Podcast: How a Former Police Detective Reduces Violence at Yale-New Haven Hospital
Host Note
If someone asked you to estimate the number of armed security officers needed to ensure safety at a large hospital complex, what would you guess?
If you guessed somewhere near 160, you would be correct about Yale-New Haven Hospital, the workplace of Don Costa, one of the featured guests on Episode 25 of our podcast series.
Upon retiring from his role as a detective on the Waterbury, Connecticut police force, Don became a lieutenant and manager of the Protective Services Department at Yale-New Haven.
The hospital takes safety very seriously, being similar in many ways to a small city, with over 18,000 employees and 10,000 visitors a day. In order to ensure that their security force has the qualifications and experience to effectively keep order at the facility, Yale-New Haven requires that their security force are former police officers certified in Police Officer Standards Test and Training, which is a national certification and standard for police officers throughout the country. Many of the officers in the department are retired police chiefs, ranking detectives, ranking patrolmen, and lieutenant captains.
A commitment to safety through training
Another key facet of the facility’s commitment to safety is their commitment to CPI’s Nonviolent Crisis Intervention® training. Don is a currently a Master Level Certified Instructor, training some 2,000 hospital staff members annually in the program.
Because of Don’s belief in and success working with the models and de-escalation techniques presented in Nonviolent Crisis Intervention® training, he is affectionately known as “Mr. CPI” around the hospital, and his efforts have helped the hospital dramatically reduce the need to go hands-on during behavioral incidents.
Also joining the interview is Dave Vargas, a CPI Lead Global Professional Instructor as well as a patrol sergeant with the Village of Hancock Police Department. Dave had the opportunity to train Don in CPI’s Enhancing Verbal Skills course back in 2012. The officers immediately established a rapport based on their shared belief in the effectiveness of CPI training and their experiences providing safety in their roles in law enforcement.
One of the most compelling aspects of the interview is the culture change Don describes as CPI training begins to beneficially affect the hospital environment through emphasis on verbal de-escalation, team preparedness, and debriefing after every incident, which at Yale New-Haven Hospital, according to Don, is necessary at least 10 times during every shift.
Guest Biographies
Donald Costa has over 35 years of experience in both the public and private sectors of law enforcement. He was initially trained as a law enforcement specialist in the United States Air Force. After military service, Don pursued a career in law enforcement, serving on the City of Waterbury Police Department as a patrolman in a high-crime area, as well as a detective who earned several commendations for bravery and valor. Since retiring from the public sector, Don has worked in the health care sector and is now the manager of protective services for one of the largest health care facilities in the country. Don developed and instituted a safety awareness program that has effectively reduced the application of physical restraints used at the hospital, resulting in reduction of staff injuries. Don also planned and implemented the Critical Incidents Stress Management Team, which responds to extraordinary events within the campus as well as the surrounding community.
Also joining the podcast is Dave Vargas, a Lead Global Professional Instructor with CPI. Dave is originally from Wautoma, Wisconsin, and holds a bachelor's degree in communication from St. Norbert College. Dave has nearly 16 years of experience in the fields of security and law enforcement, and maintains an active certification as a law enforcement officer in the state of Wisconsin. In addition to his responsibilities with CPI, Dave is a patrol sergeant with the Village of Hancock Police Department.
In Dave's words, "I enjoy training with CPI because our program prepares staff to effectively respond to real-life situations and to provide good service to individuals in our care, even during their most vulnerable and violent moments. From my perspective as a police officer, I've experienced firsthand how untrained or undertrained staff can perpetuate crises based on how they respond. My hope is that through CPI training, staff will be better prepared and more likely to handle behavioral outbursts in-house, thus freeing up law enforcement to respond to other calls for service in the community, some that may be life-threatening."
Podcast Highlights
Here are some highlights of my conversation with Don and Dave:
On the decision to bring CPI training to Yale-New Haven (11:14)
Don: Well, initially when I first arrived at Yale, every stretcher on the adult ED had hard wires and leather restraints. Every stretcher. I don't know if you can just imagine if you were ever to bring in your grandmother or mother in and on the stretcher were leather restraints. So that set not the most welcoming appearance that we wanted. And we knew that we had to make improvements.
So, like I said, we're all trained, experienced officers, and we realized that the best skills are the verbal skills and not the hands-on. So the hospital decided we needed to search out a nonviolent intervention company like CPI. And after an extensive search, they decided CPI is nationally recognized.
We have a lot of regulatory agencies that come in here. And as soon as they hear that we’re CPI-trained, everybody feels very comfortable. It sets the standard.
On restraint reduction following CPI training (22:58)
Don: Almost immediately with the mind-set of just using our verbal skills, the adolescent psych unit experienced at least half the restraint application. So that was very noticeable.
On training former police officers in the Nonviolent Crisis Intervention® program (35:10)
Don: I love during a week of training when you just see the change of the mind-set from just being maybe "Oh, this stuff is all lovey-dovey. This is great, but it's not going to work."
But when they start realizing, "Wait a second. If I just put a little bit more effort in, if I actually take my time and think about the words that I say, think about my nonverbal presentation and how much of an impact just those first initial pieces can make, it might save me a whole lot of time later on with having to deal with someone who's physically agitated, with having to maybe potentially deal with a plethora of reports to write because of the action that I took. And frankly, it might save me from having to go and seek medical assistance for either myself, a colleague, or especially that person in crisis."
Terry: You mean you decreased the need for restraints by half after the training?
Don: Yes. We reduced the application by half. So that was immediate, and it was very recognizable and it was very positive.
On training former police officers in the Nonviolent Crisis Intervention® program (35:10)
Don: I love during a week of training when you just see the change of the mind-set from just being maybe "Oh, this stuff is all lovey-dovey. This is great, but it's not going to work."
But when they start realizing, "Wait a second. If I just put a little bit more effort in, if I actually take my time and think about the words that I say, think about my nonverbal presentation and how much of an impact just those first initial pieces can make, it might save me a whole lot of time later on with having to deal with someone who's physically agitated, with having to maybe potentially deal with a plethora of reports to write because of the action that I took. And frankly, it might save me from having to go and seek medical assistance for either myself, a colleague, or especially that person in crisis."
Dave (32:25): I think just as sometimes many of the GPIs—I think there's many Instructors in general, if they have to train someone who has a law enforcement or a military-type background where they come from a very rigid kind of sometimes thought process of how to respond because of their previous experiences and previous training—it's sometimes daunting to train those individuals. . . . However, I think that when most persons, when most police officers are trained, when they go to the police academy, that they train the officers to take the enforcement action. It takes a few years of experience and being a more veteran officer, and maybe for some it takes a few more years than others, to realize that really it's not just about enforcement action—it's about taking that corrective action.
On perpetuating a culture of Care, Welfare, Safety, and Security℠ (54:37)
Dave: I hope that every organization that implements CPI and every facility, whatever the background might be (educational, health care, mental health, and most specifically, security and law enforcement), I hope that they have those same results: that if we can truly implement this, you know what? It's powerful. It works. It's not rocket science. It's something that we all can put into effect.
And maybe for some of us, it comes easily. Sometimes it just takes a little bit more legwork. But if we really, truly work at it, we really can change the lives of those in our care. We can change the lives of the colleagues and employees that we work with, and we really embrace and perpetuate that culture of Care, Welfare, Safety, and Security℠. And that should be our goal, is to make the world a better place.
Terry: That's just incredible results. How long did that take?
Don: Well, we started recognizing it immediately. The initial group of CPI Instructors . . . we were so engaged! The communication was amazing, so we were just feeding off all these great stories which occur daily because we have so many times that we have to use this per day.