Safety Culture with Dr. Michael Cull

Just like aviation, healthcare, and the nuclear industry, Child Welfare is a safety critical industry. High stakes, high consequence decisions are made by child welfare workers and caregivers every day. Although we may not think about child welfare workers and caregivers in the same way we think about pilots, surgeons, and nuclear technicians, we should!

Join Pete Cudney and Cassie Gillespie from VT-CWTP as they interview Dr. Mike Cull from the University of Kentucky’s Center for Innovation in Population Health about his work adapting safety culture, a strategy used in other safety critical industries, to child welfare systems in general, and the VT child welfare system in particular.

Guest Info:

Dr. Michael Cull is Associate Professor, Health Management and Policy in the College of Public Health at the University of Kentucky. He is also an Associate Director in the Center for Innovation in Population Health. Mike’s work focuses on quality improvement and system reform efforts in child welfare jurisdictions. He has specific expertise in applying safety science to improve safety, reliability, and effectiveness in organizations. His approach leverages tools like organizational assessment and systems analysis of critical incidents, including deaths and near deaths, to build team culture and help systems learn and get better.

Show Notes:

More information about Safety Culture and Mike’s work with the Safe Systems Improvement Tool can be found at the Praed Foundation:
More info about Mike’s Team First Approach and Safety Culture can be found at Lead Teams First:
Info specific to Safety Culture in Child welfare can be found at Casey:
Info about Safety Culture in other fields and the existing body of research in the medical field can be found at the Institute for Healthcare Improvement:


Cassie Gillespie (00:02):

Hello, I’m Cassie Gillespie. And you’re listening to Welcome to the Field, a podcast for child welfare workers, caregivers, and community partners. Today, my colleague, Pete Cudney and I will be talking with Dr. Michael Cull about safety culture and child welfare, just like in aviation and the nuclear industry, child welfare is a safety critical industry and high stakes high consequence decisions are made every day by child welfare workers and caregivers. In this episode, we’ll talk with Mike about his work adapting safety culture strategy used in other safety critical industries to child welfare systems in general, and the Vermont child welfare system in particular. And if you’re wondering, Mike is an associate professor of health management and policy in the College of Public Health at the University of Kentucky. He is also an associate director in the Center for Innovation and Population Health. Mike’s work focuses on quality improvement and system reform efforts and child welfare jurisdictions. He has specific expertise in applying safety science to improve safety, reliability, and effectiveness in organizations. His approach leverages tools like organizational assessment and systems analysis of critical incidents, including child deaths and near deaths. He uses these to build team culture and help systems learn to get better. He’s also just a phenomenal person and I’m so excited he was able to join us. Okay, here we go. So hello, Pete.

Pete Cudney (01:29):

Hi, Cassie.

Cassie Gillespie (01:30):

And welcome Mike. We’re good. Thanks for coming today.

Pete Cudney (01:34):

Excelllent. Thanks Cassie. Mike, so, maybe just diving right in. Could you just start by kind of talking with us about what is safety culture really

Dr. Michael Cull (01:46):

Sure. So safety culture is a type of organizational culture could even be a subculture within a larger organizational culture that might have, you know, you can imagine a number of different subcultures. And so it’s a type of organizational culture that we see in what we call safety, critical settings or safety, critical industries, places like aviation healthcare, the deck of an aircraft carrier, those kinds of places where you need to be able to maintain consistently reliable, safe operations over long periods of time, because when things go wrong, they go really wrong and bad things happen like airplanes crash or patients die. So we have a long history now of looking at this particular type of culture and understanding what it means to sort of be a safety culture. And so just maybe taking a step back, you know, organizational culture is it’s about our habits and how we solve problems in our organizations.

Dr. Michael Cull (02:42):

You might say it’s kind of like just how we do things around here or another kind of quick definition that I’ve always liked is it’s what we tolerate. So it’s not an abstract idea. It’s something we can measure and it’s something we can shape and change with some very specific strategies. So, safety culture in particular is a kind of organizational culture that sort of acknowledges that the work is high risk and that humans would in these complex settings are fallible. And so you need to direct resources at sort of helping them to make right decisions and helping them to make safe decisions. There’s some very specific strategies that I know we’ll get to, that you can put into the workforce and into the setting to kind of provide some structure while you’re building those habits. And again, habits form our cultures. It’s really collaborative. So you the places that I noted like aircraft carriers and operating rooms and aviation, and so it’s very collaborative. It’s really central to creating a safety culture is creating an environment that’s blame-free. That’s what we call psychologically safe. That is people in the environment feel accepted and respected part of a team. And they feel like they can speak up and identify problems in our system. Talk about mistakes as opportunities to learn and improve and not as opportunities to reprimand and punish.

Cassie Gillespie (04:11):

Great. So those are some of the traits of kind of safety culture in general, as it’s applied to many safety critical industries, tell us what’s unique about applying safety culture to child welfare.

Dr. Michael Cull (04:20):

So this is a 10 year long journey now where I got my experience in what it means to kind of create or advance a safety culture in an organization working in healthcare. And so this is kind of applying a healthcare frame to a child welfare setting. And so it’s been a different sort of approach. we talk a lot about systems thinking and applying a systems approach to understanding problem solving in your organization. So again, organizational culture is about habits and how we solve problems. So we have to bring kind of a systems lens. When you think about a system like an airplane or an operating room, the component parts are that of that system. And then how they interact a lot of it, you know, it’s engineering and math and those kinds of things. And then only a little piece of it might be how people interact with those components, but our system is made up almost entirely of people.

Dr. Michael Cull (05:10):

So when we’re talking about how do we create safety, it’s almost exclusively about how people interact with one another. So some of the strategies sit really nicely in our context, and some are a little bit of a challenge, you know, one strategy for creating safety. And for example, an operating room would be creating what they call hard stops. So just literally engineering the operating room so that humans can’t make the kind of mistakes that they’re prone to make when they’re doing fast paced, high pressure kind of work. So you might, uh, it used to be the case that oxygen, tubing and anesthesia tubing was exactly the same size. And so on oxygen tubing could fit onto the anesthesia port, which if you’re a patient that needs oxygen and that would of course be a really bad outcome. And so they created a hard stop. Now, the tubing’s a different size and the ports are different size. So those kinds of things that get baked into the work of kind of engineering, a safe environment. We don’t have a lot of those opportunities in child welfare. And again, most of our component parts are people. And so all of the strategies we’re bringing into this work really almost exclusively focus on how people communicate with one another.

Pete Cudney (06:12):

Mike, some of what we’ve, when we’ve talked about this before, some of what I’ve really appreciated about this way of thinking is that it positions child welfare child protection services alongside other industries, like you’ve mentioned that are incredibly complex, sophisticated really require high levels of professionalism. And I think it’s just so validating for people in the field, this idea that the work that they do is critical. The reliable outcomes being safe is critical, and that it’s way too complicated to do it in isolation and that therefore you need to work in teams. And I’m just wondering if you could just talk a little bit more about that because I think it, it really does honor, uh, the people doing the work in a particular

Dr. Michael Cull (07:03):

Yeah, honestly, that was the sort of the moment that we had the folks I was doing work with at Vanderbilt, where we said, you know, this stuff might apply to child welfare. And it was really this recognition that, you know, like pilots and surgeons and nurses, our child welfare professionals are making high risk, high consequence decisions all day long, and they just might benefit from some of these same approaches. And so one of the backup, a little to Cassie’s question one, to be also the differences in thinking about applying this in child welfare and applying in some of those settings is the workforce that we have. We don’t largely have a pre professionally trained workforce that we pull from in child welfare. I think nationally about 35% of all child welfare professionals actually have a social work degree. And so we’re hiring folks who want to come do the work, but might have a variety of different backgrounds in terms of their educational preparation. So we train them to do the work, and then we hopefully support them in the work throughout their career. So that makes for a really different approach. When you don’t have a pool of professional folks, we have professional mean being associated with some licensed, like a nurse or a doctor. But they might come from different backgrounds and we have to prepare them up to all work at the same level. So I think that makes it a different kind of challenge. When you think about applying this in a child worker context.

Pete Cudney (08:20):

Absolutly. It seems to mean that the agencies, the organization itself really needs to bear a certain, I mean, pretty significant responsibility in designing with safety in mind.

Dr. Michael Cull (08:33):

Yeah, for sure. You know, this is this is an approach that, you know, is not holy bottom up. It’s not an approach where you go in and kind of get the workforce excited about it and sort of build it from the ground up. It’s a top down sort of leadership has to buy in approach because they have to create that sort of blame-free environment where people feel safe speaking up and pointing out things in their system that needs to be improved. That has to get buy-in at the top level or you’re kind of putting people at risk for stepping out on a limb and then getting that limb cut out from under them. And so what we’ve seen in some other organizationsI think Vermont’s doing a great job of this is really putting a focus on creating a safe, engaged workforce that has the tools they need to do the job. It’s an essential component of creating this kind of culture that we’re talking about.

Cassie Gillespie (09:18):

And so I know you work you’re leading, I guess that’s probably the term a partnership of many states right now who are trying to implement child’s welfare, a safety culture approach into child welfare settings. Where does Vermont stack up in the partnership? Like there’s some stuff we’re doing that’s unique, but I imagine there’s lots of stuff that you’re seeing happening nationally along these lines.

Dr. Michael Cull (09:37):

Yeah. It’s been a really exciting thing to be a part of. We’re supporting a national quality improvement collaborative. It’s currently 24 child welfare jurisdictions are participating. Vermont was one of the initial cohort of eight and that was in 2019 that we sort of launched in earnest. So just in that short period of time, since then, we’ve grown to 24 jurisdictions. I’ll keep circling back to my definition of culture, but this idea that, you know, culture lives in the way you solve problems, we anchor the collaborative, like quality improvement, collaborative seen in other industries to sharing data around safety kind of critical events and typically low base rate events. So an example in healthcare would be at national collaborative of operating rooms where they come together and share into a national dataset, low base rate events that occur in the operating room at any given hospital.

Dr. Michael Cull (10:29):

It doesn’t happen a lot, but shared across a lot of hospitals, there’s this great opportunity for learning. So it would be things like what’s called retained foreign bodies. So you know, a sponge or an instrument that sadly getting left in a patient or a wrong side surgery, those kinds of events that don’t happen very often, but it’s a big deal and they do. So we’re anchoring this national collaborative to reviews of fatalities near fatalities and other critical incidents in the child welfare system. And so we’re doing that in a way that we’re helping the jurisdictions take a systems approach to viewing these incidents in their system. And maybe first and foremost, creating a safe space to think about these things. Because these, you know, when one of our professionals has a kid unfortunately die or, you know, have some significant event happen, it’s oftentimes the worst day of that professional’s career.

Dr. Michael Cull (11:15):

And so we build this approach, that’s both supportive. It’s non-punitive and it’s about viewing those professionals that are doing the work as an asset in our system and not as the problem themselves. So it takes a really specific sort of approach to review critical incidents. And then as I said, we standardize the output from those reviews and we’re sharing those reviews into a data set nationally. Vermont there’s other pieces then to the collaborative, which are more related to doing measurement of your organizational culture using what’s called a safety culture survey. And so that’s a survey that measures values, behaviors, beliefs of your workforce with respect to creating a safe, reliable delivery system. So it measures things like psychological safety and burnout. This idea of mindful organizing, which is a teamwork construct it’s about how teams work together, innovate seek out new solutions.

Dr. Michael Cull (12:06):

And then from that helping do sell for jurisdictions, do some work with their teams, using some really specific strategies that we pull from places like aviation and healthcare. So it’s things like using huddles before critical decisions are made or using debriefs after things don’t go the way we want them to go. And so Vermont, Cassie asked how they stack up, One, Vermont was one of the very first jurisdictions that got excited about this and got involved. And then two, Vermont has really leaned into the organizational assessment piece, really understanding, you know, taking the temperature of their workforce and then implementing some of those team-based strategies in huddles in particular has really taken a hold as a strategy for helping teams come together and in a collaborative way plan for, you know, some kind of really critical decision like a removal.

Cassie Gillespie (12:56):

Great. One of the things that I know we’re working on here is we’re early enough still in our implementation that we focus predominantly on the workforce implementation through both leadership and, you know, direct service workers, but a huge part of our system, the real unsung heroes are the caregivers for kiddos, you know, foster parents or kin caregivers as well. And so I’m wondering if any of the jurisdictions that you’re working with are doing interesting things, pulling caregivers in the safety culture, or even if you just have thoughts about how safety culture might impact caregivers differently from workforce.

Dr. Michael Cull (13:30):

Yeah. I don’t know if any of our jurisdictions have done anything sort of formal with caregivers with foster parents specifically. We do have one jurisdiction working on use what you’d call mill U staff in their congregate care settings, some group homes and residential care. They’re spreading this model into those settings with our help. And so that’s really exciting, especially when you think about the idea that this is borrowed from healthcare. It’s from, it’s kind of much easier to think about how to translate something that happens on a nursing unit into residential care, for example, because the settings are so similar. So we do have a jurisdiction that’s engaged in that, but yeah, really excited to think about how we extend this out to our foster parents. You know, when we get more mature in our thinking about this. Cause it really, you know, sadly I just read a report from an ombudsman out of one of the jurisdictions that, you know, they get reports from foster parents and they described kind of a culture of fear that something like 90% of all the reports they get from foster parents have some element of the fear reprisal from the system, if they complain.

Dr. Michael Cull (14:31):

And so you need a dislike, you need team members inside your system to feel psychologically safe, to be able to speak up and provide candid feedback. We need our foster parents letting us know when they are worried about something going wrong. We need them to feel safe that they can speak up and talk about problems, even talk about mistakes they made because we don’t want other foster parents making same mistakes. So I think it’s, it’s a natural extension of the work we’re doing. And in fact, I don’t know that we can fully accomplish the kind of change we want without extending it out in the door classrooms.

Pete Cudney (15:01):

It’s a really good point, Mike and I don’t, I don’t want to oversimplify something as complicated as this and maybe this risks doing that. But one theme that seems to keep coming up again and again, is this idea of psychological safety. The idea that it’s important that the culture not just even feel safe, but almost feel encouraging and inviting of all voices and especially any voices where they have concerns about whether we’re adequately meeting a child’s needs or providing for safety. And so I’m wondering, you know, whether or not that central, I’m just wondering about what have you learned are the key components to driving that kind of culture change? I mean, you’ve talked a little bit about cert, you know, measuring surveying, you’ve talked about paying attention to key critical incidents, the importance of leadership. Are there other pieces that you would want to name that are important in driving culture change?

Dr. Michael Cull (16:00):

Yeah, I think, you know, I think you asked it is psychological safety sort of central to this work and it is actually just the sort of bedrock and kind of condition you need to create in your environment to accomplish this. Like without it, you just really can’t accomplish anything. So again, psychological safety is this idea that I feel accepted, respected. I’m part of a team. I can speak up and take personal risks. We don’t treat mistakes as opportunities to punish, but rather opportunities to learn. And so Amy had mentioned in the early work on this at Harvard looking in the Harvard health care system, and she was specifically tasked at the time to go and look at error reporting in nursing units and how that was correlated with outcomes, patient outcomes. And so the assumption going in obviously was the number of areas you saw on a nursing unit would predict worse outcomes, right?

Dr. Michael Cull (16:48):

So more reporting would equal worse patient outcomes because they were on making more mistakes on their right nursing unit. What she actually found was the inverse Munis that had higher levels of reporting actually had better outcomes with patients. And so that was kind of a confounded everyone on the research team. And they went in and did a much deeper dive into each of these units to figure out what, you know, what’s going on with this. And what they named in the literature at that time was this idea of psychological safety. That those units that felt safe talking about mistakes also were more likely to report those mistakes. So it wasn’t that mistakes weren’t happening in high numbers on the other units. It’s just that they weren’t reporting them because they didn’t feel safe enough to. And so that earlier search has just really mushroomed into not just through rippling through healthcare, but through other industries as well.

Dr. Michael Cull (17:31):

And aviation has known this for a long time. If you’re in a situation where the copilot doesn’t feel safe, speaking up and challenging the pilot, that plane’s just not as safe. There were a number of high profile Korean air crashes that they determined that to be one of the sort of root causes of those events. So we know people have to be able to have this thing that we call psychological safety. And importantly, it’s not psychological comfort, like being psychologically safe. Isn’t always easy or comfortable because it means you do have to speak up and in a candid way, challenge your colleagues, but that’s an essential tool in a professional workplace. You know, you have to feel safe to do that. Google actually just went through a big five-year study where they were sort of trying to identify what makes a team in the Google environment most effective. And I think they probably went into it thinking, you know, when they came out the other side, they’d be able to say something like we need one MBA and two data scientists, you know, software engineers or whatever, but what they found was psychological safety or is the strongest predictor of outcomes in the Google environment. Could our teams speak up, talk about mistakes, fail without fear of reprimand and those kinds of qualities. Yeah.

Pete Cudney (18:42):

And are there times where it’s helpful, if there are leaders who are trying to push this kind of change in an organization, are there times where there’s resistance that this is just kind of taking care of staff? Do you need to help make the connection at times that it’s in service of the safe outcomes for children? Do people miss that connection?

Dr. Michael Cull (19:03):

We often have to come back to that. I think it’s, you know, it’s not always, and it’s less and less of what I’ve been most taken by. I think as we’ve done this in child welfare is how quickly child welfare and leaders, many of them are again we’ve grown to 24 jurisdiction so quickly that it’s almost like we’ve given them a language for something they’ve been thinking about all along, you know, this is how people generally would want to run their organizations. And, you know, we’ll hear from people a lot too about this idea of a parallel process. So this is kind of about treating your colleagues and your workforce in the same way that we’d expect them to work with families. And so it’s really natural kind of for, I think folks in child welfare to think about the importance of meeting people, where they are and creating a safe space for the new people to talk and those kinds of things, but it is important.

Dr. Michael Cull (19:50):

I, it’s definitely the case that we frequently have to come back to that this is about creating a safe, effective, reliable workforce. And these are some of the critical things you need to do to create that. And so being effective and reliable in child welfare means getting good outcomes with your families and keeping kids safe. You know, it means other industries, we talk about places like aviation and healthcare. They now have decades of research supporting this approach. So there’s a good literature base in all of those places that we’re borrowing from, but we’re having to kind of make some assumptions about how it will work in child welfare. So we are also, and you know this well because we’re engaged with your team at the university on some papers right now, but we’re taking on the responsibility. I think of building the evidence base in child welfare.

Dr. Michael Cull (20:34):

So we have a number of folks at universities around the country now that are partnering with child welfare, their child welfare systems like Vanderbilt in Nashville and to Northwestern in Illinois and working to and you guys in Vermont and working to build the evidence for this. So we know from the organizational assessment data, that there are a number of important relationships that play out in organizations that we can work on to improve. So we know for example, when we see teams that are more psychologically safe, we see less burnout and we see less turnover. So those are really important workforce level outcomes that gives us some evidence for why we need to build these teams in the way that we’re building them. But we also are starting to do some work to link these things to child level outcomes. Our colleague Richard Epstein at Northwestern is doing some really cool work, trying to link the practice of mindful organizing that team-based construct that they sort of about planning forward and reflecting back and being resilient as a team and innovating together as a team, connecting that practice as we measure it with our survey tools to some child level outcomes, like repeat maltreatment and length of stay and even parent-child visits.

Dr. Michael Cull (21:41):

So there’s some really exciting work going on. And this big collaborative gives us an opportunity to really have access to a lot of really good data.

Cassie Gillespie (21:49):

I that is so exciting because I feel like the kind of narrative has long been, you know, that you can attend to your workforce and their burnout and their workload, or you can get the work done, you know, and it just really seems like safety culture is debunking that essentially. That the way to have the most effective and transformative work is to attend to your workforce and the systems.

Dr. Michael Cull (22:09):

Yeah. I couldn’t agree more. We’ve got a couple of jurisdictions that are doing some neat things from a strategy perspective. Know, so this is about culture and we you’ve seen my talks where I was put a slide up that talks about culturating strategy for lines. And I, and I do believe that’s true. Strategies are our best intentions. That’s what we plan to do. It’s what we draw. And then we introduce it to our culture and you know, who knows what’s going to happen, but you need strategies too, right. So, Los Angeles county for example, has a public facing strategic plan called invest LA where they put right in the middle of their sort of pillar metaphor. You know, they have five pillars that support the strategic plan, creating a, you know, a safety culture and how it addresses safe and engaged workforce.

Dr. Michael Cull (22:57):

So they’ve really, you know, creating it in that way, putting it in a, in a document like that one creates kind of an organizational artifact that can be a touchstone for the work, but it also creates accountability, public accountability. Again, this is their public facing plan and accountability internally because each of those pillars will have, you know, a senior leader responsible for some metrics to be able to demonstrate that they’re achieving their goals. So I, to your point, Cassie, you know, putting your workforce in a plan like that and making their safety a part of it is really forward-thinking. And I’m excited about that

Cassie Gillespie (23:31):

So are we, so cool. So question, I have, we’ve talked around this, but I really want to get clear on it as from the perspective of someone who’s working in the system, like your average child welfare worker, holding the caseload, how would role their job or their, their organization look different when safety culture is implemented?

Dr. Michael Cull (23:51):

Well, I think he use a different set of tools, I think, and strategies, you know, this isn’t, none of the things that we bring to the work is sort of at the level of a new practice model. You know, like most child welfare systems have some form of practice model that creates the contours of the work. And it’s really more about the blocking and tackling of working in a team. So again, it’s using things like huddles and debriefs and, you know, bars from aviation, where are places we can use checklists to help us make sure that we discover everything. How can we use tools that help us structure the way we communicate with one another so that we get the desired outcome and that two way process of communicating? I think it’s some of the strategies that would change. I think for child welfare in particular, because again, we’re borrowing from places where work is very collaborative and team-based, and we’re putting it into a place where sometimes it can be very isolated sometimes in child welfare, it’s a child welfare professional out there engaging with a family on their own.

Dr. Michael Cull (24:45):

And they may have some structure for touching base with a supervisor or some kind of informal way of getting support from their peers. But we don’t often think about child welfare work from a perspective of like a team coming together to make decisions about work, unless it’s a child and family team kind of model, but that’s a different kind of team that I’m talking about. So it might look different in that we’re using some different strategies for thinking differently about collaborative work. And then, you know, you have to bring a new lens to the work it’s I oftentimes talk about it being akin to becoming trauma informed. Like when we kind of went through that process as, as organizations of becoming trauma informed, becoming trauma informed is as much about just changing your paradigm as it is about anything else.

Dr. Michael Cull (25:29):

It’s nice for you to understand the brain science. It’s nice, maybe for you to understand the details or have some sense of, you know, things like trauma-focused CBT and how they work, but really it’s about just changing your lens. It’s about understanding that no, that externalizing 13 year olds is pulling up their placement and has a trauma history needs to be thought of a little bit differently. So this is about bringing new lens to the work it’s about understanding things like, you know, the cognitive biases that all humans have that affect the way we make decisions and that all systems and all people are fallible. It’s about when you’re asking questions, asking different questions, it’s about, you know, thinking about the what and the how of decision-making and not the who and the why so not going and trying to find out who did what and why they do it, but what did they do on how did they do it and what, what were the thought processes behind it? So we can really fully understand how to make it better next time. So much of it is about just changing your lens, having a different paradigm.

Pete Cudney (26:23):

I appreciate that Mike. And I mean, as you know, we’re, we’re pretty excited about this in Vermont too. And I just want to reflect back to pieces that, that you just said, and they resonate with my experience. And one is that I think, you know, being trauma informed and developing a safety culture, I think are really, really similarly connected. You know, I think there’s an awareness of the impact of secondary traumatic stress on the workforce and how that affects decision making within safety culture and a trauma informed approach, you know, acknowledges that we’re human and that secondary traumatic stress really does physiologically affect people. So I appreciate that you drew that parallel. I’ve also really appreciated that something as seemingly abstract, as culture can really be affected at the team level with simple strategies. I mean, that’s really been our experience so far in Vermont is that these mindful organizing team level approaches are really a pretty concrete way to start moving this work forward and change your culture in the process. If there are people listening to our podcast who, for whom safety culture is new, and they were curious about this and wanted more information, are there places that you would point them to get more information? Like, what would you suggest as a, as a starting place.

Dr. Michael Cull (27:44):

You know, I think if you want it specific to child welfare, we have some resources on the pride foundation website. So I’m at the university of Kentucky, but I also, part of our work is also with the pride foundation that supports a lot of work in child welfare and public sector, mental health around the country. So there’s a spot on that. It’s It has some resources that are specific to the work we’re doing in child welfare systems. Casey family programs, you would have to do some searching, but they have a number of resources and some briefs they’ve recently developed about the work we’re doing in child welfare. But if you really want a lot of really good information about this, the Institute for healthcare improvement is an awesome resource for this kind of work. And so it’s just You could go there and set up a free account and have just tons and tons of resources available to you there.

Cassie Gillespie (28:36):

Great. And we can put those up on our show notes with this episode.

Dr. Michael Cull (28:39):

Yeah. Pete, I’d like to go back to something you were mentioning about, you know, this parallel between becoming trauma informed and how trauma plays out in our system. And you know, what we’ve really learned through doing this work and doing the kind of that organizational assessment that we do. And we’ve done a lot of great work in child welfare around secondary trauma and understanding it and understanding its impact. What we’ve maybe not been as good at is understanding how to keep folks from, you know, kind of suffering from the exposure. How can we build in some protective staff, one. And two understanding that, you know, it’s one influence from our work, but there’s a lot of crappy stuff that goes on in child welfare systems that impacts the way our professionals do their work. And so we know, you know, we measure it all across the country.

Dr. Michael Cull (29:26):

Now we know that burnout is in the high 40% in child welfare, and that’s consistent with other helping professions like doctors and nurses. So burnout is really high just by virtue of doing the work at really high risk for burnout. We know that as I mentioned, you know, we bring cognitive biases to our work that affect the way we make decisions. And that gets mixed in there with the effects of trauma, exposure and burnout. And then I think less well understood and child welfare is the role of fatigue. Our professionals in a lot of systems. And I apologize, I can’t remember exactly how they’re not structured, but they might get called out on an investigation and that keeps them out, you know, late into the night. And then it’s oftentimes the case. They’re kind of, that’s not by policy. They’re sort of culturally expected to be available to cover their case the next day, because if they’re not there somebody else will have to cover it.

Dr. Michael Cull (30:12):

And so, you know, we work long hours even if we’re not out of overnight. So I think fatigue is another one that, you know, really is not well understood in child welfare and the impact it has on our workforce. Unlike other safety, critical settings, where the pilot can’t fly, as long as they want to, they effectively have a pitch count where after a certain number of hours, they’re called from an airplane and surgeons, can’t just do as many operations as they want to do in a row. They control that. So other industries that make these high risks, high consequences decisions, like we do have a better understanding, I think, of the role of teaming on decision-making then thing we have been able to understand and child welfare.

Pete Cudney (30:48):

Yeah. Thank you.

Cassie Gillespie (30:49):

Mike. That was amazing. We are about out of time. Is there anything else you want to leave us with before we wrap up?

Dr. Michael Cull (30:56):

I just, I really appreciate the opportunity this is always super fun to talk about. I love working with Vermont. It’s a system that has really leaned into this at all levels. And you guys Cassie and Pete have been such a great academic partner to the state. It’s really been a fun place for us to try this out. And I think we’re having some real success in getting an implement.

Pete Cudney (31:18):

Well Likewise, Mike. Right back at you. Yeah. We’re really enthusiastic as well.

Cassie Gillespie (31:23):

A hundred percent.

Pete Cudney (31:24):

Yeah. I really appreciate you taking the time to talk with us about

Cassie Gillespie (31:26):

This too. Thank you so much. Have a great day. Thank you for listening. Welcome to the field is produced by the Vermont child welfare training partnership and the state of Vermont. Our music is composed and performed by local band Brick Drop and our sound production and engineering has been brought to you by Esmond Communications and Ian media productions for welcome to the field. I’m Cassie Gillespie, and we’ll see you next time.

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