From Rollout to Results: How Hospital Systems Are Making Safety-Care Work

A recap of our May 2026 Safety-Care Live webinar

What does it actually take to successfully implement Safety-Care in a hospital setting? Not in theory, but in practice, across emergency departments, inpatient psychiatric units, outpatient clinics, and everything in between?

That was the question at the heart of our most recent Safety-Care Live webinar, where we brought together three health systems at different stages of their Safety-Care journey to share what worked, what didn’t, and what they wish they’d known from the start.

Our guest panel included:

• Seattle Children’s Hospital – Julie Meyer, Professional Development Associate, and Mindy Huttenstein, Program Manager
• Brown University Health – Scott Sylvester, Behavioral Health Workforce and Professional Development Manager
• Johns Hopkins School of Medicine – Dr. Mackenzie Sommerhalder, Assistant Professor, Department of Psychiatry and Behavioral Sciences

The Programs: Three Systems, Three Journeys

The panelists brought a range of perspectives to the conversation. Scott Sylvester has been at Bradley Hospital, a Brown University Health partner, since 2013, and Bradley has been using Safety-Care since 2008, making it one of the longest-running hospital implementations in the country. What began as a single children’s psychiatric hospital has now expanded to five Rhode Island hospitals across Brown University Health, with two additional Massachusetts hospitals currently onboarding.

Seattle Children’s launched Safety-Care in 2022, rolling it out across a complex system that includes outpatient clinics, partial hospitalization programs, urgent care, emergency department, and inpatient units. Safety-Care is now embedded in their behavioral health code response, the system-wide response to psychiatric crises throughout the hospital.

Johns Hopkins Children’s Center began implementation in 2023 across their acute psychiatric service line, motivated by a clear need. As Dr. Sommerhalder described:

“Our staff were experiencing quite significant moral distress around caring for kids, feeling as though they didn’t have the kind of self-efficacy on how to manage crisis events, and not only manage crisis events, but how to do so in such a way that reduces the likelihood of the events occurring again in the future.”

That combination of crisis prevention and genuine de-escalation support was central to why Safety-Care was selected at Johns Hopkins. “There was that embedded component of both de-escalation prevention, as well as reduction of crisis events in the future,” Dr. Sommerhalder noted.

Getting the Rollout Right

Early implementation in a hospital system is not a small undertaking, and the panelists were candid about what that process requires.

Julie Meyer emphasized that a thoughtful rollout starts well before training begins:

“The things that I think were really important for us were a really clear plan with the correct stakeholders. Who is going to be impacted by rolling out Safety-Care, rolling out a new program, and getting the right people at the table really early to start talking about clear communication.”

This includes deliberate trainer selection. Meyer noted that Seattle Children’s made a point of choosing trainers who would ask hard questions and challenge the plan, not just enthusiastic early adopters. “Picking trainers who are going to challenge the transition, ask the really tough questions and really push, poke holes in our plans so we can have those conversations early” helped surface implementation challenges before they became real problems.

For their initial go live, Seattle Children’s set an ambitious target of training approximately 500 staff in a single month. Trainers were given extensive practice time before the launch, including specific preparation for the tough questions they knew would come up in class. They also trained some managers as trainers, giving them a frontline leadership presence during go live as super users and support resources.

Scott Sylvester offered a perspective on what happens when you take a well-established program and bring it into new environments. When Brown University Health expanded Safety-Care from Bradley Hospital to its broader system, trainers who were deeply experienced in a psychiatric hospital setting found themselves navigating emergency departments and behavioral health units with very different physical spaces and very different staff cultures.

“There’s only so much room next to a hospital bed. There’s only so much room in an ED,” Scott observed, which created unique scenarios for consideration with realistic implementation in these new settings. The team leaned on a mentor trainer model, pairing newer trainers with experienced ones and ensuring that trainers spent time on new units learning their rhythms and routines before training those units’ staff.

Building Buy-In at Every Level

Getting staff and leadership aligned is its own challenge, and it looks different depending on the setting and staff.

At Johns Hopkins, buy-in developed organically from the ground up. Staff were already calling for change before a new model was selected, which gave the implementation effort strong momentum. But buy-in at the leadership level required its own intentional work, including clear agreements about how Safety-Care requirements would be treated in relation to job performance. “We spend a lot of time with leadership preparing for things like how do we want to handle when staff are unwilling to arrive to their training? Are we going to make this a requirement as part of their job description?” says Dr. Sommerhalder.

Hopkins also made a deliberate choice to train all disciplines together, from administrative staff to physicians, and to nominate trainers from each discipline. “All of our trainings are done at a multidisciplinary level,” Dr. Sommerhalder explained. “Whether it’s a psychiatrist or a nurse, they’re all going through the training at the same time.” That decision required navigating scheduling complexity across departments, but it was a priority for ensuring that everyone was working from the same foundation.

A key cultural shift that supports buy-in at all levels is moving from asking “What is wrong with this person?” to “What has happened to this person?” Scott Sylvester described this evolution at Bradley:

“I can say that when I first started in this field, it was, you know, what the heck is wrong with that person, to now I see it to what has happened to that person. And just that little bit of switch throughout the hospital was a huge change.”

He also noted that this shift extends even to non-clinical staff. When maintenance workers were asking why the same repairs kept being made, taking the time to explain the trauma-informed perspective made a real difference in their understanding and willingness to support the program.

What Changes on the Floor

When Safety-Care takes hold, panelists described meaningful shifts in how their teams respond to behavioral crises.

The most frequently cited change was the value of shared language. When a large hospital system is responding to a behavioral health crisis, teams from different departments may converge on a unit at the same moment. Having a common vocabulary and a common philosophy makes coordination far more effective.

“Just simply the shared language can be really powerful,” Meyer said. “We have a shared philosophy, shared language. We’re coming from the same baseline level of understanding first.”

Dr. Sommerhalder added that Safety-Care’s built-in decision-making framework sets it apart from other models:

“There’s an embedded decision-making algorithm that I found that many other models struggle with teaching, like how do I make the decision to sidestep, backstep, or increase? How do I make a decision to use this particular tool versus this one? That’s a really lovely component.”

Scott Sylvester described one moment that has stayed with him over the years: seeing a staff member calm and focused while a patient had grabbed their hair, with other staff nearby responding seamlessly without the situation escalating. “It was just how fluid people were, and they kept it calm, kept everything cool. No one even knew it was going on.” No one was harmed, treatment continued, and the whole situation resolved without escalation. “That was years ago, but it was one of those little things where I still, to this day, I can see it clear as day.”

Measuring What Matters

Measuring the impact of Safety-Care in a hospital setting presents both opportunities and challenges. Metrics like physical management incidents, seclusion hours, and injury rates can capture important trends. But as Julie Meyer pointed out, some of the most meaningful outcomes are inherently hard to quantify:

“It’s harder to track what [procedures] you don’t need to use. What did Safety-Care prevent us from having to get to in terms of a more restrictive intervention? It’s really easy to track the things that maybe go wrong or the level of intervention you had to do, but not necessarily what you didn’t have to.”

One practical solution Seattle Children’s has implemented is a brief pre/post confidence survey in recertification sessions. Asking staff how confident they feel in their skills at the start of class and again at the end reveals meaningful shifts, often showing staff that they either needed more reinforcement than they realized, or that they emerged from training feeling more capable than when they arrived.

Sustaining the Program Over Time

All three organizations have invested heavily in practices that keep Safety-Care fresh and prevent drift.

At Johns Hopkins, weekly mock codes give staff a regular opportunity to practice in realistic scenarios, particularly around situations that came up the previous week. A “skill of the week” during nursing shift changes keeps specific techniques top of mind without requiring major time investment. Trainers meet monthly as a group, and there is a shared email channel where units can send questions from debriefs directly to the trainer group.

At Seattle Children’s, trainer rounding is a cornerstone of their sustainability approach. Julie Meyer described making regular rounds throughout every area of the hospital where Safety-Care is used, asking staff what is working, what they wish they had known sooner, and where they are running into challenges. “The really focused rounding on what’s working and what’s not, how can I help you, is really powerful,” she said.

Scott Sylvester framed trainer relationships as the engine that keeps the program going over the long term:

“The trainers have to be 100% bought in and they bring that enthusiasm. They bring the passion for the class, for the subject matter. And I think that trickles down. Having those relationships, seeing them around the hospital, checking in with them here and there, it makes individuals want to come to the class. They’re not dreading it. They know it’s going to be a good day.”

Closing Advice: What They Wish They Had Known

The webinar closed with each panelist sharing a piece of advice they would give to organizations earlier in the process.

Scott Sylvester emphasized the importance of communication before rollout. “Make sure that you message it out 100 ways to the middle. The preparation is key. Spend a little bit more time planning it out, mapping it out, communicating, and getting everybody on the same page, as opposed to trying to just get it done.”

Julie Meyer focused on building practice into the program from day one. “Bake in that practice time from the beginning and you will see a lot of positive impact. Technique naturally drifts, it’s normal. The more you can pre-plan for consistent practice, structured, unstructured, whatever it looks like within your staffing model, the better.”

Mindy Huttenstein encouraged organizations to invest in the human side of implementation. “The more effort that you put into this program, the better it is. Really communicating and taking the time to connect with the staff. It’s more than just having the class and then ‘see you next year’. It’s really keeping the connection going.”

Dr. Mackenzie Sommerhalder highlighted the importance of aligning Safety-Care with existing hospital policies and procedures. “Hospitals are kind of a unique beast. I wish there had been more thought on how does this new program or protocol or process fit into our current policies and procedures. How do we advocate for policy change at the hospital level so that it fits with the cultural practice that we would like to be doing.”

Safety-Care Live is a monthly webinar series hosted by QBS, bringing together practitioners and experts to explore real-world implementation of Safety-Care across healthcare, education, and behavioral health settings.