Bringing LTC Training to the Table — and the Tabletop (Episode 31)

June 29, 2018

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Darcy Grabenstein: Hello from SmartLinx! In today’s podcast, we’ll talk about virtual training for healthcare facilities. Our guest today is Kyle Golding, CEO of The Golding Group, an Oklahoma City business development think tank. Kyle and Tadd Weese are co-owners and partners of VORTTX Training, which provides virtual online tabletop exercises for healthcare facilities. Kyle is a born entrepreneur who started his first business as a teenager. With 30 years of experience building, owning, operating multiple businesses, he has positioned, marketed, and managed artists, musicians, startups, corporations, and non-profits to local, national, and worldwide success. He was quoted by Entrepreneur Magazine about “what it takes to be a creative entrepreneur.” Welcome, Kyle.

Kyle Golding: Well, thank you, a pleasure to be here today.

DG: Kyle, before we get into VORTTX, what does it take to be a creative entrepreneur?

KG: You know, traditionally, entrepreneurs are sort of dollars and cents, kind of nuts and bolts type of thinkers. A lot of structure in systems come out of traditional entrepreneurs. But I consider myself a creative entrepreneur; I was always a creative professional before going to work for myself full time. And it’s more about the process than the end result for creative thinkers, artists, and designers, etc. So it’s more about solving a riddle, completing the puzzle, building something from the ground up, as opposed to just being rooted into a system or a business model that traditional entrepreneurs look at. So, you know, creative folks always start with a blank slate, a clean piece of paper if you will, whether it’s if you’re painting something or taking a photograph or doing graphic design.

DG: Or writing.

KG: Yes, exactly. You start with a blank sheet of paper and for me, writing a business plan is the same process. The process is more exciting than the end result, which is what creatives tend to focus on a little bit more. You know, the right-brain folks get a little bit more focused on the process, the left-brain folks a little bit more focused on the end result. And so that’s the difference between a traditional entrepreneur and a creative entrepreneur.

DG: Thank you. So how did you come up with the name VORTTX, does it have a special significance?

KG: It certainly does. There’s a term, an acronym used by FEMA [Federal Emergency Management Agency], called VTTX, which stands for the virtual tabletop exercise. And this is thing that FEMA does typically when they do these large-scale exercises where they come to your town and they actually kind of fake an accident or fake a disaster and they bring out the firetrucks and they bring out the police cars and everyone’s in their gear and they’re walking through as if they’re responding to an emergency. That’s a tabletop exercise, and anything you do online or more of a situational based as opposed to actually bringing the trucks and the equipment out is a virtual tabletop exercise. So FEMA’s been using the acronym VTTX for a long time. And so that was the thought process between VORTTX was trying to come up with something that was very similar to the acronym VTTX. And a vortex itself in nature is typically water or smoke or something like that that’s in an organized flow. And so this is a system for organizing based around something that’s similar to VTTX, and that’s how we landed on VORTTX.

DG: When you said tabletop exercise, I thought literally on the table. But you’re talking about a real creation of a simulation.

KG: A tabletop can be anything from two or three people sitting at a table and just discussing across the table through elaborate very expensive and extensive exercises. Anything in between is considered a tabletop exercise for the people who do emergency management and training of that nature.

DG: Got it. Could you tell me when and how VORTTX came to be? I know that Tadd is Director of Facilities Management at Saint Simeon's in Tulsa, which is a non-profit long-term care community. Can you tell me what role he had in this and what role did governmental regulations play? Is VORTTX specifically for long-term care facilities?

KG: It’s actually been a three-year process to get from the original idea that Tadd had in his role at Saint Simeon's and where we are today. But what you have to start with is kind of realizing that people who are in long-term care facilities, these are folks who on a majority level are not mobile, they’re people who can’t get up and run out the door if a fire alarm goes off. And they’re there typically 24 hours a day. And so the staff at a long-term care facility like a nursing home, a hospice, long-term hospitals, etc., the staff is totally responsible for the people who are there because they’re non-mobile. And so emergency response — responding to fire, to weather, to an active shooter — all of these things, the facility staff, and everyone in the staff, not just nurses and doctors but everyone in the facility has a responsibility because everyone else in the facility in unable to leave on their own.

So this is the reason that training like this is so important. So it also makes it mandated by the federal government and by the state and local governments that the training has to occur for emergency response for everyone in the facility before they start on day one. So they have to do their training before they even start. That’s how important emergency response and safety training is in long-term care facilities.

So in Tadd’s role as the Director of Operations for Saint Simeon's, he was responsible for doing the training for his staff. Every person that he brought on board had to go through the training, had to go through their protocols. They were given their operations manual with where everything was, who is responsible for what, etc. And he was having a hard time, A, finding tools for training.

You know, there’s all this government regulation but they don’t give you any tools to support it. They give you a printed Word document that’s about 100 pages of just ideas but nothing very concrete. So he was doing a very regular training with his staff, trying to keep them compliant. But what he found was just simply kind of reading from a government document to his staff and then asking them if they understood or going through a policies and procedures manual was very boring, and it wasn’t very engaging for the staff, and a lot of them came to really not appreciate the meetings at all, they don’t want to do it. And they definitely weren’t engaged when they were.

And as the person who ultimately would be the head person if an emergency happened, and hoping that his staff would be filling all their roles while he filled his role leading the process, Tadd was very concerned that he wasn’t doing a good enough job with training his staff, with getting them engaged as to what their actual policies and procedures were in case of different types of emergencies.

And the other thing too is it’s not one size fits all. You can’t say well, for every type of emergency we do this, because fire is different than crime, which is different than weather. And it’s even different too, obviously, facilities in California and places like that have earthquakes that we don’t have necessarily here in the Midwest, or mudslides, but we have tornadoes here. So, you know, it has to be specific to the area it’s in as well.

So in his frustration of not having tools to train his staff very well, Tadd actually created what he called a game, where he wrote down a variety of different scenarios, whether it’s fire, crime, weather, etc. and in some different variations of them, and then with his staff would actually take in dice, and roll the dice and create a random number so he could pull a random situation so that the staff would actually listen to what he was asking them and actually answer back to what each of their responsibilities were in that scenario. And then he would roll the dice again, which would give them another option into that scenario, a little bit deeper down the idea of what was happening, in order to make sure that they truly understood from beginning to end what everyone’s roles and responsibilities and what the policies and procedures were for Saint Simeon's.

And so he originally approached us about two years ago, about developing what he called his game as a packaged item that could be sold to other facilities. Because he was actually helping some other facilities in the area around Tulsa, Oklahoma where they operate do the same thing for their staff. He said, “Let’s package this up and let’s sell it to other facilities all over the country.” We really didn’t find a packaged good game with dice and all kinds of printed material to be very economically viable, both in production and distribution. So instead, we developed this online system, a virtual system, if you will, so that we could develop a single system and then distribute it via the internet and give people access to it 24 hours, make regular updates, etc., and create a more robust training system for long-term care facilities.

DG: Wow, that sounds like fun. Tell me exactly how does the training work? Do your clients need any special hardware or software? And is it designed for individuals or for teams, or both?

KG: So it’s designed for individuals and teams. Typically before VORTTX was a thing, most of these facilities would have regular meetings and typically with the shift, so first shift, second shift, third shift would have a meeting on maybe the first Monday of the month or the first Monday of the quarter, and they would go through the training together, they would talk about their policies and procedures operations, and then the person responsible — whether it’s Tadd at Saint Simeon's or someone in another facility — would make a report and say these were the people in the meeting and here’s what we discussed and they have been trained and we are being compliant.

That's the other half of the government regulations is you have to have compliance reporting. It’s not enough to just do training. You have to prove that everyone’s been trained as well.

So as far as the training system itself, it’s online, it’s done through a website, so all any facility needs is access to the internet and a web browser of any sort. And it’s a multiple choice, multiple scenario question-and-answer system that’s basically presented on a website. And so the way it works is, we give — beginning with a basic concept of a type of disaster, and there are multiple types of disasters, like I’ve mentioned a few times. And we give the operator the chance to either choose their disasters, the ones they want to discuss the emergency responses, or have the system choose it for them blindly so that it’s not the same as training every single time.

But what makes it even more interesting is every time we give a scenario, there’s a time for the trainer to discuss with the people in the room and record their answers in text form on the training system itself. And then as they hit next, they get a further development of the scenario, so if it begins with there is a fire in the facility, the next scenario is the fire is in the kitchen and there is a lot of smoke. And the next scenario is that it’s overnight, and so all of the people who are living at the facility are asleep. And then, even further from that, sometimes we get variations such as everyone is accountable except for a single guest, what do you do.

Every question ends with “what do you do,” which begins discussion in the room. There’s also a way to do this in an individual manner so when someone starts working at a facility, they can be run through this training in an individual aspect and then there will be proof that they’ve been trained and then they can get on the floor without incurring any of those penalties from the government.

DG: How many trainings have you done so far?

KG: We’re up to a couple hundred. We spent the last 18 months with five test facilities, kind of our beta testers. They’re using it on a regular basis, and after 12 months of beta testing we’ve been in the open market for the last six to eight months, and we’re having organizations that are purchasing and using the training on a regular basis there as well. So we’re around 200 at this point.

DG: Got it. So, Kyle, is the training used only for emergency situations, or can it be applied to other uses? And how many different scenarios would you say you have?

KG: So we have over 3,000 combinations of scenarios, between fire, weather, and crime being our three major segments. Also, each of the segments are broke down between first shift, second shift, third shift, and then the multiple variations between all of them like I said which equals over 3,000 different combinations. So you could run this simulation 3,000 times and not necessarily get the same combination of elements, not the same answers, either.

It’s designed specifically for emergency response training, and again for these long-term care facilities because it’s mandated as part of their licensing and regulatory compliance.

But other facilities definitely could use it as well as a way of identifying employees who are either excelling at the policies and procedures or lagging behind and needing additional training. So that’s why testing and training is in the title of it itself.

It’s one thing to be compliant and for everyone to have an acceptable level of understanding of the procedures during an emergency response. But facilities today are having to compete with each other on a very regular basis for people to come and pay their good, hard-earned money to have their loved ones in their facility and they want to know it’s safe. And so being able to train their staff better, or train up the folks that are kind of lagging behind in order to get their staff really highly engaged in the safety process, is advantageous for facilities. So the primary role is for compliance and specific training to make sure that their licensing is updated and that they do a proper job in an emergency situation. But it can be used to really identify your key employees and your employees that need additional help as well.

DG: Right. I know you mentioned — you started to discuss a fire in, say, a kitchen. Can you give me an example of a scenario for a long-term care facility, maybe playing it out through several of the stages?

KG: I can, I’ll try. My area of expertise on this one is the technical side, but I definitely played the game a few hundred times. Tadd knows all these by heart for sure. So a good example would be — this was one I didn’t expect when I first read it in the scenario presented by Tadd — so a plane has crashed nearby your facility, is scenario number one. So that’s a pretty big deal, right. And so what do you do. And there are members of the staff who are responsible for actually going out, see what’s happened. There are members of the staff for securing the people in the facility. There are actually members of the staff who are responsible for securing things like the narcotics that are on hand, because there are drugs, Schedule I and II drugs, that are in these facilities. And then, of course, contacting the local authorities and coordinating with the local emergency response.

The next scenario can be that the plane crash has caused a fire that’s encroaching upon your facility. So now it’s gone from a shelter-in-place scenario to a possible evacuation which now has to be organized completely different than the original scenario of a plane crash. And then the coordination with the local emergency response has been elevated even further, and so it changes everyone’s responsibilities there.

And then the next scenario can be that during the evacuation from the fire, there are unaccounted-for guests. And so this now creates a different situation where different people have different responsibilities to go checking in certain areas and doing different things in the protocol so that they make sure that they’ve covered everything and figured out who is doing what and coordinating again with the local authorities. So that’s three levels of variances that might occur from a single emergency response to a plane crash.

DG: Right. In a situation such as that, where someone might need medical assistance, do you think they might come to the facility looking for medical assistance, because they know it’s a healthcare facility? And what would the response be in that case?

KG: There is actually protocol for that as well. So your initial response has to be the safety of the people who live at the facility, but then there is a social responsibility to anyone who might be associated with accidents in the area. We actually have some scenarios too that have to do with riots and loss of power, things like that, where actually the facility would need to be locked down for the safety of those who live there, and again for the protection of things like powerful narcotics and other things of that nature.

So there are scenarios where you’re supposed to help those who show up at your door and there are scenarios where you’re supposed to lock your facility down and protect the people involved. And knowing the difference between the two and making sure you do them in the right way at the right time is very important.

DG: Sure. Have you had requests for specific scenarios to be added?

KG: We haven’t yet. Tadd did a really good job of covering the majority of the scenarios that these facilities are thinking about. Like I said, we’ve definitely had some people refer to specific weather events. The weather event we have now is sort of a storm that involves rain, lightning, wind bringing down power lines, trees, etc. But our friends out on the west coast would really like to consider mudslides. Here in the Midwest we definitely see a lot of storms. Folks on the east coast would definitely like to think about flooding and scenarios like that.

DG: Hurricanes.

KG: Absolutely, hurricane response. After the flooding in Houston, where literally the media was showing examples of people in senior citizen centers with water up to their knees sitting in their wheelchairs waiting to be rescued, that’s a very prime example of something that can happen, and those people can’t just get up and walk out. The people in these facilities can’t just run away or even jump in a boat that comes by. It has to be done in a very coordinated way and the staff is wholly responsible for that.

DG: Right, I know that California just passed legislation requiring workforce training for healthcare organizations for workforce violence. So I’m sure that those scenarios would be helpful as well.

KG: Safety is always a huge paramount concern. Obviously, things that we have no control over such as weather and fire, or accidents, are primary. And then we’re seeing more and more where response to crime, active shooter, even something as widescale as rioting or power outages, because society is the way it is today, that these facilities have to be equipped for those and have to be trained beforehand.

DG: Well thank you, Kyle, so much for sharing your idea and your concept with us today. And to all our listeners, thank you for tuning in. For more information on VORTTX, visit And if you’d like to learn more about SmartLinx and our fully integrated suite of workforce management solutions, visit us online at

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