The Brain Behind the
Strongline Staff Safety Badge System

“We needed a product that did not exist,” says safety executive Joseph Byham of a new system to enhance the security of patient-facing staff. His solution? Create it.

The Hospital and Healthsystem Association of Pennsylvania (HAP) reports that despite health care workers comprising only 13 percent of the United States workforce, 60 percent of workplace assaults occur in health care settings. It’s a staggering statistic that led to the launch of a recent grassroots advocacy campaign to urge Pennsylvania lawmakers to pass several workplace safety bills aimed at protecting health care workers. The issue also resonates with Jefferson Vice President of Public Safety Joseph Byham.

From the beginning of his career at Jefferson, Byham has continually made improvements to campus safety across the clinical and academic campuses. He’s advocated for and has installed metal detectors in the emergency department, instituted a visitor management system and created a Jefferson police force, and is now ready to deploy his newest idea. It’s an innovative Bluetooth-based system for patient-facing staff that can help de-escalate volatile patient/visitor situations that could turn violent, or provide immediate assistance when they do, and it’s gaining national interest from other health care systems.

We sat down with Byham to talk about the Strongline Staff Safety System and to find out just what it takes to keep a university and an academic medical center safe.

Have you always been in security?
I was a police officer in New Jersey before arriving at Jefferson as the university’s emergency management coordinator. I was in that position for just about a year before I became the director of environmental health and safety and then the managing director of public safety. As Jefferson’s enterprise grew and we merged with other organizations, I was promoted to the vice president of public safety for the university and health system.

What are some of the changes you have seen in terms of safety and safety issues since you started your career at Jefferson?
The way we approach safety as an organization has changed significantly. When I first started, we had a fairly open campus where people could come in and freely walk the buildings…and we had some concerning statistics that reflected an open campus that we needed to address. One of the first things we did was add metal detectors in the emergency department. Next, we added security turnstiles in all the main buildings on campus. That also meant establishing a visitor management system that requires visitors to check in before entering the hospital. Staff can pass through the turnstiles with their badge.

That must have been a significant project.
It was. The project was massive due to the number of buildings on our campus. It was a long process because some buildings needed renovations to accommodate the turnstile systems, like our Gibbon hospital building. We needed to demolish the staircase in both entrance lobbies and literally turn them around to make enough room for the turnstiles. It was a big commitment and I’m grateful for the support we received from leadership.

Any other major changes?
We hired an armed police force for the campus. Four years ago, we did not have armed police. We had unarmed security officers, of course, but we were seeing what was happening not only locally but also nationally. There are so many incidents involving firearms happening in today’s world; we knew we needed to be able to respond quickly in the event of something happening. We also recently added body cameras for all our police officers as well as some of our security officers. That has been a tremendous help. We are constantly adding more cameras for increased surveillance of the entire campus, which has helped us prevent thefts, identify all visitors coming in and out of our buildings, and for complaints like slip and falls.

You are also dedicated to safety for our patient-facing staff. Can you tell me more about that?
One of the many hats I wear is overseeing environmental health and safety, which investigates all employee accidents. A couple of years ago, I noticed an uptick in nurse injuries due to violent patients. We implemented security one-on-ones where an officer sits outside a patient’s room if needed, and if anyone goes into that room, the security guard follows to assist. Since we started this two years ago, we have reduced nurse injuries by just over 30%. We went from some months where our count of nurses injured was in the double digits to now sometimes not a single incident.

Jefferson nurse holding Strongline badge in her hand at a nursing station

Jefferson nurse manager Denise Shapiro holding a Strongline badge.

That’s impressive. You still weren’t satisfied? What led to the idea of creating the Strongline Staff Safety System?
We lacked a pathway to get from that 24/7 security guard sitting outside a patient room to having safety measures in place that could provide that same level of security.  We can do periodic checks every hour, walking through the units, but if we’re not there and a patient starts acting up, what then? That’s one of the things that led to the Strongline product. We could give any patient-facing staff a Bluetooth-activated badge with a button that would alert us immediately—without leaving the room. Running to a phone to call us, or running back to the nursing station to alert us, was not an efficient or effective way for staff to notify security when they really needed our help.

That makes sense. In these situations, every second makes a difference.
If a patient or visitor is attacking you, you can’t ask them to please hold on while you make a call. Putting alert buttons in each room was not cost effective or possible with the amount of cabling it would have required. We needed a product that did not exist. That’s when I brought the idea to Jefferson Strategic Ventures (JSV) for a wearable badge with a button so that staff could alert security before things could get out of hand. JSV helped us test and refine the idea.

How exactly does the notification system work once the button is pushed? Have you seen a reduction in the time it takes for security to arrive?
What we have found is that it helps to de-escalate a situation before it gets to a point where the patient is acting out and turns violent. Once the staff activates the badge, it alerts the security office and sends a text message to the unit’s nurse manager. The system also provides the name of the individual needing assistance and their location. Nine times out of 10, the nurse manager is the first person to arrive to the patient’s room. This sometimes de-escalates the situation because the manager is able to ask the patient if they’re OK and what’s happening. By then, my team has arrived in case back up is needed. There have been plenty of times when we arrive that we are no longer needed.

Where is Strongline being used at Jefferson?
We have been testing the system in certain units in the Gibbon hospital building for about a year and a half. We also have it at a few offsite locations. At this point, we’re ready to roll it out to various locations in Center City and then out to other parts of Jefferson. I think it is one of the best enhancements to safety we have done yet.

What motivates you to keep making these types of improvements?
I thrive on the experience. The more you are prepared, the better you are at responding to incidents. Every day is a learning experience here, and having the responsibility to protect the safety of our employees gives me even more motivation to think outside the box. One of the benefits of having a large organization is the fact that we can draw from one another’s experiences and help improve the organization as a whole. My first and top priority is keeping our staff, our patients and our visitors safe. That is my focus and motivation every day.

The Health Nexus Podcast highlights the Strongline Staff Safety System in the fifth episode of season one. Hear one nurse’s account of a violent incident and more from Joe Byham and others on how the system came to life:

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