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A Dose of Optimism
A Dose of Optimism is a podcast dedicated to exploring the world of healthcare innovation and the optimists driving meaningful change.
Hosted by Omkar Kulkarni, this show shines a light on bold ideas, transformative solutions, and the passionate individuals working every day to make healthcare better for children and their families.
Each episode dives into the real-world challenges facing the healthcare industry and highlights the people and organizations pushing the boundaries of what’s possible. From tackling mental health and food allergies to reimagining hospital care and harnessing Artificial Intelligence for better outcomes. Listeners will discover game-changing solutions, hear stories of creativity and resilience, and gain inspiration from leaders who believe in building a healthier, more hopeful future.
From medical professionals and entrepreneurs to patients and community advocates, the podcast brings together diverse voices united by a shared commitment to improving healthcare delivery. Whether you’re working inside the industry or simply curious about the innovations shaping tomorrow’s care, A Dose of Optimism offers insight, connection, and inspiration.
“The content, views, opinions, and information presented on this podcast do not reflect the views of Children’s Hospital Los Angeles or of the sponsors of the podcast. CHLA does not endorse the views, opinions and information presented on this podcast and CHLA specifically disclaims any legal liability or responsibility for the podcast’s content.”
A Dose of Optimism
Workplace Violence in Hospitals
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Healthcare workers are facing a crisis that rarely makes headlines, and it's getting worse. In this episode, three innovators share what's really happening to nurses and other frontline clinical staff, and what's being done about it.
Sandy Hall, Executive Director, PCS Quality, Safety, and Patient-Centered Services at Children's Hospital Los Angeles, describes the landscape of workplace violence in pediatric settings, from verbal harassment by families under stress to physical injury from neurodivergent and behavioral health patients who can't control their actions. She explains why pediatric settings have a particular underreporting problem (the "pediatric pass") and why the behavioral health crisis is making conditions for frontline staff dramatically more difficult.
John Bracaglia, CEO and co-founder of Marvin, shares how his company is working to address the $70 billion healthcare workforce crisis by providing mental health support specifically designed for healthcare workers, through counselors who understand clinical culture, an opt-out model that removes the stigma of asking for help, and outcomes data showing a 94.5% retention rate among nurses who engage with the program, compared to a national baseline of 79%.
Ali Al Jabry, CEO of Kwema, describes a deceptively simple solution to one of the most urgent safety needs in healthcare: a smart badge reel with a silent panic button that lets a nurse or clinician call for help without escalating a dangerous situation, and that integrates with existing hospital IT infrastructure to geolocate the person in need in real time.
Episode Resources:
AHA Workplace Violence Resources
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Today's episode addresses a really important topic that sometimes goes unaddressed in conversations that happen across the country. The topic today is about workplace violence in hospitals and healthcare centers. It's become a serious challenge facing almost all healthcare workers today. And unlike many other industries, we've unfortunately normalized violence in healthcare settings to a degree that many people don't realize. Healthcare workers are four to five times more likely to experience violence on the workplace than workers in other private sector professions outside of healthcare. And this isn't just physical assaults. It includes verbal abuse, threats, intimidation, harassment, bullying, and aggression from patients, family members, visitors, but also coworkers, supervisors, other nurses, physicians, surgeons, team members. It's really challenging and it's almost from all over the place. Studies show that nurses experience approximately 13 physical assaults and nearly 39 non-physical violent incidents per 100 nurses each year. So you can see it's a sizable problem. And more recent data shows that verbal abuse and threats are happening very frequently. Over 80% of nurses reported experiencing at least one form of workplace violence in the last 12 months, with 68% reporting verbal threats, and more than one out of four saying they were physically assaulted, hit, kicked, bitten, pushed, or grabbed. Emergency department staff are facing some of the highest risks, with more than three-quarters reporting exposure to some sort of workplace violence. Unfortunately, a lot of these incidents are never formally reported because staff often believe that nothing's going to change or they've become desensitized or normalized to this type of behavior. The consequences are really problematic. It not only impacts employee safety and well-being, but also it impacts patient care. It impacts the culture of the organization and healthcare organizations and workforce stability. People are leaving the workforce because of this environment that they're surrounded by. There's burnout, there's anxiety, psychological trauma, and people are absent, taking leave. They're unhappy with the job. They leave their organization. And many people leave the profession altogether. Six out of 10 nurses reported that they've considered leaving or changing their jobs because of violence that they're experiencing in their work environment. This is particularly a problem in healthcare today because we're already seeing staff shortages across the board because of a variety of factors. And this just exacerbates it. This creates a bigger problem on top of an existing enormous problem around workforce staffing and the sustainability that is required to keep our healthcare workers in place. So today's episode is going to dive into this topic. We're going to talk to three incredible people who've got important things to say about the current state and about this issue and some of the things we're doing to find solutions to these problems. Welcome to the Dose of Optimism, where I talk to the optimists in healthcare. My name is Omkar Klokarney, and I work at one of the world's best children's hospitals where I lead innovation. I started KidsX, which is a premier international startup accelerator for pediatric innovation. And over the years I've met thousands of startups, investors, and innovators. Every one of them has a story, and every one of them is optimistic about the problems they're solving. On this podcast, you'll meet amazing people who will share their stories and what makes them optimistic about the future of healthcare. A little note before we get into this episode. All right, let's get started. Our first guest is Sandy Hall. She's a senior nurse and patient care leader at Children's Hospital Los Angeles. I've had the privilege of working with Sandy for many years, and she has an amazing perspective, both from a local perspective, but also a national perspective around this specific issue. She is the executive director of patient care services, quality and safety, patient and team member experience, and accreditation. Specifically, she oversees clinical quality, patient safety, employee safety, and accreditation readiness. And her lens is going to be really important as we just set a baseline around this topic and how problematic it is today. I hope you'll enjoy this interview with Sandy.
SPEAKER_00So that's sort of the area that I think about and focus on. And there's so many different issues when you think about sort of the complex nature of workplace violence in the pediatric setting. You've got the workplace violence that comes from non-patients like parents, caregivers, and visitors. A lot of that doesn't rise to the level of physical violence, but there's a lot of intimidating harassment, uh, abusive language that gets thrown at nurses on a daily basis and every member of the healthcare team. And you do have situations where those actually do rise to the level of physical violence, which is really scary in the healthcare environment. Then you've got this entire other space in pediatrics with our behavioral health patients. We have a quite a behavioral health crisis happening in pediatrics across the country. And that's really been accelerated, all of the data showing us by the COVID-19 pandemic. So our systems are not equipped to handle the dramatic rise that we're seeing in behavioral health patients. And a lot of these are behavioral health patients with comorbidities. So they're requiring inpatient admission. I think we spend a lot of time talking about how we prep our teams to de-escalate patients and de-escalate family members. And that is incredibly important. It is probably the primary intervention that we spend a lot of time focusing on. But what we tend to miss is that a lot of our patients who inadvertently cause injury in the behavioral health setting are not capable of sort of rational thought conversation following instructions. We've got patients who are neurodivergent. We've got patients who are suffering from neurological issues. They might have a traumatic brain injury. And I think because of that, we also end up seeing a lot of under-reporting of workplace violence, because there's this, uh I've seen it referred to as a pediatric pass where the nurse says, oh, they didn't mean to do it. Nurse gets kicked in the stomach, spat on, hit in the head to the point of concussed and bitten any number of things. And there's dramatic underreporting of those, if it is not sort of intentional violence aimed at that person.
SPEAKER_03The behavioral health crisis has definitely gotten worse as the pandemic. If we look at violence, whether it's physical violence, verbal assaults, any form of that, for either the patients or the the caregivers, the family, the the non-patient, but part of the people in the room, is that a problem that has gotten worse lately?
SPEAKER_00No, I think it absolutely is. It definitely has existed all along. I've been a nurse for 20 years and probably experienced my first incidence of workplace violence in about 2008. It's definitely been there all along, but it does seem like it is getting worse. It really has seemed really since the pandemic, um, which is difficult to sort of put your finger on in terms of the why entirely. Um, but we see a lot more escalation, a lot more instances of threats of violence, physical intimidation, abusive language, a lot of unrest and distrust among our patients and caregivers towards the care team. I definitely see that it's that it's increasing. And I don't know that we have been able to completely adjust in a way that accommodates for that change.
SPEAKER_03Feels like we're all a little more incivil, or that we we've normalized incivility in in society broadly, not only in healthcare, on airplanes, in public venues. I think healthcare clearly there's even more stress on everybody in the system, both the providers, the caregivers, and the patients. So I imagine it shows up more. But I feel like we're normalizing, even not the physical abuse, but even the verbal microaggressions or the this yelling or screaming or making comments.
SPEAKER_00I think that normalization has always existed. I one of the concepts that I think we see a lot is the this is the worst day of their life sort of mentality. And it's true. It's, you know, we owe a lot of compassion and a lot of kindness to our patients and families. And I think sometimes we are more ready to excuse bad behavior because of the heightened stress of the situation. And it's interesting, I've seen instances where a family member is incredibly abusive and is actually given guidance, for example, by security, that, you know, we don't tolerate uh, you know, language like that or, you know, talking to our team members like that. And they actually, after getting called out for their behavior, will say, show me where it says that I can't talk like this. You know, not just recognizing that they're behaving badly, but actually insisting that they have the right to treat people badly. It does feel like the world has just gotten meaner in the last several years. Yeah.
SPEAKER_03And I imagine this then has a tremendous impact in terms of psychological safety of for staff, right? For nurses and others. Are we seeing this being a reason why people are leaving their jobs? Find, you know, people taking leave. Like, what's the impact on the workforce that you're seeing both here, but also across the country?
SPEAKER_00Absolutely. So I pulled a few statistics for this conversation. Um, and what I found was 76% of healthcare workers think about their safety daily. 85% have experienced some form of workplace violence. And at least one in three have left or are considering leaving the profession. When you think about nursing, as a nurse, I think a lot of people who go into this profession do it from an intrinsic desire to provide care and to serve. And it is a really difficult thing to sort of reconcile with that you show up every day with that intrinsic desire to provide care, and yet you constantly stand the risk of being injured, of being threatened, of being abused in some way. And going back for a second to the behavioral health crisis, most of our nurses are genuinely not prepared to take care of the very specific needs of patients with behavioral health diagnoses in the inpatient medical, surgical, or critical care environment. I'm seeing from nurses also just this sort of constant tension of like, what is my assignment going to be today? Um, how am I going to handle it? Will support come quickly when I call for it? We've had some situations, long-term patients, and you know, really, really critical and complex situations that have resulted in deep psychological uh safety issues, compassion fatigue, exhaustion. Uh, you know, in hospitals, we tend to measure days away restricted and transferred when there's an injury. And that's how we determine the long-term impact. But what we don't tend to do well is account for the leaves of absence that take place because of mental stress, uh, because of the PTSD or the sort of traumatic aftermath of a workplace violence event. So I don't think we're doing a good job in healthcare at this moment in tracking the psychological impact to our workforce. So there's a lot more uh that we need to be doing to really understand how that's playing out.
SPEAKER_03The solutions I'm seeing for this are or feel like they're reactive. What can we do proactively or prevent some of these things from happening in the first place?
SPEAKER_00We've got to take a multidisciplinary approach first and foremost. And we've got different types of violence that we're talking about. So when we're talking about parents, visitors, caregivers, and this workplace violence that occurs from them, we've got to leverage our entire multidisciplinary team, our patient relations, our security, our social workers. We need to leverage these resources early rather than waiting for an event to fully occur. We need to surround these uh these families with the right resources. If they're getting escalated, they are having the worst day of their lives. So, how can we support them appropriately? We also need our entire team, every single member of the team to come to um really solid agreements about what we will and will not tolerate from families and where we hold the line. And we need team members to come together and ensure that families are getting consistent messaging and consistent expectations. What I see a lot of the time is um, you know, we'll set a boundary with a with a family member on one shift or from one team, and then someone will come in and change that boundary. And it becomes almost like, you know, the sort of the equivalent of if mom says no, then dad says yes. And we end up seeing team members almost being played off of each other and manipulated in certain circumstances. So one of the things that we're doing uh more of our uh proactive safety huddles when we recognize that we have a problem, a complex situation that is going to require that multidisciplinary approach. We really try to bring people together and think through how we're going to all consistently carry forward in that situation. When it comes to the behavioral health patients, I think we've tried as much as we can to provide the right education, the right guidance, but we have such a large nursing workforce that are trying to take care of these patients. I think what we've got to start thinking about is how we supplement with the right team members, with the right training in the right places to really be the boots on the ground frontline team members providing care for our most complex behavioral health patients so that we are able to use the most therapeutic techniques imaginable, partner really closely with our psychiatry and social work teams, as well as child life, the entire multidisciplinary team to really proactively meet the needs of the patient to help them try to stay de-escalated as much as possible and to have the right safety plans in place when a patient does escalate and we need to react appropriately.
SPEAKER_03What more do we need to do from a reactive perspective once some of these issues happen that we're not doing right now?
SPEAKER_00From a reactive standpoint, I think one of the things that we've got to get better at is encouraging team members to report workplace violence. When we take proactive steps and really get out there with team members and encourage them in the moment to report, um, we see dramatic increases in reporting, which tells us that there's a general under-reporting happening. So I think the more we can ensure accurate reporting of workplace violence incidents, the more we can understand the problem and advocate for the right resources to support our team members.
SPEAKER_03What would a rationale be for why that's happening?
SPEAKER_00I think the biggest one is with our pediatric patients who might be uh neurodivergent, as just an example. You have a patient who, through no fault of their own, not necessarily aware of or intentionally acting, kicks a team member or bites a team member or flails their arm and bruises a team member. We have incidents like that happen all the time, every day in healthcare. And there's a mentality around, well, they didn't mean to do it. It doesn't necessarily feel like violence in the same way that somebody intentionally acting to harm you does. And so we miss those. And at the end of the day, it's still team members who are getting hurt. That still leaves both a physical and a psychological mark. And I think particularly in pediatrics, because they're children, that sense of, well, they didn't mean to do it. It's not real workplace violence. I'm not going to report it, it really permeates. I think we also have, again, that sense of, you know, this is the worst day of their lives, and a level of tolerance towards the behavior of our patients and our parents and caregivers in stressful situations that sometimes lead to that under-reporting.
SPEAKER_03Do you have colleagues in nursing who work for healthcare systems that take care of mostly of adults where underreporting doesn't exist as much because it's it's not kids that are creating the violence?
SPEAKER_00Think about nurses working in like a memory care situation. You've got another population of patients who may or may not be in control of what they're doing with their bodies and the way that they might be harming their caregivers. I think we kind of see it there a little bit more in the same way. But when you get into that adult population and you have primarily adults that are able to follow commands and interact with their care team, when violence occurs, it feels like violence. It is a much different feel to it. And I think that perception is what really plays in.
SPEAKER_03Our next guest is John Berkaglia from a company called Marvin. Marvin is focused on helping those healthcare workers, particularly nurses, who have been impacted by workforce violence. You'll hear about their very focused solution that is creating an impact across the country as we try to find ways to help those who've been impacted by this type of violence. So tell me more about Marvin.
SPEAKER_01We're a company on a mission to end healthcare $70 billion workforce crisis. Really, our goal is to provide care for the well-being of the healthcare worker population, supporting both the individuals as well as the systems, really to help those who are helping others.
SPEAKER_03Now, the system has a lot of challenges today. Let's start with nurses, for example, and a really important part of the workforce and a part of our care delivery system. Tell me more about what you've learned about how nurses are challenged today and what you're trying to do to help them.
SPEAKER_01Well, so nurses are a third of the healthcare system. And as you mentioned, they're really the sort of backbone providing care for others and a part of the workforce that knows critical to the overall operations. We see, despite that, there are burnout rates that are hovering above 50% within the population. Uh, in the most recent survey, the AMA found that it was almost 55% of the healthcare workers' workforce more broadly is facing these types of concerns. In specialties like oncology or emergency medicine, it can be even higher. And most folks are not accessing care, which, you know, for their employers leads to downstream effects, including burnout-related turnover, worse patient experience, if folks are in a bad state of mind, but really just to decrease stability and provide great care for patients and communities. And so, Marvin, we work very closely with hospitals and nursing leaders of all sizes. So for both for-profits, nonprofits, academics, children's hospitals, really to help them think about building a strategy to support their nursing teams, as well as the nurse managers, the charge nurses, uh folks to really help build well-being and a culture of it across the organization. One area that we really highlight and focus on is the first and second year nurses. So the new nurses that are joining the organization, uh, where the turnover rates for new nurses, the first year nurses, can be up to a third, 30%. Uh by year two, it's almost 60%. So a lot of folks are joining, they you know, join the organization. There's not really the support mechanisms in place. And the culture itself can sometimes not be as supportive as maybe we would want. I think the phrase I've heard is that you could say they eat their young, and I didn't make that up. That's just in the literature. And so we really work with these first and second year nurses, for example, as of subpopulation. Uh, we really help them to meet with a Marvin counselor, they can learn about the resources that are available, provide some actionable guidance on how to best support themselves, set expectations with someone who's been there before, and also to work with the teams to build a culture of psychological safety, one where it feels okay to ask for help or to not be okay, and support both the sort of systemic aspect as well as the individual.
SPEAKER_03Yeah, how's a Marvin therapist different than a therapist you could find anywhere else online?
SPEAKER_01Our therapists, and you know, we call them counselors, but they're all fully licensed and state of practice. Generally, they've been in the field for 15 years or more. Uh, they're bringing a real clinical rigor and expertise. Uh, you know. You're meeting with a Marvin therapist, not only are they a licensed professional, but they're someone who understands your context, uh, they understand the health system. Generally, they've either worked in a hospital system themselves before, where they've built a private practice of supporting nurses or physicians or really anyone in the healthcare workforce. And when you meet with them, that they are, you know, one available immediately. We guarantee, you know, same day, next day uh availability as a starting place. Uh, we are 24-7, 365. So we're available around shift schedules, but the access is just, you know, a baseline. I think the real key is that they're working in a clinical model and understanding that they can evaluate things like uh patient depersonalization. So are you losing your sense of your patients as people and you've almost become numb to providing care for others as most depersonalized or compassion fatigue and helping you understand the difference between compassion fatigue and burnout or vicarious trauma? They're really trained in this sort of world of caregiving for others, can bring that expertise to the therapy sessions. You don't have to explain your context. And uh, we found that to be really helpful.
SPEAKER_03And you're really selective about who you pick. You don't just take anybody to be a Marvin counselor, you're pretty selective.
SPEAKER_01We like to say it's harder to get into Marvin than you know, Harvard or Stanford. And we typically accept about five percent of the applicants. We are doing a lot of assessment. Uh they go through multi-round interviews that do an online application. Whether or not it's harder to get into Marvin than Harvard or Stanford, I don't know. But I think the the point is that we really do want to, anytime you meet with a Marvin therapist, that you feel like they are not only just a very rigorous, clinically rigorous therapist, they are maybe the best therapist that you could be meeting with for you. And that we we think a lot about that matchmaking as well in our outcomes. We have very we measure a lot of our outcomes, we publish on them. And we see that you know, 95% of our patients think of their therapist is a great fit, very high satisfaction rates, and we're constantly measuring that and ensuring that we're providing that really optimal care, a step above maybe what you would find in the community.
SPEAKER_03Now, so let's talk stats, right? So, how on average, how much time does somebody spend with Marvin, with a Marvin therapist or a counselor?
SPEAKER_01It depends on their treatment plan and their presenting issues. And some people, you know, have relationship issues, that's different than maybe a more serious mental health issue on bipolar disorder or deep anxiety. And our goal is to really find that right path for each person, measuring the uh success rate or the outcomes or remission rate for that. That results typically in around 15 sessions per person. Uh, but we do have folks who come for, you know, five sessions and they feel like they're on their way, or you know, some people have been for us with us for years. But 15 is typically about the median. We're there for as long as you need it. There's no session cap. You know, we're really here as a partner to support folks.
SPEAKER_03And the hospital's paying for the show. The employer of the nurse is paying for their therapy.
SPEAKER_01That's correct. And really for the employers and the health systems, you know, we've really worked in a model where you know, well-being is, I think what we've learned today is it's not just a nice to have. Actually, supporting the well-being of your nurses and doctors and clinicians, it's critical for the hospital's operations and and operating margins. And that, you know, if you don't do this, then we see very high rates of turnover, you know, there's uh worst-patient outcomes and a whole host of measures that are associated. So the hospital does pay if they cover a lot of the sessions. Uh, folks, typically the models they'll cover a set number of sessions, and folks can use their in-network health benefits after for you know however long they they need and beyond that.
SPEAKER_03Now, what kind of outcomes are you seeing? Are you are we seeing a reduction in burnout? Are we seeing an improvement in clinical outcomes, depression, anxiety, things like that?
SPEAKER_01On an individual basis, that you know, we see remission rates above 70%, which are very, very strong and in behavioral health. So that's the percentage of people who finish really remiss in anxiety or depression, depending on their initial diagnosis, uh, if they have them. Outside of that, organizationally, we really look at turnover rates as our primary outcome to understand are we impacting the workforce? Do people feel like they really, you know, because they have the support for that first-year nurse, they have a real support system around them, or are they more likely to stay with their employer? Are they more likely to refer a colleague to their place of work? Um, and all these things come back to the health system in spades as in terms of financial outcome. And what we see is that baseline across the US, there's a retention rate nationally of about 79%. So about 21% of employees are turning over year over year, which varies by role. Physicians turn over a little bit less, they're more expensive to replace. Um, there's other roles to turn over more. But folks who use our service, they engage in our care model, they retain it at about a 94.5% rate. So they're much more likely to stay. If we give them the support mechanisms, we really try to address both systemic challenges related to burnout and well-being. So a lot of it is related to just how hospitals operate sometimes, but also to provide support for that individual. And by addressing both, that we've really seen that needle move in terms of folks' likelihood to stay with their employer.
SPEAKER_03How do you get people in the care?
SPEAKER_01Uh so we think a lot about communication. You know, so how do we communicate about mental health? We I mentioned that we say the word counseling and not therapy. That's like a small thing. Uh, we never say the word depression or anxiety, we only say stress. We found that stress is a lot less stigmatized to talk about. Uh, but really beyond that, we really try to integrate into workflows. You know, if there's a critical event, someone loses a patient, Marvin is there at that point in time. We do a program we call an opt-out. So rather than needing to raise your hand and say you need mental health care, we'll host what we call well-being week and put a free 30-minute session. We set it up for everyone in our department or location. Uh, they don't have to go, but it's already set up for them and it's there if they want it. And I think what we've seen is that when we do that and we sort of flip the switch, we make it opt out rather than opt-in, that that helps to create a little bit more of a culture around around accessing support. And if everybody's doing it, it feels a lot less.
SPEAKER_03That is really cool. So one week a year, everybody gets it kind of added to their calendar. They can choose not to do it, but they basically they're in unless they choose not to. That's a very interesting way of doing it.
SPEAKER_01Yeah. And I think it's helpful because you don't need to self-identify, you don't have to be like, oh, I'm depressed. I need to reach out to a mental health company. Right. That's just, you know, it's on your calendar. I can go. And I think what we've seen is that once folks join that session, they realize they're talking to someone who's not, you know, this is not a new grad. This is someone who's been in the field for 20, 30 years. Generally, if it's an MD, we match them with an MD. Someone who understands the experience and they can, you know, be a helpful context point. It's free and it's available 24-7. I think we've seen that's a really nice on-ramp because uh you're sort of reducing all barriers and then you know helping people to to try it out too.
SPEAKER_03Yeah. Are you seeing with the rise in violence that exists in the hospital healthcare setting, whether it's physical violence or verbal assault or verbal abuse, patients being aggressive towards nurses and other staff?
SPEAKER_01Totally. I mean, workplace violence is one of the top, if not the top, sort of topic that we think about a lot because it's just unfortunately so common and people don't realize how common it is. I mean, it's not a good thing. I don't think people realize it. I agree. I don't think it's still realize. It's like, yeah, it's crazy. We uh we have a program we call caring after crisis. And we come in and we can deploy onsite support or we do it virtually. We help the managers how to talk about these types of concerns, we provide support for the individuals, and really there's like a it's said a you know, uh, it doesn't always have to be a crisis, but even just some sort of patient safety event. We have a sort of model that's specific for that, but it happens with a pretty unbelievable amount of regularity at a large health system that um it's shocking for me.
SPEAKER_03It really realize it. I'm curious if nurses or physicians that come into the field and realize how much to expect of that on a regular basis. And a lot of hospitals will only put the first name of their employee on a badge because the staff may not be comfortable with having their full name because of psychological safety issues.
SPEAKER_01Yeah, and it's only gotten worse, right? I mean, I think after the pandemic, uh sadly, that the trust has eroded in healthcare systems as a whole, and there's a lot of reasons why that we don't have to talk about, but you know, they're there, it's real. And I think they, you know, that means that unfortunately the patients aren't always as appreciative as you would want them to be. And in I think there's not the necessary understanding that, hey, your nurse is here to help you, right? I was talking to a a Picky pediatrician, and she was telling me, she's like, you know, I have patients that come families that come in and they they're sort of against the treatment options that I'm sharing. And she's like, like, why are you here? Right. You know, you're like, I'm here to give your child, I'm gonna give your child vitamins, and you're saying no to this. What is the I don't understand? And and it's almost like a basics, and you realize that there's just such this, that creates you know what we call moral injury.
SPEAKER_03And our last guest is Ali Al Jabri from a company called Quema. Cuema was actually featured recently in the Kids X and Solutions for Patient Safety Innovation Challenge meeting in St. Louis for their innovative solution. Cuema is helping nurses and all healthcare workers feel safer and have quicker access to help, whether it's security, police, any sort of help, whenever a workplace violence incident happens. It's a button on a badge or something along those lines that you'll hear about. It gets help to the person faster because it is designed to do so. And I hope you'll enjoy this conversation with Ali.
SPEAKER_02I've been somebody who likes to solve problems for over two decades. And when I noticed that technology itself wasn't the solution, it was more the human component of it. That's really what stuck with me because when we started talking to healthcare security leaders and clinicians, we realized that they were already wearing a lot of things on them, right? Frontline workers and more specifically, healthcare workers are the ones that face the most amount of violence and that they could not predict when it happens. And more importantly, you can't really tell who's gonna be a violent patient and who isn't, right? Or a patient family member. So we we came up with this idea of making a smart badge reel, right? And it's so specific because there's a lot of like panic buttons that are part of badges and other things. We really honed in on the badge reel because we realized that everybody wears one and likes to portray their message or really proudly wears it. And in healthcare, you kind of need it because you're badging in 30 times a day. So you're pulling on your reel and being bing that door like 30 times a day, 50 times a day. So your badge reel is really important to you because you're not going to keep taking it out of your pocket and badging into different doors. So when we came up with the idea of putting the panic button within the badge reel and giving it that whole vibration, so you know the trigger has been set, but it's silent, and then leveraging kind of like existing investments that healthcare systems have already made. We realized that it was actually a couple of challenges we were solving, right? And we just became so obsessed with it.
SPEAKER_03A few things that jump out to me there. One, you used a form factor that already exists, you're not introducing something new. The badge is something that everybody has, and so uh you you're introducing the solution on something that doesn't need to be a net new ad for the employee. The second piece you mentioned was the vibration. So there's some sort of feedback loop when somebody activates the button.
SPEAKER_02The fact that it's a real is something that they'd love, and that's really what makes us understand why they love it, right? Because they most healthcare workers are wearing 20 cards. Sometimes they have to change five to seven cards a week because they're going to a different clinic, or there's a lot of workflow around the card itself that adding an additional thing to take care of in your workflow of changing your ID cards is a recipe kind of designed for failure, right? But the reel always stays the same. And that's something that when we when we came up with this idea, we're like, what if we just made a better badge reel, period, and added a safety feature to it as well? So we're not just solving the the problem of hey, I need help and pressing a button. It's also, hey, my badge reel is pretty robust, it works for all my reels and my activity and my durability of a healthcare worker. I'm not replacing seven to ten reels a day, right? So that's the one side. And then the second side is when I press the button, how do I know somebody's on their way? How do I know this was successfully triggered? Because at the end of the day, you have to get that peace of mind to de-escalate a situation before it becomes the worst case scenario, right? So if the first signs of violence are taking place and you press the reel, it vibrates and you just continue de-escalating. Somebody might show up and might be like, hey, is everything okay in here? Or like, hey, like, you know what I mean? Like there would be a protocol that already takes place before it happens. So it's a near miss rather than an incident that escalated, right? And then the worst case, if it's escalating quick, at least the reduction of that violent incident takes place, right? So in several scenarios, it it ends up working, and that's what the caregiver field or clinician feels.
SPEAKER_03And so you're able to then also link into the hospital's existing IT infrastructure to be able to geolocate where that employee is or whoever the person is that's actually activating the panic button.
SPEAKER_02Yeah, yeah. That's one of our exciting models because um we don't have to install additional infrastructure to basically have real-time location services within your building, right? And that's uh that's really exciting because we've done it as quick as five minutes in some of the children's hospitals we're working with, where we walk in, we get API access after going through the whole paperwork stuff, right? Get API access, and in five minutes we press a real and we're showing up where what room or where we are in that ED and showing that to some of the nurses. And in a matter of weeks, we're going live, right?
SPEAKER_03Ali, thanks for coming on the show and talking about the great work you guys are doing. I think there's a tremendous amount we can do, hopefully, to prevent these incidents from happening in the first place. But when they happen, it's nice to know that employees in in hospitals, nurses, doctors, et cetera, have tools like what you're building to help get uh help on the way as quickly as possible.
SPEAKER_02I appreciate it. And hopefully we also retain people in the industry because you know our healthcare system would crumble if we didn't have our frontline workers, right? And that's that's really the big challenge out here, keeping our staff committed and happy at where they are and knowing that they're heard. And that's that's probably why there's a lot of vocal vocality around safety and workplace violence.
SPEAKER_03Agreed. Thank you, Ellie. Thanks for the great work. All right, thank you for joining us for your dose of optimism. Make sure to check out our show notes to get more information about our guests and the work they're doing. Visit our podcast page on the Kids X website to join our podcast community and to learn more about pediatric innovation. Thank you to our sponsors and to our presenting partner, Kids X. Please subscribe wherever you get your podcasts. And remember, it takes a village to make sure our kids grow into healthy adults. So volunteer at your local library, help out at the community center, and if you're so inspired, donate to your local children's hospital. Alright, see you next time. The content, views, opinions, and information presented on this podcast do not reflect the views of Children's Hospital Los Angeles or of the sponsors of the podcast.