and he served as a critical care flight nurse and trauma nurse with the United States Air Force and he served as a critical care flight nurse and trauma nurse with the United States Air Force.

Deb Tauber 2:28

So thank you for your service. Thank you, yeah, great.

Health Partners Simulation Journey

Ryan Aga 2:32

No, thanks, Deb, for having me A pleasure to join you and Jared on this episode. I just want to again thank you, Deb, for your years and years of convening simulationists across the globe, and Jared, your insight too. You're doing amazing work and I think in the midst of where we are in the world, convening people and bringing people together to hear a shared vision is so, so important. It keeps us grounded. So I just want to thank you, for you and Jared, for all the work that you're doing. It's very important. Thank you for you and Jared for all the work that you're doing. It's very important. And know, even within the simulation, you know community and world. There's everybody's like. Have you listened to the Sim Cafe recently? So you're well known and highly regarded. So thank you for having me Appreciate it.

Don Brock 3:17

I concur, thanks.

Deb Tauber 3:17

Ryan Don, you want to tell our listeners a little bit about you.

Don Brock 3:22

I can. I landed in this wonderful world of simulation because I got coerced out of retirement by Ryan Aga. I was kind of in the latter part of my career and trying to figure out what I wanted to do, and with no target in mind. I just finished another degree and I'm like I guess I want to get something for return on that and I landed here at the Health Partner Simulation Platform. I've been in this position for a couple of years now and it's work. It's rewarding work, it's fun.

Don Brock 3:50

Prior to that, I'm a, you know, like you mentioned, I'm a critical care trauma flight nurse, retired US Air Force. It's been 10 years this year since I retired and on my civilian side because that was all reserved I've been critical care and trauma ER nurse. I flew for a helicopter service for a while. I've done many different roles in education and training. I do tout that. I've been doing simulation for over 30 years because before it was really defined I was doing it in the military and it's just really amazing to find myself in this particular arena now and where I'm at and how we're defining and looking at the simulation and impacts that it has. So I'm just blessed to be here and looking forward to our conversation. Thank you.

Ryan Aga 4:35

And I'll dial back, just add in a little bit more context to myself. So I've been at Health Partners. It'll be 20 years this August. I'm an emergency nurse by background, so 17 of my 20 some years in emergency nursing. We're, at our level one pediatric and adult trauma center. And now I am coming up on my fifth year of being leading our simulation team and I think you know since my previous podcast on the Sim Cafe, it has really been buckle your seatbelts. I came in through the throes post-COVID of you know, into a team of only four staff member within four and a half years and have gone from 10,000 learner or simulation reaching 10,000 people or learners across our system and in our community now to 14,000 in 2024. It's just been an amazing team. It's been challenging, like Don talked about, we've had a lot of curveballs but we've had a lot of successes and I can't believe how five years has gone so quickly. But that's a little bit more about me, deb and Jared.

Jerrod Jeffries 5:54

Thank you, but Ryan, that's I mean. I just want to touch on that because that's a dramatic increase in a short amount of time. I mean, so one is 17. I mean, with 10 plus people in those many years. One, what are they focused on? And two, is it going deeper, Is it going wider? Both, yeah, Elaborate please.

Ryan Aga 6:19

Yeah, yeah, I think Don's correct, it's both. Our health system definitely is expanding, so growth is one of our strategic priorities for health partners. And then one integration of one system through our care group has been huge and blending that we've got multiple employers across our health partner system, employers across our health partner system and through more strategic alignment we're going to a one care group model. So all of OB service line, all of surgery service line through our eight hospitals is now becoming one and through that expansion is a part of that strategy. And so when I took the role over close to five years ago, that's what the first thing out of the chute was Become one simulation program across eight hospitals and then literally democratize them, expand simulation across our health system geographically and not just the health system but also into the community. So that has been more that outward. So really right now we're focused on Western and West Central Minnesota. We have two critical access hospitals out there Hutchinson Health and Olivia Hospital and Clinic, and that's where we're likely will be leading to a simulation platform out in that sector of our health system.

Ryan Aga 7:51

And then I'll note that Don fill in.

Ryan Aga 7:53

But really, as you say, up and down, that alignment is really being.

Ryan Aga 7:58

You said, Jerrod, what keeps people driven, it's the mission of preventing medical harm and quality and safety.

Expanding Reach Across Healthcare

Ryan Aga 8:08

And to look at the statistic in the United States regularly that we talked through our team about, it's 250,000 people in the United States are dying due to preventable medical error and there is just fierce tenacity of our team to keep aligned to that and to keep coming back, even despite just the massive amount of growth and the work that goes along with that. And I will say just to stay true to that, what we are, don and I are fiercely advocates for is bringing the stories back to the team of saves lives saved through simulation. And really, I'll say proudly, our CEO, Andrea Walsh, president and CEO of Health Partners, recently opened up to a leader, a team leader weekly update a leader, a team leader weekly update over 800 leaders and she brought the story of simulation and life saved. And so our highest ranking leader at Health Partners is bringing up the power and the utility of simulation to just massive amounts of people throughout the organization. So that's kind of the up and down and the across sort of stories.

Deb Tauber 9:27

Ryan, can you share that story? I'd love to hear it, I think our listeners would love to hear it.

Ryan Aga 9:33

So this is a really cool story. We have done numerous simulations with the cardiopulmonary rehab team at Regents Hospital. It's an offsite facility and we have for years have gone in there and done cardiac arrest simulations with that team. I will say I will attest that if you need to have a cardiac or have a cardiac event or an arrest, that is the team that you want to have your cardiac arrest with, because we have gone in there and have really not only shown the convergence of skill but the culture that simulation has been used to develop a wonderful team, dynamic culture has been developed. So we were in there about a month or two ago. We were doing again the same simulation and giving them different scenarios, simulation and giving them different scenarios.

Ryan Aga 10:29

And after the simulation our simulation education specialist, sue, noted that there was one of the evaluation forms that had a lot of handwritten writing and she was like oh no, either this is a good thing or this is a not so great thing as a simulation education specialist, right, or is it a lot of feedback?

Ryan Aga 10:45

Or is this good or bad as a simulation education specialist, right, or is it a lot of feedback, or is this good or bad?

Ryan Aga 10:51

And she went home and it was a cardiopulmonary rehab specialist that said I have never let you know this before, but about 13 years ago your team was here and I was here at that time and about a day or two later our team had a cardiac arrest out in our parking lot and it is because of what your team has done over and over for years and years that we were able to save the life of this patient and the patient arrested.

Ryan Aga 11:23

They got the patient transferred to our hospital regions and the patient ended up calling the cardiac rehab team back a week later and said thank you for saving my life and if the doctors gave me a 5% chance of coming out of this and you were able to save my life and you did and I was able to see my grandson born. So she took the time years later to share this story and said your team is continuing to do amazing work and I want to be thankful and wanted to express gratitude of what you did years ago. So we are now in the midst with our communications team of looking to link the patient, the staff, the SIM staff and the cardiopulmonary resuscitation team together and bringing that alive again. But it just goes to show that what our team has done, both from a cultural developing a great culture with the cardiac rehab team and the skill set, is an incredible gift to everlasting life and impacts. So Don anything, I should add.

Don Brock 12:34

Well, you can take that story and replicate it like maybe 10 that mirror that in the last.

Don Brock 12:41

Well, the last two and a half years or three years since I've been with this program and the organization has done a great job of capturing those stories and I think it overarchingly has benefited the sim platform to take away some of the mystique of who we are, the clinical avenues that we've been in or areas that we've been in, and not only as clinicians ourselves, because a lot of our folks are clinicians that come out of bedside and into the simulation platform.

Don Brock 13:09

But I think it's really demystified a lot of that perspective of simulation and how we can impact and we're just getting a lot more buy-in and it's a culture and it's taken a while. I mean I was here when they started the Sim Center here many years ago. I was in the ER and it's just taken a long time and even to this day I still have students say, oh, I fear sim or they've had a variety of bad experiences in simulation and a variety of arenas. I'm like, well, let's see if we can change your attitude in that. But I think it just highlights the application of storytelling and what we can do and how we do it, and it's definitely humbling to be part of that. Yeah, it's a great story, Ryan.

Jerrod Jeffries 13:51

Yeah, thank you, and Ryan really powerful. So thank you so much for sharing. But I want to actually go to the cross piece as well, because we were going up and down, but I want to make sure we hear the cross as well.

Ryan Aga 14:02

Yeah, jim, I think that that's just a growth across our system, geographically, across our care delivery system. I will say what has grown us from our leaps of learners as the system has gone to a one care group. We are particularly aligned with our quality and safety department the highest, the chief quality officer at Health Partners, which is Kara Hall. One of the areas that across that we're reaching to get to your point is that our primary care areas of our clinics have become.

Life-Saving Impact Stories

Ryan Aga 14:41

The acuity of patients that are reaching out and landing in primary care is just through the roof. Our clinicians are seeing more sicker patients. The acuity of them that used to be in the ER is now in primary care or urgent care. And so that's what really jumped our level of numbers, our learners, up this past year from 12,000 to 14,000 was our biggest integration across our health system in primary care. So we can say comfortably that through our gosh I don't know many, many, many clinics I don't have the number in front of me of our primary care clinics across our system and our dental health clinics, which is 20, some integrated dental health clinics. Simulation has been in every single primary care and dental clinic at Health Partners, so I think that goes to show that a cross strategy of where we're geographically getting out is to every single sector as we can in our organization.

Ryan Aga 15:46

And then one more thing I'll touch on is that what's really special to us is that we're not just in our health partner system, we also have partnerships outside of health partners. So two smaller health systems in Minnesota our team took on last year and that's part of our regional growth across Minnesota and Wisconsin and we're looking to even stretch that even further, since we've known that there's just particularly in the rural parts of our country that people are just struggling to get the tools that they need to do their jobs with training and they want simulation, and I think it's the newer generation that is like enough of this passive learning environment. We are demanding that simulation is the way that we learn best. But Don gets all of these asks weekly because he's reviewing all of what's in our queue of who wants us and who needs us, and it is overwhelming to to know that the people who need more simulation and want services. So does that answer your question, jared, about our cross strategy of reaching as many areas that we can?

Jerrod Jeffries 17:03

certainly, and I love to hear it, I well one. I do believe you're in a very fortunate position and I can hear the gratitude as well, because that type of buy in starts at a systemic level and it's not, you know, one person kind of marching down, but it's organizational wide and I think that's but back. You know, even circling back to the story of pushing this type of you know message at the highest level also resonates across why it's going bilaterally right, up and down, left and right. So really I'm impressed, I'm just impressed, with what you're doing at Health Punters.

Don Brock 17:37

I'd love to add to that a little bit, if I may. When you talk about the lateral movement, they're both synonymous, right? And so when I look at the vertical movement, I look at the addition of our team members, right. So we keep, we keep adding people. So it's kind of like a stack.

Don Brock 17:52

But what we've done, especially when we talk about the ambulatory care clinics and the dental clinics, is we hired an individual. That that's what they're responsible for, and so we help the scheduling, we do the coordination as the full-time staff, but this he's part-time or per diem, but that's all he does. He's a phenomenal educator. He's been around for 30 years, paramedic by background, but he's a phenomenal educator. And so Ken does all the we call them CAMELS which is cardiac arrest, medical emergency learning or extended learning, and it's an hour that he gets with these clinics and then, subsequently to that, the clinics are exposed to it and then come back to us and put additional requests in, because they identify, you know, pluses and deltas when he's out there and it's just expanded. So those number of requests, and so and I want to validate too we get probably five to seven requests per week from the system and we have an intake system that we track all this and those are those are delegated out accordingly with our team members and it works very, very well and we've been doing that system for about a year and a half now. So it gives us the opportunity to track our intakes and then who's working on the work and then, subsequent to that, the other piece stretching outward we haven't talked about our pipeline.

Youth Programs and Pipeline Development

Don Brock 19:17

So we have a youth program that we're in all these different spectrums of the community. So we're into the schools, we do a lot of stuff with the schools and the pipeline and those requests. Essentially I probably get what one or two a week, ryan. So a teacher hears something and they're like, hey, we would like to have that. So we come out and we do something with the school, or they come in too as a partnership through our HR department here at Regions, a little bit at Methodist, and then our institute partners, who I have a very special friend, abigail Ward, who helps me coordinate and collaborate so many efforts with these youth, and we're in the process of building a program that is much more formal and lineal and then it'll be an intake process a lot like what we have established right now for our regular sims for these programs that are looking for youth experiences.

Don Brock 20:17

But I will tell you personally, um, the joy that I get out of it and our team gets out, of getting in front of these youth to pull them into health care, um, and it's across the spectrum. It's not just doctors and nurses, but our lab partners, our imaging partners, respiratory therapy, you name it, social services, guest services, it doesn't matter, it's a full spectrum because we try to expose them to that. And then we have a program that's a formal program, it's called Share, space for Learning, and we get these youth integrated into that system so we can track them. But, most importantly, we're able to reach back to them and get them resources where they want to go. And so, when you look at just this lateral component of this, it'll never end, and that's our hope is to get these young people in here, because we're going to need somebody to replace Ryan and I here pretty soon. Well, me anyway. Ryan's got a few more years, I'm getting there.

Jerrod Jeffries 21:13

I just thought that was really important to check there. Certainly Don you also made me think of hearing about, and I also love the dental aspect. But just getting kind of back to the scope and the full spectrum is how do you then, you know, given the size, but how do you create standardization among all those programs?

Don Brock 21:30

Oh, my goodness, that's great. Well, we do a lot of after action reports. So we have we're in the process of actually completely formalizing this process it's called REDCap and so we do our intake. You know the team members sign in, they'd sign their, and so we do our intake. You know the team members sign in, they sign their confidentiality, they're cued into a survey. So we get survey stuff back and then we take notes during the simulations themselves and then we put that in a formal report. That also, that formal report, also links into avenues that we can query quality safety, patient experience, adverse events, any environmental emergencies or whatever. So we have a timestamp of where that's at.

Don Brock 22:15

And we've been doing the after action reports in a fairly standardized format.

Don Brock 22:19

But this is going to level set, basically four programs into one so the whole system can see it and then we can review it.

Don Brock 22:27

And then in the end, this REDCap, you can query it at any time and ask it questions, because well, if you're not familiar with Power BI, but the power of BI and the power of REDCap combined together, you can ask it so many questions and then we're going to continue to glean from that and then Ryan can attest to when we're talking about our global strategies and we overlay that, on top of the questions that we ask, and we're looking for tools, we're looking for best practices, we're looking for deltas, and so we can have exposure at the highest level, and that helps us get resources, both financial resources and then the personnel resources to continue. This strong work and a lot of these algorithms or information flows are what helped us grow as fast as we have, because we're reporting this stuff out and people are seeing oh, we have a president Sim's doing a great job. We need to support them because it's not just Sim. Ryan, I'm going to swap the tennis ball.

Ryan Aga 23:27

I'll take a couple jabs, I don't know, or injects here, jared and Deb, I think you know, as we all have lived in the most complex adaptive system, probably the most complex out of all the adaptive systems ever is healthcare, right and so? And we've just seen quality and safety repeat itself, right, we've seen the same problems, the same issues, the same tactics.

President's Award Recognition

Ryan Aga 23:54

I think, to dive deeper into the areas that we are, we're at a point where we need to convene different people, bring people with different insights into what we've been doing forever. For me, for example, I've been a nurse for over 20 some years. So to bring different insight, we just hired. Her name's Kelly Landsman. She's a biomedical engineer by background and she went back to nursing school after she did years of biomedical engineering and research and development because she really wants to figure out why aren't we moving things? Why haven't we? Have we not had precision into moving our problems in healthcare? So she is bringing a whole new skill set to somebody for me.

Ryan Aga 24:40

Like me have lived in healthcare my entire career and I'm like, wow, the questions that she asks, the insight from an engineering perspective, really bring Glean areas that we should have been doing all along. And she can't believe that we've had protocols, policies, work standards that have gone to our clinicians and have never been simulated. She's like in an R&D side of things and working in med device and through engineering that never, ever would have happened and we've allowed that to happen. And so we're really looking at how do we our areas of focus, what is Kelly's insight into all of this? And just offering the wide open table right to ask these questions and to think about things differently. Now is the time for us to rebuild and to figure out what the future is, and we can't do it alone anymore. We can't say healthcare we got a lot of really cool, smart people here, we got this. We need to say no, we don't this and to invite as many different people from cross-sectional industries into this problem. So that's my two cents on that one.

Deb Tauber 25:58

Thank you. Now I understand you guys were the 2024 president recipient winners. Why don't you share what this means to Health Partners? And a little bit about the award itself.

Ryan Aga 26:09

Go ahead Don.

Don Brock 26:10

Oh boy. So each year, health partners has a selection process and it's by your peers and it's rather formal and you submit through the portals the documentation for nominating, whether individuals or teams. And last year we I got wind that I got wind that perhaps we were going to try to put Ryan Aga in for this President Award as an individual. And I immediately jumped on that bandwagon because Ryan is Ryan and the impacts he has in this platform are so numerous and certainly deserving of a president's award. Well, in doing that and going to his immediate supervisor, she's like we want to put the whole team in and I'm like that is awesome. And Ryan, he leaned onto that because it is a team effort and it's taken every single person on this team, in their own right, in their own capacity, to be up there amongst our peers. And so there were two teams that were deemed president award winners and you just look at these people and they were telling the stories. You know some of the individuals and the impacts that they've made. I know for me it's work, it's great, it's an award. Ryan's going to get a chuckle out of this, but it's like all right, we're going to seize the moment. We're going to tell our team. You have to seize the moment.

Don Brock 27:42

We had a beautiful dinner, beautiful presentation. They gave us this big honking vase with all of our names on it president award winner and talked about the impacts on the system. And just to listen to those impacts, it's pretty amazing I might get a little emotional here what we do in healthcare as a clinician. Ryan and I have both been clinicians. We've been bedside clinicians. We impacted individuals, people that we worked around, the patients that we took care of.

Don Brock 28:11

But what's so phenomenal about this award is this validation that we're impacting and have been able to impact the system at large. And it's not about us. This is not about Ryan, it's not about Don. It's about us as a collective and I'm very proud of that and I told the team too. I was like this is what it means to me to be in this position, to be able to glean tools and processes and look at things and look at you people as the resources and the assets of the system and make all the impacts that you do. That's a presidential Award winner, if you ask me, and so I just believe very, very humbled that we were able to get that award. But in the words of Ryan Auga okay, great job. Don Now get back to work. That's what I have to say about the President's Award.

Deb Tauber 29:07

Thank you and congratulations. Yes, very much so Now do you have any final thoughts? You'd like to leave our listeners with.

Ryan Aga 29:17

Final thoughts. I'll get very human factors here. I've been in healthcare for, like I said, over two decades. We are at a breaking point. We are at a breaking point and, for me, coming into a health system and especially in our level one trauma center, and looking at where we are in the United States and across the globe, of where we are today, right now, in 2025, we need to keep coming together. We need to keep coming together just like we are right here today. We need to listen to people's feelings, of what's on their hearts and their minds. We need to be very humble and we need to extend vast amounts of gratitude, having led the emergency department team at Regions over 400 colleagues through COVID coming out of that and we're still.

Ryan Aga 30:23

We've got residual of that, that pandemic. It's residual, there's still. It's still there, it's still maybe been boxed up and some people they put it on a shelf and they haven't even addressed it. On top of what we're dealing with right now in the United States with defunding research, all of those elements are continued waves of overwhelm, uncertainty, anxiety. I'll just admit that a couple weeks ago I broke down right.

Ryan Aga 30:56

It's been layers of things that have been happening and I was surrounded by two. One of them was Don and the other one was another nurse, kelly, and the other one one was another nurse, Kelly and the other one I was online, michelle, and they allowed me to just be human and, I think, for my message to everybody, whether you're across the pond or you're in an office space or you're on this sort of environment, to have friendships right now and for people to be supporting each and every one of us is so, so important and, in healthcare, particularly right. We're strapped for resources. We have fine margins for financial contributions. We don't even know if Medicare and Medicaid is on the chopping block. Those are layers of, I would say, trauma that keep coming at us at different elements in time. So my message for everybody is continue to be humble, offer gratitude and come within community to support each other, now more than ever.

Deb Tauber 32:06

Thank you.

Ryan Aga 32:09

You're welcome.

Jerrod Jeffries 32:10

I love it and Don any last words.

Don Brock 32:12

I would just add that you know, Ryan and I are.

Don Brock 32:15

We're very close in ideology. I have two paths in line with this One he's the visionary and I'm the mechanic and, as our team, he's the director, I'm the operations leader, and so he continues to envision where this path is and what it looks like, and it's it's our job, actually, but I say it's my job to mechanicalize that and push through. When I look at people, the thought is everybody has a story and I walk around and I literally look at people. You know this person's got a story If we get in the challenges, everybody's got a background.

Don Brock 32:49

And I try to take pause and I try to emulate, take the time to listen to somebody, hear it out, see where they're coming from. What kind of resource do they need? Maybe they just need to talk to you, maybe they need some real resources, but everybody has a story and I just think we need to slow down and understand and appreciate people at its core and try to try to make this world a better place, because it's tough, right, and we've got a tough job and I'm I say I'm blessed to get up and I get to go to work every day. I get to go to work and I work with some amazing people and it definitely it's work, but it's work that's worthwhile, and so Thank you, thank you both, and with that, if our listeners want to get a hold of you, where would they do that?

Ryan Aga 33:39

You can hold me on LinkedIn. Post a lot of the information on our team there. So don't hesitate to reach out to me on the LinkedIn portal Same here.

Don Brock 33:49

Okay, If they wanted to find us through the health partners too, they can find us through the health partners org. But I'm on LinkedIn as well. I don't post like Ryan does. He's a phenomenal. I just concur with what he puts on there. That's wonderful.

Deb Tauber 34:03

Like and share. All right, thank you so much for your time and your contributions to healthcare. We really appreciate it. Thank you, thank you both. Thank you so much for your time and your contributions to healthcare.

Ryan Aga 34:11

We really appreciate it, thank you. Thank you, Jared, appreciate it.

Deb Tauber 34:16

Happy simulating.

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