00:16:59 Robin Goodman: Looks great!!! 00:22:50 Kate Remick: Any audio or video issues on your end, Robin? 00:23:19 Rachael Alter: No audio issues here. 00:24:11 Robin Goodman: Its perfect! 00:27:36 Michael Bullock: Many times family spots an error because they know the entire history and story of the patient. Having a safe place for them to report is a great way to support family and the patient safety. 00:27:57 Laura Garcia: Inspiring story. Many of us have stories of family and friends that have reached out to us as medical professionals to question the care they are receiving. This is a good idea to have a hotline for everyone. 00:28:12 Trey Spooner: Patients (or their guardians) need to be empowered to be their own advocates. 00:28:27 Brighan DeFazio: From Covenant HealthCare in Saginaw, MI. We had Sorrel come speak at our organization a few years ago. Very powerful presentation. We have made some system level changes from what we learned, but it is an ongoing effort to ensure patient safety using family-centered care. 00:28:38 Robin Goodman: When changing from Louis to Michelle we were able to see everyone for a quick second 00:28:45 Gabrielle Smith: The families need to be made part of the care during rounding and care planning 00:29:03 elen rodriguez: This is Elen Rodriguez I will have to sign out and sign in from another computer. 00:29:05 robbie besel: need to include the families in the care plan 00:29:07 Robin Goodman: Everyone meaning panelists 00:29:29 Kate Remick: Good to know. Thanks! 00:29:51 Tim Case: @Michael, I think families are also very good at noticing subtle changes in patient affect that indicate change in condition. 00:29:58 Tanya Trevilian: I think that sometimes pediatric considerations are an after thought- and there have been times that following existing protocols and standards of "normal values" families get ignored...programs that connect with EMS agencies in their area allow the providers to know more about the child and include families in the care plan 00:29:58 Yashas Nathani: Families are important members of rounds, especially with increasing number of hand-offs and turn over in providers. They are the constant in the care team and are better equipped to gauge the efficacy of the plan in place. 00:29:59 Janet Carson: We may be medically trained when we respond to a home with a chronically sick patient but the parents know so much more about the treatment and needs of the child. We need to listen to the family. We also try to get to know the families with children with special needs so we can learn about them before we respond to an emergency. 00:30:28 Melinda Damone: Parents/Guardians should be able to voice their concerns. They usually know their child better. 00:30:55 Tanya Trevilian: Agree- primary caregivers know the child best 00:31:02 Jennifer Rofrano: YOu have to make sure the family understand what is going on , that way they can advocate for the child 00:31:09 Caitlin Pieschek: Red Flags: when the parent for caregiver doesn't know baseline of the child... 00:32:26 Laura Garcia: I think the challenge can be that the family doesn't feel like they can question the care they are receiving. Many do not question or feel they can contribute to the conversation. "the doc knows best" 00:32:59 Kathleen Hart: Continuity of care is vital. In nursing homes they have team meetings with the parents, nursing, doctors and even rehab meet together to discuss their care plan. I spent 10 years working in the Trauma Center at Children's Hospital of Philadelphia, We always had the family with us in the Trauma room and supplied cot's+ to stay in the room with them. 00:33:02 Gabrielle Smith: We use AIDET and Bedside handoff to allow for inclusion of families in care 00:36:16 DAWN WRIGHT: want to know that we care and personal touch. They expect safety and that I know what I am doing 00:36:17 Ryan McCarrick: knowing what they have to do after they leave the office/hospital 00:36:17 Brighan DeFazio: Parents know their children the best. Listen to the caregivers. Allow their presence & ask their feedback. Keep caregivers informed in a language they can udnerstand 00:36:23 Rosemary Thuss: Chat: If we asked children and their families, "what matters to you?" 00:36:28 Milian Ortiz: kids=parents. parents=kids. Making them comfortable by caring for who matters to them. 00:36:28 Lindsey Jelsma: Personalized care 00:36:41 Caitlin Pieschek: communication! 00:36:44 Danielle Fontaine: Speaking to PT families in plain language that they can understand, make eye contact and clarify if necessary 00:36:49 Tia Dickson: Most are so willing to find work arounds 00:36:51 Jennifer Rofrano: Having the childs support system available to them, always. Transparency of the care being given. If the child can advocate for themselves, let them be part of the discussion. 00:36:57 Julie Rossie: Involving parents and children in care. 00:36:57 Laura Garcia: pain control and not waiting for very long 00:37:00 Andrew Carter: It would be a good time to explain vaccines. Still in COVID world children may understand the importance of vaccines. 00:37:08 robbie besel: being listened too and getting understandable discharge instuctions 00:37:21 Desiree Willinger: I've had a child worry because I was white and they were not. Their concern was we wouldn't treat her. She was 8! 00:37:32 Erin Patisteas: knowing what to expect, discussed in a way that they can understand. 00:37:45 Nicole Fisicaro: feeling safe and heard. not feeling pain. have an empathetic care provider 00:37:54 Fernando Montes-Tapia: Empathy 00:37:56 Bradley Starkey: Including the pedi pt in the discussion if they are old enough. 00:38:05 Merardo Becerra: knowing what their chilidren have, (dx), treatment, prognosis, and a detailed and "understandable" explanation of the pt's medical condition 00:38:09 Kathleen Hart: It helps to have a cell phone and allow the parent to Facetime the child 00:38:19 Melinda Damone: understanding the needs of the patients and their fears and concerns. Making them feel safe and having a family member at bedside. 00:38:39 Rachael Alter: Love the idea of using FaceTime! 00:38:41 Karen Groeneweg: Children want to know who you are, what you're doing and why. They want their pain managed and their people close 00:38:50 Rosemary Thuss: Chat; Which systems in your organization impact pediatric patient safety? 00:39:10 Robin Schultz: Supply chain; risk management; policy and procedure 00:39:12 Tia Dickson: System wide safety initiative 00:39:14 Kevin Dillard: The Establishment of PECC 00:39:15 Jennifer Rofrano: Operations, support and training 00:39:19 Lindsey Jelsma: simulations 00:39:20 DAWN WRIGHT: pharmacy, actually every team member 00:39:21 Duane Spencer: Training, Policy, Leadership 00:39:23 Melinda Damone: Communication/polices 00:39:25 Michael Bullock: Training is a big part of patient safety. Keeping up to date on low frequency calls is a must 00:39:26 Dawn Tasche: weighing in kilo's, SBAR,, training, PALS, ENPC 00:39:27 Erin Patisteas: Policies, Equipment/supplies, Role definition and expectation 00:39:27 Nicole Fisicaro: the sheer lack of pediatric specific policies/procedures/training. the comfort level of the staff directly affects pedi safety 00:39:37 Laura Garcia: training, education, policies and culture 00:39:39 Tanya Trevilian: Training, policy, leadership, quality 00:39:40 Fernando Montes-Tapia: Team membre in University Hospitals 00:39:40 Osborne Mary: Communication, being part of EDAP program, policies, quality program. 00:40:05 robbie besel: Our EHR charting system records wt in lbs even though it is taken in KG 00:40:40 Carina Castillo: For my ED, it is preparation and knowledge of pediatric equipment/supplies when it comes to taking care of critical pediatric cases. 00:41:52 Emilia Gonzalez De La Torre: In our hospital, rounding is one of the most important aspects because it is where we discuss our decisions and mistakes in order to make better decisions for the next time 00:42:16 Rosemary Thuss: Chat: If you want to begin creating a Patient Safety Culture, where do you start? 00:42:24 Jennifer Rofrano: Financial 00:42:27 Rosemary Thuss: Chat: What barriers can you think of? 00:42:33 Robin Schultz: Reporting system 00:42:36 Brent Hahn: Training 00:42:42 Fernando Montes-Tapia: Training 00:42:46 Amanda Michalek: Time 00:42:46 Duane Spencer: Other distracting priorities, knowledge, low frequency pediatric contacts 00:42:48 Adrian Ruiz: Educating parents 00:42:49 Anathea Gordon: language, financial, religious 00:42:49 Jay Barrera: Training 00:42:55 Merardo Becerra: reluctance from administrators to change 00:42:55 Taylor Lueking: protocol 00:42:57 Jennifer Lemaster: Cost 00:43:03 Dawn Tasche: Trying to make a change in a big organized facility takes forever, years 00:43:06 Tawny Baxter: low number of children that come to our ER 00:43:09 Melinda Damone: Education/Policies 00:43:11 Carina Castillo: policies and procedures, education and training. 00:43:11 Ryan McCarrick: Leadership not wanting to change because they either do not want to "waste money" or because "what we do has been working ,why change"" 00:43:12 Kathleen Shear: Training, equipment, SOG 00:43:27 Dawn Tasche: *big organization 00:43:28 Nicole Fisicaro: change takes too long. the “buy in” for change takes even longer 00:43:32 Andrew Carter: Protocol, training, patient safety equipment 00:43:39 Rebecca Vanderpool: evaluation of existing potential safety hazards 00:43:44 Amanda McQuistian: Education 00:43:48 robbie besel: training and equitment 00:44:09 Merardo Becerra: Institution's Protocols that are not patient & Fly centered but rather Institution's centered 00:44:10 Chantel Benish: For EMS, Community, being cognoscente of barriers in the community. Noticing issues before they become emergencies. 00:44:19 Danielle Fontaine: Good equipment and orientation on pediatric transport. 00:45:07 Kathleen Hart: My local hospital has a portal that holds each Physician, lab work and a chat area. This portal allows the physician' to collaborate, the parent and physician can see exactly what the status of their Patients. 00:45:32 Laura Garcia: One of the biggest barriers is eliminating the fear of repercussions for identifying an error or potential error. Even if the policy is there for no negative consequences, staff fear it will be held against them. 00:48:17 Nickol O'Toole: We should always listen to the family as they do know the best about the patient and we should not be tunnel vision. We need to also pass along to the hospital staff for continuity of care. However, we are mandated reporters so if there is a safety issue for the pediatric patient we need to follow through with that. 00:49:49 Kathleen Hart: When a child is diagnosed with say diabetes. The child spends 4 days in the hospital to stabilize and the parent is offered classes to understand the balance of food and medication. They have a baby doll to practice giving injections and monitoring the childs glucose level as they grow, 00:51:16 Fernando Montes-Tapia: We do same like Kathleen and also psychological support for the teenagers 00:52:16 Kathleen Hart: We had a med box in the trauma room with the most used jed8d+ 00:53:00 Ryan McCarrick: My EMS agency just put a separate ALS bag together for Peds with color coded pouches that match up to the length based tape (i.e. the tube sizes, meds, other items. so if the patient is "yellow" you would pull the yellow pouch from the bag and everything is inside. 00:53:38 Rosemary Thuss: Chat: What other potential practices and systems improvements in your organizations? 00:54:21 Jay Barrera: We utilize IBW throughout Handtevy for the weight. 00:54:22 Hollie Raymer: broselow tape or handtevy 00:54:26 Danielle Fontaine: Broeslow tape 00:54:35 Andrew Carter: Our department uses Handtevy 00:54:42 Taylor Lueking: Broselow tape 00:54:46 robbie besel: We developed color coded bags to match braslow 00:54:53 Juliana Soriano: Chesapeake Fire uses Handtevy app. 00:54:57 Andrew Carter: The bags are wonderful and easy to use. 00:55:03 Albert Musto: We use hand tevy in our system 00:55:07 Heidi Kirschbaum: Ebroselow online system! 00:55:12 Erin Patisteas: we use kanga bands to identify the patient's broselow color 00:55:19 Melinda Damone: Broselow tape 00:55:31 Osborne Mary: having appropriate scales readily available for use., use of length based resuscitation tape 00:55:33 Laura Garcia: We use Broselow tape. Kilo weights only and recorded only in kilo weights. EMS uses color coded dosing app, which matches with hospital based systems. 00:55:34 Jennifer Rofrano: To prevent miscommunications, have the family explain back what you said to them. Then ask them if they have suggestions on how to implement this with their child. 00:55:52 Kevin Dillard: Is Handtevy practical with a 2 person ambulance crew?? 00:56:03 Juliana Soriano: QA/QI done on all pediatric calls. 00:56:40 Karl Moore: as america has become a more mixing pot of cultures and nationalities. ems is still way behind the times in using video translation services. though phone translation services are out there, it is mostly only used in dispatch and not at the point of care in the field. 00:56:44 Ryan McCarrick: My county requires broselow tape and some of the more dangerous drugs have medical control contact for pediatric patient's to get the second person to potentially catch an error. 00:56:59 Rachael Alter: Can someone help with the “Pediatric Screening” Question in the Q&A 00:57:48 Lawayne Ponzio: anyone have examples of pediatric screening? (I work in a regular ED) Thank you! 00:58:00 Laverne Hardwick: When a car seat is involved in an impact the seat is supposed to be decommissioned 00:58:24 Laverne Hardwick: Each unit should have a pediatric transport device 00:59:18 Lisa Gray: @rachel - I am going to defer to Louis because I'm not sure what he means either. Need a hint. 00:59:28 robbie besel: ENA has a Pediatric ESI course we had all our ED nurses take. 00:59:37 Cindy Bobcek: We have made laminated copies of each weight group of the Broselow tape. We place the appropriate "code card" in each patient room. 00:59:41 Albert Musto: Could create an atmosphere of apprehension on the child’s behalf 00:59:47 Laverne Hardwick: I work in a Pediatric ED and we allow the parents in the room for all procedures unless they are impeding care. We have a nurse , Child life specialist and a social worker explaining things as they occur 00:59:56 Albert Musto: Could affect the family as well. 01:00:30 Laura Garcia: Having a patient's voice in our planning and policies is important. 01:01:49 Jay Barrera: I agree with Laura Garcia about having the patient’s voice in the planning and policies. 01:02:47 Laura Garcia: The PECC becomes the pediatric perspective at our facility. 01:09:48 Rosemary Thuss: Chat: Questions? 01:10:30 Osborne Mary: thank you. excellent information 01:11:07 Kathleen Hart: We have a quality team that I spent 4 years learning tools for process improvement. We always had the individual that did the job to writ everything down on a white board and walk through the project to see where there were extra steps and areas where you might miss something. We developed color charts and realized it is easier to have the individuals that do the job involved to learn the new process themselves and then they by into the new process. We check one week later to see if they started to slip back into the old ways, what worked and what did not. It was very effective. 01:12:20 Milian Ortiz: Thank you 01:13:06 Laura Garcia: great idea Kathleen. 01:13:19 Mark Cicero: Hello Team! Will we be moved into the breakouts automatically? 01:13:29 Michelle Moegling: When talking about screening, think about adult screening? Do you have appropriate pediatric screening.. Suicide screen, child abuse, language barriers, how do they learn best for discharge teaching. 01:13:44 Zachary Smith: signed up to participate shouldn't whine about number of emails 01:13:56 Kate Remick: No - you will need to move to the breakout manually. The link will be shared shortly. 01:14:40 Charlene Cahapay: how to get to the break out session 01:15:09 Kevin Dillard: Thank you Meredith 01:15:30 Laura Garcia: review your confirmation email. the link is there on the bottom 01:15:34 Meredith Rodriguez: • Prehospital Practitioners: https://dellmed-utexas.zoom.us/j/7990752124 01:15:38 Christopher Blake: Will the individual break out sessions be recorded / available? 01:15:43 Meredith Rodriguez: • Nurses & Other Healthcare Providers: https://dellmed-utexas.zoom.us/j/2202555306 01:15:59 Lawayne Ponzio: Thank you Michelle, great ideas! 01:15:59 Meredith Rodriguez: • Prehospital Practitioners: https://dellmed-utexas.zoom.us/j/7990752124 01:16:06 Meredith Rodriguez: • Nurses & Other Healthcare Providers: https://dellmed-utexas.zoom.us/j/2202555306 01:16:12 Meredith Rodriguez: • Physicians & Advanced Practice Providers: https://dellmed-utexas.zoom.us/j/8338596783?pwd=TG1kS3Vnb2NMSjhQQ0pLZzgvRFUyQT09 01:16:21 Meredith Rodriguez: • State/Territory EMSC Programs: https://dellmed-utexas.zoom.us/j/4997818994