Meredith Rodriguez: Alright, welcome everyone welcome everyone i'm.
Meredith Rodriguez: Welcome to our coaching session and as a reminder, this is kind of just an open hour to have your questions answered or any concerns or comments in general we're happy to answer them so.
Meredith Rodriguez: If anyone has a question go ahead and you can either use, you can speak up your you have full access to audio and whatever works best for you.
Meredith Rodriguez: Okay, so i'm kind of a quick question for the group I am sending I don't know if you saw my email earlier this week, but in sending out the.
Meredith Rodriguez: survey or registration form for phase two of the collaborative which will begin on march 17.
Meredith Rodriguez: And i'm curious if anyone has some questions or concerns about participating in phase two or what that might look like i'm happy to kind of walk that out a little bit more, if you guys are interested in hearing about that.
Meredith Rodriguez: You see, the the question and attack, can a new participants start at phase two.
Meredith Rodriguez: And you know that's I think a great question I, I think, as long as they're planning to participate and are planning to implement a Q I project at the organization and.
Meredith Rodriguez: I think that's completely fine now we are limiting participation in phase two to those who are actually implementing a project, because we want.
Meredith Rodriguez: Everyone to come to the sessions kind of on the same level that they also are working through a project and really want to stimulate that sharing of.
Meredith Rodriguez: successes and challenges and barriers and something that will that will be much more effective if everyone on the in phase two is also working on a project that would kind of be our only stipulation for new participants to started phase two but otherwise they are absolutely welcome.
Louis Gonzales: Just to add on to that meredith it, you know, in a very good question credit.
Louis Gonzales: It would be most helpful if it had to that person who's joining that new participant like like you, your question addressed.
Louis Gonzales: If that person was able to review the previous session so that they could as meredith said come in on somewhat equal foundational ground as the others who have.
Louis Gonzales: kind of grasp grasp some of the concepts, since the phase two will be pretty much hit the ground running, I think.
Louis Gonzales: that'll be moving pretty quickly and there's there's not this more of a time for refinement rather than learning some of the QA kind of concepts, but certainly they could review those things before it starts.
Meredith Rodriguez: I think.
Meredith Rodriguez: I kinda want to iterate that that phase two is when will really kind of.
Meredith Rodriguez: start to get your hands dirty, so to speak, so you'll be diving into really how you actually do this so phase one was really about learning kind of.
Meredith Rodriguez: The focus areas of pediatric readiness, it was really exploring sort of what that focus area looks like within your agency or fire department of ED.
Meredith Rodriguez: kind of the current state identifying areas that you might improve.
Meredith Rodriguez: And then, this phase two is really jumping in and really working towards those improvements and seeing how others are doing it and learning from each other on how to really approach this so you'll get a lot of more of examples and how to go about this, as we move through face to.
Meredith Rodriguez: You know, part of the registration form has you.
Meredith Rodriguez: list your get your in your mind, we have to put a smart amen if you have one developer, you can check a box to say that you maybe need some more assistance with that identify your change strategies.
Meredith Rodriguez: Give us a few ideas of what you're going to be measuring so that we can really structure the content in place to around your projects but that's, not to say that you need to come with all the answers to phase two so having a general idea of what your project will be.
Meredith Rodriguez: would be great you're going to have through about February 20 to decide if you want to participate in phase two so that will include a whole nother coaching session like this, where you can come with your questions about things to.
Meredith Rodriguez: But right now, you know start thinking about if it's really for you, if you want, if you know speak with your leadership, if you have the bandwidth to do it.
Meredith Rodriguez: All those sort of foundational elements who might be on your team to assist you or who you might rely on a little bit as you go through this project.
Meredith Rodriguez: Then, as a reminder so for our physicians you can get 25 MLC part for credit points.
Meredith Rodriguez: And for nurses or anyone else you can really use this as a kind of a ladder project and we're happy to support you in whatever documentation or forms or letters that you need from our end to really assist you in it.
Meredith Rodriguez: Phase two is is open for our managers as well, so I want to reiterate that you will also, we will be working with you directly i'm working on a specific project so not only will you be kind of.
Meredith Rodriguez: will be available as a resource to those that are implementing improvement projects that sort of the clinical level in your state or territory but also.
Meredith Rodriguez: We have a whole QA aspect for for you as well as whether it's you know recruitment of pecs are maintaining and network or hosting an educational conference or working at sort of the more regulatory level or pediatric medical recognition programs and getting the.
Meredith Rodriguez: physician more recognized within your state or territories so definitely I defined.
Meredith Rodriguez: area for the msc programs as well.
Meredith Rodriguez: Any other questions on the face to look like what we've done so far in Phase one this month we're focusing on care team competencies.
Meredith Rodriguez: And the recordings of that sessions went out on Monday, all of the recordings right now, and all of this size, I got Dr are both sides this morning.
Meredith Rodriguez: And he sent me a few of the links to some of the simulation websites that he had mentioned during this talk, and so I put those under the resources for the focus area so everything should be there for you to access and review need to.
Meredith Rodriguez: and sustainability.
Meredith Rodriguez: and
Meredith Rodriguez: You really not expected to have really sharp find 10 QA skills and phase two we're going to help you develop those so you know come with idea of a project and jump in and then that's really what we want to help you with this is really what the how to implement in.
Meredith Rodriguez: How to develop your statement, how to identify change strategy and how to monitor improvement.
Meredith Rodriguez: think it could be very useful and it's only march to June is the official timeframe so it's.
Meredith Rodriguez: It shouldn't be a ginormous time commitment This structure is going to be relatively the same as this, except for the we won't have the first hour of sort of that more lecture style so.
Meredith Rodriguez: it'll be more small breakout rooms, where we're really exchanging ideas with each other and helping each other to overcome barriers and solve problems.
Meredith Rodriguez: But the general layout of the time commitment is the same so it'll be approximately an hour or so.
Meredith Rodriguez: On the first Thursday of every month, and then on the second and third Thursday of each month we'll have another office hours, just like this, where you can come and get additional assistance if needed.
Meredith Rodriguez: Killing every Christian topic for policy ship.
jillian walsh chla: Okay hi Thank you yeah so.
Meredith Rodriguez: i'm.
jillian walsh chla: I guess i'm.
jillian walsh chla: Seeking like feedback, or if people have experienced with this, but.
jillian walsh chla: There was conversation at the facility that I work at within the emergency department of essentially eliminating all of our policies and moving toward just having.
jillian walsh chla: I forget the exact phrase they're using but basically just having.
jillian walsh chla: standards of care in the place of them, and my initial response was I was horrified but then I had to.
jillian walsh chla: So I I took a step back and I was just quiet because I wanted to get more information and just like get some feelers out and talk to some people about I guess a if there's experienced with this.
jillian walsh chla: be reasons for or against it, I have lots of against it, and also the impact like you know, on the camera trying to provide for patients, and so I have some thoughts and feelings about it but i'm really interested in in the group's experience and and feedback around this.
Michelle Moegling: So this is Michelle so.
Michelle Moegling: From my experience policies really should guide like laws and regulations by like governing bodies in care practice or guidelines is more of a hands on patient care perspective, at least at our site.
jillian walsh chla: Right, and so I took lots of notes from the policies and was really focused on that.
jillian walsh chla: Right like what the purpose of a policy is versus you know the procedures and guidelines and Dan was, and so I feel armed and really empowered with that information i'm really glad to have it.
jillian walsh chla: But I just wanted to feel out I also I I didn't get a good rationale for why they wanted to do it and, but I wanted to be able to come back in the conversation and just make sure.
jillian walsh chla: I was like talking to other people to see what other people were doing or if they were doing this and and why, because what I learned in that, and what my experience is exactly what you just said right.
jillian walsh chla: And I think they serve a broader purpose and so yeah i'm just curious what you all are thinking.
Michelle Moegling: I mean, I think you usually need a few policies that just overriding give guidance on like regulatory issues there's certain regulations on like suicide and how to manage those types of patients that you have to follow, and the more how to is really in your clinical guidelines.
Michelle Moegling: And usually do it like even if you're I don't know if you guys are accredited by joint Commission but.
Michelle Moegling: They usually in their regulations and guidelines they have certain policies that they want to look at and see.
jillian walsh chla: yeah we are accredited them are also you know we're an e DAB in there was like things we need to have yeah for that as well, but also the work the wording of our.
jillian walsh chla: Standards for a depth says policies and procedures and so again, like the interpretation of that i'm i'm pro policy but i'm just like I said really just trying to make sure i'm not you know being old school or like narrow minded or anything and this.
jillian walsh chla: Is.
Louis Gonzales: Julian this is i'm loose consultant I can't speak to hospitals like Michelle can I speak more.
Louis Gonzales: In terms of systems and organizations.
Louis Gonzales: So if I heard you correctly, that shift is is more on the clinical patient care side is that understand that correctly.
jillian walsh chla: um.
jillian walsh chla: They yeah yes it's it's within the clinical setting and they just were, I think, part of what they were talking about was.
jillian walsh chla: You know the process and which policies have to be approved and updated and.
jillian walsh chla: All those things, but I believe that there's other parties involved it's like a system of checks and balances right if we just hand these things over to.
jillian walsh chla: Whoever is in leadership at that moment in time within the department like these things could be changing and go unchecked and not necessarily reflect um you know best practice and I just have concerns about.
jillian walsh chla: That, I think.
Louis Gonzales: The.
Louis Gonzales: The other side of it and so that's very helpful is when you look at things from a systems perspective and they mean systems within your specific institution.
Louis Gonzales: From a systems perspective, the role of policies sounds like you said, good notes and so you're you, you understand you know kind of that role, but from a systems level the policy provides kind of the general this is how we do things at institution X and and provides that.
Louis Gonzales: General kind of hades or direction but kind of.
Louis Gonzales: have this is this is how we do things here, which is really culture.
Louis Gonzales: at that particular institution and not so much the how and it's really more for systems that are I shouldn't say more.
Louis Gonzales: You can certainly still apply it for those systems that are non clinical like, if you look at equipment or or how that works, you could certainly still have policies that work on that they're not necessarily clinical.
Louis Gonzales: And that's why I asked the first question, but the clinical side, yes that's I understand there's lots of changes.
Louis Gonzales: that are going on at different institutions, but you could look at the other systems that are not directly direct patient care kind of a policy related in there, surely, so an avenue for that, if your institution still is okay with policies peers.
Rosemary Thuss (she/her): I think it.
Rosemary Thuss (she/her): Was gonna say, if I may add this ball on absolutely an emergency department is a clinical.
Rosemary Thuss (she/her): departments in a clinical program, but it is still part of exactly what he was saying that ecosystem of the hospital and so.
Rosemary Thuss (she/her): Under recognizing that even though an emergency department is very critical focus it is supported by many non clinical systems and non clinical processes in order to have these clinical.
Rosemary Thuss (she/her): You know, standards of practice be carried out and for it all to flow and also evil things together, and so I hear you when you say you know.
Rosemary Thuss (she/her): Perhaps on the clinical side wanting to remove the policy aspect of it, but there certainly needs to be a bridge that connects the clinical to the non clinical on what their administrative or whether it's that support side.
Michelle Moegling: And I think, remembering that.
Michelle Moegling: Clinical guideline doesn't mean you don't have to follow it.
Michelle Moegling: It just gives that little bit of wiggle room.
Michelle Moegling: For providers, if something is in between two different guidelines or they're not sure and there's trying to figure out what hat what the patient has going on.
Michelle Moegling: But like even IV management it's a clinical guideline but it's still should be followed by staff and there's evidence to support changes so that.
Michelle Moegling: You can look at that and just have it same processes for policies How often do you review them.
Michelle Moegling: In what group reviews them what does that process look like.
jillian walsh chla: Thanks, I really appreciate all of that information and feedback a just like I said really wanted to make sure i'm not like completely just out of the loop on you know things as they change and.
jillian walsh chla: That I was understanding information that we went over last month, so thanks I really appreciate that.
Michelle Moegling: Does anybody else have questions.
Michelle Moegling: About policies or even any of the other content we already presented earlier.
Michelle Moegling: or any thoughts on any of it.
Meredith Rodriguez: And I see.
Meredith Rodriguez: carol's questions if you could access template sides before each session so you could work on drafts and you're attending the breakouts and we're kind of up in the project i'm assuming that's for phase two you're talking about are you talking about like the last two.
Meredith Rodriguez: Focus areas yeah he's still okay perfect yeah no so first of every month, or even maybe immediately following the learning session each.
Meredith Rodriguez: Of the previous month we will send you the slide templates and and the idea is to be that we would you would.
Meredith Rodriguez: kind of fill those five templates out so, for instance.
Meredith Rodriguez: You know one one will probably be pretty simple it'll be like this is my team, or who is helping me, and you can you know list those numbers and then you know the bottom half of the side might be your aim.
Meredith Rodriguez: Now, it could be a global aim ideally it's a smart name, but we can help you get there um.
Meredith Rodriguez: But the idea being that you'll have that coming into the learning sessions So then, as a group, as we're discussing.
Meredith Rodriguez: example or Howard can talk about how to improve their you'll have that ready to go, and you can share it with the group and.
Meredith Rodriguez: i'm so you will have that ready to go if you want to speak up and share your hands, hopefully we'll get enough repertoire to the whole group that you'll feel comfortable doing that i'm also going to have you submit it through red CAP and then I can show them anonymously so.
Meredith Rodriguez: And then we can work through them as an example and i'll even let you i'll even have maybe a checkbox where you can say yes, you know, please use this as an example, but don't.
Meredith Rodriguez: let anyone know it's mine and then we can work through your site template really look at just Martinez and really how we can we can improve it or tweak it or give you any coaching or suggestions beyond that.
Meredith Rodriguez: So yes, ideally you'll you'll have those templates and ready to share and we can.
Meredith Rodriguez: make them make them perfect.
Meredith Rodriguez: and
Meredith Rodriguez: We can talk about sort of some of the.
Meredith Rodriguez: options for projects that we are looking at to phase two so.
Meredith Rodriguez: we'll see what the best to you is.
Michelle Moegling: Somebody asked meredith about what type of policies.
Michelle Moegling: Are there to create and I referred them to the M prp tool kits and give the link, because it does tell you.
Michelle Moegling: i'm for peace readiness.
Meredith Rodriguez: me doing the toolkit have suggested policies that would be good, and you can go back to learning session or even by focus area guide and hopefully have a little more direction to.
kind of policy.
Meredith Rodriguez: You can look at.
Meredith Rodriguez: And, really, the idea is to kind of talk to.
Meredith Rodriguez: Others at your institution see what's important see what you know, the biggest concern is a maybe you need one around six or their use of restraints or.
Meredith Rodriguez: kind of what you see as the biggest problem right now, so what would you say.
Michelle Moegling: yeah look and see what's good to do is look and see what do you have guidelines or policies for and where do you see gaps in what you currently have, for your safety for quality.
Michelle Moegling: For care of patients, or if you're just seven gaps in your pediatric patients Is there something you can add to those rather than recreating new or is it something you need to create a specific policy or guideline for yeah.
Meredith Rodriguez: Sometimes it might be helpful, a day we kind of do is conduct this sort of baseline assessment and really can maybe look at a couple of your a few of your.
Meredith Rodriguez: Previous pediatric runs and patient encounters and.
Meredith Rodriguez: You know what went well where it could you, you know even maybe ones that resulted in a safety issue or something that you know your staff, maybe felt uncomfortable and say Okay, maybe we can develop a policy on really how to go about this or.
Meredith Rodriguez: You know kind of the easy one, Sir, that we've worked on to the pediatric readiness quality, I would say that easy, but maybe.
Meredith Rodriguez: Simple, but most of highly effective various things like weighing all children in kilograms only or you know, developing a policy for the recognition and triage of abnormal vital signs and how you go about that notification processor.
Meredith Rodriguez: think those are kind of you know that it's not conditioned specific it really would hit pretty much every pediatric patient that you encounter and really where you can make a lot of improvement in the quality of care for those kids.
Michelle Moegling: yeah those are great examples man.
Meredith Rodriguez: No money that's it but i'm wondering articulate has any suggestions on policies regarding parents riding in the back of the ambulance i'm a critical piece.
Meredith Rodriguez: Let me pre hospital folks something here this Rachel.
Louis Gonzales: Well, I can jump into it could be quicksand.
Louis Gonzales: Maggie I think you raise a really good question is is what you're seeking example policies are just kind of the pros and cons kind of discussion because i'm not sure there's a simple answer to that you're looking for suggested policies.
Louis Gonzales: and
Louis Gonzales: I only know it actually I think what you'll find.
Louis Gonzales: From my experience in.
Louis Gonzales: well.
Louis Gonzales: The last 29 years with MS is.
Louis Gonzales: Many don't create a policy.
Louis Gonzales: it's it's more an unwritten kind of standard.
Louis Gonzales: The wise ones, probably do have a policy it's just very difficult because, as you know, you know it so situational.
Louis Gonzales: But, as we know, you know for children who, who are awake and aware it's already pretty subject pretty scary for them it's a stressful environment and so having you know someone that they they can relate to with them makes makes them, it helps with the care is you know.
Louis Gonzales: The downside, though, from the administrative side is is always the concern about risk and so that's why it becomes really a kind of a local situation, based on the degree of risk that the organization is willing to take on.
Louis Gonzales: So you know, there are there are suggestions you can make it a policy like if the child meets these kinds of criteria.
Louis Gonzales: Meaning that they would benefit from the parent being there then makes a lot of sense to have in your policy that they can they can do that as long as they're.
Louis Gonzales: they're able to be safely secured, meaning the parent can safely secured in a seat and there's room for them, but if they don't have a benefit then.
Louis Gonzales: Then the risk manager at your organization might say why, why do it so.
Louis Gonzales: So there's just lots of nuances to it in the US segments mostly geared around stems from the risk concerns.
Louis Gonzales: I see Jen is kind of kind of right there with me and that you know, often it's an unwritten kind of policy kind of thing I think there's some advantages personally to having that policy.
Louis Gonzales: Because in that policy where you could still have lots of wiggle room, you could maybe I don't advise wiggle room for unsecured.
Louis Gonzales: Parents in the back of anyone's I that's that's not a safe practice.
Louis Gonzales: I know medics maybe unsecured providing care, but for family members and other writers in the back.
Louis Gonzales: We should be secured.
Louis Gonzales: Just because we know that one of the riskiest things that that image practitioners do.
Louis Gonzales: is just being on the streets in a moving ambulance.
Louis Gonzales: So risky for everyone so let's try to protect the child and the parent as much as we can.
Louis Gonzales: So I know it didn't help you with that I could, if you'd like who was Maggie.
Louis Gonzales: It can certainly check around with a couple of my local agencies, which are big organizations and see if someone has written one since I left them and reach out to you.
Louis Gonzales: If you'd like I can certainly do that I put my email address in the in the chat box and you can let me know.
Michelle Moegling: And Rachel put also an example and there.
Louis Gonzales: is a chance for the child.
Michelle Moegling: safe transport guidelines yeah Rachel I think out of that.
Louis Gonzales: And I think that's.
Louis Gonzales: More for the child or the parent.
Michelle Moegling: I am not sure.
Those.
Louis Gonzales: So there's no question Greg guidelines for for the child and make perfect sense for the child tip for you, for there to be a policy for child protection during transport, the parent one's a little bit harder, if I understood maggie's correct question correctly.
Louis Gonzales: And it's a question that's been dealt with by agencies for.
Meredith Rodriguez: Did they see your question in the chat box and I think that's phenomenal question and, yes, we would absolutely encourage interdisciplinary teams that include both physicians and nurses kind of working at the same project within the same.
Meredith Rodriguez: organization that would from our experience UK collaborative know that that makes a project that much more effective.
Meredith Rodriguez: and have a higher chance of succeeding if you really have these multi disciplinary teams that are are collaborating to really drive forward that improvement, so we would 100% encourage it, we obviously don't want to mandate it because it's not the reality for a lot of us, but.
Meredith Rodriguez: I think that would be great and we'd love to have them work together yeah I can absolutely get and i'm trying right now to kind of put a couple of slides together, so I can show you more fluently what phase two will look like, but in the meantime, we can run through some more questions.
Meredith Rodriguez: Sierra question to piggyback on the question your medical director is in the physician good for the collaborative and I would.
Meredith Rodriguez: strongly encourage you to work together on on an initiative project for phase two absolutely I think so, but you don't necessarily have to release it.
Meredith Rodriguez: We encourage it and we think it could be that much more effective if you work as a team, but.
Meredith Rodriguez: If that's maybe not true reality, you certainly do not have to if they're also participating do your own projects, but it would certainly encourage you to work together, trying to pull this up feat.
Meredith Rodriguez: Okay, I promise i'll have this little prettier by the time we get to.
Meredith Rodriguez: talking more in depth about these two have February learning session but.
Meredith Rodriguez: I wanted to show you this so you.
Meredith Rodriguez: Have the chat box.
Meredith Rodriguez: And so you'll be able to choose from four areas for a project that being sort of the petrol.
Meredith Rodriguez: equipment supplies medications policies or procedures and then care team competencies.
Meredith Rodriguez: And I think kind of the best place to start as you're thinking about a project and what you might want to do to improve is really these process flow maps that were.
Meredith Rodriguez: Included in the presentations and they're also in all the focus area guides and this is really how you can kind of walk through.
Meredith Rodriguez: What it currently exists, and maybe help you identify some of the gaps, so if we take sort of the Pec role as an example um.
Meredith Rodriguez: You know, you can look Okay, you know do does your organization haven't pack no we don't even have a pack so let's start there and then.
Meredith Rodriguez: From this flow map, we suggest team strategies and that's it, and if you go into the focus area guide so, for instance, here is the policies and procedures focus very guide.
Meredith Rodriguez: um we work through this and then each of these change strategies has its own key driver diagram So if you come down here.
Meredith Rodriguez: i'm in a way, so let's see you know, we need to raise awareness of kind of the importance of a pack so one of the ways, you could go about that is really good garnering leadership support so.
Meredith Rodriguez: And this is not the right focus a guide for the pet girl, but you know really kind of advocating for the role of the pack, and how are you going to go about that and.
Meredith Rodriguez: There are some tools and I think Michelle and Rachel have been jumping into the chat box or.
Meredith Rodriguez: The national pediatric readiness project toolkit and the pre hospital pediatric readiness project tool kit all as well as at the very end of these focus area guides i'll have tools to help you do that.
Meredith Rodriguez: fun.
Meredith Rodriguez: So there's tools and resources down here.
Meredith Rodriguez: At the end of every focus area guide that takes you to, for instance template elevator pitches or i'm.
Meredith Rodriguez: Not gonna let go here, but, for instance, has been around policies and procedures, you can see that we have some sample policies we have example and pre arrival instruction, so you can kind of use that to really start to build your project.
Meredith Rodriguez: And so.
Meredith Rodriguez: Ideally, and if you have been kind of working through this environmental scan worksheet each month that was really the idea behind this environmental scan or she is to kind of help you.
Meredith Rodriguez: work through that or decide what your project might be for phase two so.
Meredith Rodriguez: As you work through you know, maybe we want to do a policy and procedure so is there a standard format like how do I go about really doing this, how do I go about developing a policy that I want to and so.
Meredith Rodriguez: These are kind of things you would work through and identifying areas that you can really do or change or improve their.
Meredith Rodriguez: And then, when you begin to think about how you're going to measure change how you really going to know that.
Meredith Rodriguez: Change you make is is leads to improvement that's when you can also come back to that and start thinking about ideas on measurement and we're going to help you kind of pick out some measures to as we work through this.
Meredith Rodriguez: Think it's not the side of sort of the high try model for improvement and we'll go over this in our final learning session in March, but I want to show you kind of the foundation of fees to.
Meredith Rodriguez: Give me a minute let up in the meantime anyone you're welcome to jump in with questions or.
Meredith Rodriguez: Maybe ideas you have for what your projects going to look like and bounce them off the group that's kind of why we have a lot of our.
Meredith Rodriguez: Experts on the call, we can kind of help you work through some ideas on what you're thinking about doing does anyone have an idea, you can even just use the raise hand feature if you already know, maybe about the area you're going to work on.
Kate Remick: him marianas I might and i'm sorry folks to join the call a little bit late, but if I could just add a few comments around this work, you know.
Kate Remick: These four areas of focus were really chosen strategically as areas that we knew one were of interest, but that started with some simple aspects of readiness and kind of moving into more complex areas of system improvement.
Kate Remick: So, really, you know the focus within you know, an organization that chooses to say we want to you know focus on a publishing the petrol.
Kate Remick: A lot of this will be on really getting garnering support within your organization for why this is important.
Kate Remick: Now there'll be a lot of opportunities to work collaboratively with others to really kind of reframe the elevator pitch revise it to really fit the culture of your organization identify ways that you can do this to really try to enhance.
Kate Remick: awareness within your organization's leadership and among you know other colleagues of them, the value of pediatric readiness and the work that we do.
Kate Remick: And we found a lot of times in the past there's individuals who are more or less serving in this role, but their their work is almost you know.
Kate Remick: You know.
Kate Remick: gone unnoticed or the value or potential impact of their work on actually improving care decreasing risk and adding value to an organization so that's really what the focus is of that and I would say, you know if if you choose that particular area.
Kate Remick: There will be, of course, collaboration across organizations, but if you do have the ability to work collaboratively with your medical Director or.
Kate Remick: Another staff member, by all means you, you know you should go ahead and do so and I think there is really a powerful diane that's.
Kate Remick: represented within the pete's read the guidelines, which is that it takes, you know, on the hospital side physicians and nurses working together, and I think on the MSI to medical director.
Kate Remick: And the frontline providers working collaboratively, so I think that's very powerful and the influence that you have across the organization will be greater because of that.
Kate Remick: The next one that we really tried to identify for equipment and supplies was like this was the next kind of easy step up.
Kate Remick: Is there are very clear national guidelines on what equipment supplies and medications should be in place in every single ED and Ms agency, regardless of your size scope resources, so this.
Kate Remick: is really a nice initial kind of quality improvements to have if you've already got support from your organization and the leadership that site saying.
Kate Remick: yeah we think pediatric readiness is really important, this is the first step that we might take us just making sure we have all the necessary equipment and supplies in place.
Kate Remick: And so, this is a little bit more structured as well, because this is intended to be kind of a one size fits all in terms of what equipment supplies medications you can you should have.
Kate Remick: And then, how we develop processes to sustain that and that of course is going to be slightly variable based on you know the individuals and resources that you're working with but.
Kate Remick: You know, establishing and ensuring maintenance of those equipment supplies and medications that they're easily accessible and available to staff.
Kate Remick: is a really nice kind of first initial quality improvement project to really dive in and impact clinical care, I think the Third, the third one on policies procedures and protocols is.
Kate Remick: Really kind of event that next step up because there are some you know national clinical care guidelines or recommendations when it comes to evidence based care.
Kate Remick: But it's a little bit difficult to sometimes figure out exactly how that fits within the scope of our organization based on either the equipment and supplies that we have available.
Kate Remick: Or, based on the scope of practice, based on the resources that we have within our Ms agency or hospital, and so this is really a chance to kind of take that evidence base and morph it into a setting in which we work and to implement it to make it as effective as possible.
Kate Remick: We know that this is a high level of interest for folks and one that a lot of people don't have a lot of experience with of how do I actually write a policy or procedure.
Kate Remick: and implement that into practice and roll that out, so it, you know, has a high level of adoption.
Kate Remick: And I think you know if we look back on all of these it requires buy in and it requires buy in from other staff and buying from leadership.
Kate Remick: And so you know, building on this first conceptual framework of you know, the Pec role and establishing prioritization of pediatric readiness within your organization.
Kate Remick: That is an underpinning of every single quality improvement effort is having the buy in.
Kate Remick: And the team, building on the front end to be able to do that, so if you're thinking about establishing a policy and procedure.
Kate Remick: it's not necessarily what you want, or what you're most interested in but it's based on either the needs within your organization, maybe Sentinel events that have existed safety issues that you've identified or maybe it's an interest.
Kate Remick: that's come from you know the medical Director or the leadership within your organization to say me, and we really need to develop a policy on pain management, so that we can help to standardize that.
Kate Remick: And then I think the last piece is the care team competencies, which can, maybe, be a little bit more challenging or complex to implement.
Kate Remick: Because it is external to the day to day care pathways and processes, but accomplish that well.
Kate Remick: And this is one where we start to look at do we need you know simulation, whether it be low fidelity high fidelity or we just walking through.
Kate Remick: Codes or how are we starting to establish in the work here to competencies, so I just, I just wanted to walk walk that out a little bit, and then you know, to the comment in the chat box.
Kate Remick: Which is so we should use the structure of the environmental scan worksheet to really work out resources needed for the project.
Kate Remick: You know the idea of the environmental scan is to identify where the gaps might be so that you can choose an area of focus, so that you can actually.
Kate Remick: target that as your primary focus over the coming three months and, yes, we will be sharing tools and how to measure change and our plan is to really walk each of you.
Kate Remick: Through these projects, starting with okay let's let's figure out what we're trying to accomplish what's our what's our global purpose and developing a smart aim.
Kate Remick: identifying those gaps walking through some potential change strategies that you might choose based on the resources at hand.
Kate Remick: And then being able to implement that imagery or improvements over time, so we will be walking you through each of those and you'll learn so much, I think, from.
Kate Remick: each other as you do that and depending on your area focus so sorry I know that's a lot, but I just wanted to to walk that out a little bit and reiterated for everyone.
Meredith Rodriguez: Murphy can see your html yeah I was trying to I was trying to get off mute so that I can explain that but I couldn't find my controls on my funnel so.
Meredith Rodriguez: kind of just been acting out but Kate had to send this kind of gives a visual of how we're going to do this to phase two and it's it's really.
Meredith Rodriguez: kind of just structured exactly what you just said, so you really got to start here with what do you, what do you want to do, what are you trying to accomplish but in that spirit will work with you to develop a smart thing to really, really get specific about what you're trying to accomplish.
Meredith Rodriguez: And then we'll walk through how you know that changes in improvement, and this is where you'll get to like what are you going to look at what are you going to measure to that you know.
Meredith Rodriguez: That, if you implement a certain change strategy that is actually working towards your goal working towards your team.
Meredith Rodriguez: And then the third question of the team model for improvement is okay what changed, can we make and and, as I mentioned, we put some suggestions and a focus area guide.
Meredith Rodriguez: There is plenty of resources online in the tool kits that have been shared in the chat as well as we can help you think through that a little bit and what resources do you have and what what might be a great.
Meredith Rodriguez: Change shy, did you to us and then we'll jump into what we call pdsa cycles are plan do study act cycle is where you're going to implement that change so we're going to think about how to implement it.
Meredith Rodriguez: As the planning aspect you can implement that change, so I think the example we always give back give is maybe.
Meredith Rodriguez: The the one of weighing on children in kilograms only, and this would be an easy example.
Meredith Rodriguez: And so you know that's your goal, you want to wait every child that walks into the door and kilograms only.
Meredith Rodriguez: And how are we going to know that this is an improvement and we're going to we're going to record how many kids were made in kilograms and how many weight in pounds.
Meredith Rodriguez: And we're going to see hopefully that the percentage weight in kilograms over time is more not what we're going to look at.
Meredith Rodriguez: So what changed, can we make so we could buy skills that only that locking kilograms only way to lock them in kilograms and that's going to help them for CDs, are you get that in every room and everywhere that we have scales.
Meredith Rodriguez: And let it go from maybe 30 pediatric patients and then we're going to look at that and we're going to look at the proportion of pediatric patients every weight in kilograms only.
Meredith Rodriguez: and decide what to do so maybe that did it for us, maybe we have we're not always 100% of kids in kilograms only so we accomplished, our aim, and that was great or maybe you're not so maybe you need.
Meredith Rodriguez: You so, then you come back here Okay, so what next change can make, and like I said this is going to be the topic of our of our march 3 learning session we're really going to dive deep into this, but.
Meredith Rodriguez: This high level of what phase two will look like is we're going to walk through this Okay, so you tried this and, as a group we're going to talk about Okay, so what went well and how did you improve and.
Meredith Rodriguez: What do you think he could do next started, maybe we need to put posters in the rooms and all the rooms are my name is you know everyone do eight kilograms only and then.
Meredith Rodriguez: Do another 30 pediatric patients and see how how that improves you how many what percentage of kids are waiting kilograms only now it's kind of keep working through this until you reach your aim of we want 100% of pediatric patients leading kilograms only.
Meredith Rodriguez: quickly you're able to share size.
Meredith Rodriguez: I can, I can share these sites are they immediately Catherine i'm happy to post them to the website, or on the mountain, so you can take them and do whatever you like, with them and.
Katherine Schafer: Thank.
Meredith Rodriguez: All of yeah, of course, and actually you were a post, and here we go to hopefully you guys know this exists and you've been here, but if you come to a website and QA collaborative tech workforce development collaborative.
Meredith Rodriguez: Every session has the spy the recordings the slides here recordings and focus area guides and skin worksheet you can go explore the focus area more.
Meredith Rodriguez: can see those flow diagrams that I posted can come back and look at all the different for.
Meredith Rodriguez: You so that i'll be here, I will do that under today's coaching session after the slides up so that you can come back I don't even put it on your have the link up here right now, but I will put it right here, you can access it to you.
Meredith Rodriguez: I don't think you're the only one, Catherine, by the way.
Meredith Rodriguez: I think that's probably my most frequently asked question right, you know that's where the recordings are the slides there here on the website and.
Meredith Rodriguez: You can access everything and you don't need a password or anything they're completely publicly accessible.
Meredith Rodriguez: scanner on the edge of this in the chat so you can only get to a place now you want.
Meredith Rodriguez: Thank you let's see.
Meredith Rodriguez: I guess the last four or five minutes I put this in a speech email, but I wanted to make sure that you all are aware to that there is a trauma improvements sprint coming up it'll be two half days.
Meredith Rodriguez: February 23 and March 2, and this is really designed for trauma centers to meet the new ACS co T verification guidelines around pediatric readiness.
Meredith Rodriguez: would essentially be is this collaborative really condensed into two half days and then those participants will be invited to jump in with a QA project for phase two as well.
Meredith Rodriguez: So if you're a trauma Center or you work closely with the trauma coordinator and another trauma Center please share this with them it's here on the website as well, calling it our time improvements sprint.
Meredith Rodriguez: Registration has been hope it'll close I think February 20 that'll give us enough time three days to really kind of make sure that we are fully prepared for the half January 23 but.
Meredith Rodriguez: Another option or if maybe you've missed a lot of the sessions, and you want to come here, so the have definitely more more the examples will be more trauma in nature.
Meredith Rodriguez: But not completely because trauma centers pediatric readiness, is still a foundation for trauma centers regardless of whether it's at a trauma patient or not so.
Meredith Rodriguez: You know another option, just to let to be aware of.
Meredith Rodriguez: Can I show you guys nice minutes.
Meredith Rodriguez: latest news to try to post every.
Meredith Rodriguez: newsletter that I send out through constant contact appears so that you can access.
Meredith Rodriguez: Because I know that some of my emails that come through constant contact they're blocked by.
Meredith Rodriguez: hospital systems so.
Meredith Rodriguez: Any last questions or comments thoughts feel free to email me.
Meredith Rodriguez: or email.
Meredith Rodriguez: me see happiness improvement.
Meredith Rodriguez: There you have any other questions or comments, if not we'll see you all.
Meredith Rodriguez: On February 2 and.
Meredith Rodriguez: be looking for the registration form for phase two, it should be coming out later this afternoon.
Meredith Rodriguez: Thank you.