Next up: FR201a- An epic step forward- a universal #pedpc navigator in the EHR with @conradw4, Alice Bass & Kat Thomas #hapc23 Image
Actual cartoon of Conrad and Alice at work creating a #pedpc workflow in Epic. #hapc23

“If we could make the EHR better it would make me feel so much more well.” - @conradw4 Image
“We thought it would take a year and we were certainly wrong.”
On building the navigator in epic.
#hapc23
The local epic team @nationwidekids took what was available in foundation (eg available to all who use epic) to tailor what they asked for. - Alice Bass (this is not a real pt) #hapc23 Image
They built the navigator with metrics required for @PalliativeQual
Building the foundation for #pedpcqi
#hapc33
They streamlined everything they need into the navigator; saves the team tons of time in the am in what used to be taken for chart review. @conradw4 #hapc23 Image
There is a psychosocial and spiritual screen- “you can hover to discover” aspects of the child’s personality, what a good day looks like, etc. This piece gets basics for if SW or chaplain isn’t there on first visit. #pedpc #hapc #hapc23 Image
This section has lots of text boxes to document specific pieces of #pedpc consult. This exists at the pt level too so crosses encounters. #pedpc #hapc #hapc23 Image
Does it pull into the note?
Duh.
Of course it does!!!!
Alice, Conrad and Kat would not let you down! #hapc23 #hapc #pedpc Image
Sorry guys messed up my thread again.
#blametwitter

Barriers- this is a huge practice shift. People who don’t like change may struggle a while.
There is a learning curve.
Prep the team!
#hapc23
You need to be able to describe to your IS counterparts what you need.
Help them understand the why behind this tool.

They are already on v2.0!
V1.0 is available on epic though now. #hapc23
They are adding the ambulatory navigator too.
They are adding out the interdisciplinary piece- many can edit simultaneously and see others work.
PCQC @PalliativeQual reporting will be integrated
#hapc23
Qs- can more than one persons nav contribution flow into note?
A- yes
Q- will code status orders flow into nav, can non-pal teams click on code and see what we are documenting re: goals
A- room for growth but possible, Alice is thinking about this
#hapc23 #pedpc
There is thought of letting people add PROs through my chart to flow into this. So much potential! ESP for @PalliativeQual
#pedpc #hapc23

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More from @RThienprayoon

Mar 24
Next up: Fr218A- Agitation and feeding intolerance in children with medical complexity with @StocktonBev and Dr. Katherine Maddox! Image
Front row is Dr. Julie Hauer. The OG of this topic who wrote the book. If you don’t have it and you do #pedpc here is a link:
bookshop.org/p/books/caring…
Julie Hauer did a study on gabapentin in children with Med complexity and feeding intolerance- remarkable response in sx. (That’s Julie’s head in front of the slide! I fan girl every time I interact with her.) ❤️ #hapc23 #pedpc Image
Read 9 tweets
Mar 24
Dr. Martin Bogetz, a bereaved father, sharing the legacy of his daughter Alyssa:
- an MSW who cared deeply about wellbeing
- the first non-physician associate program director in Peds at Stanford, who focused on supporting trainees
- sister of @jbogetz, #pedpc wonder ❤️ #hapc23
The inaugural Alyssa Bogetz lecture: Dr. Susan Block talking about the state of integration of #hapc and #mentalhealth
Alyssa died of AN. The educational fund was started in her honor @AAHPM w the appreciation that our field needs to grow to support people like her. #hapc23
"I think it's a miracle how far we've come." - Dr. Susan Block

We are the 6th largest subspecialty of the largest specialty in the US! #hapc #pedpc #hapc23
Read 10 tweets
Mar 23
Next up! TH110B- A seat at the table: professional competencies define roles and value of psychologists in #pedpc!
@PedsPCTF members @RachelKentor and Amanda Thompson & Sarah McCarthy! #hapc23
Competencies help standardize roles and practice requirements for #psychologists in #pedpc and highlight the important and unique contributions they bring to the interdisciplinary team. #hapc23
PPC Psychology workgroup was formed of 9 peds psychologists, then reviewed by 15 multidisciplinary stakeholders to create competencies. Here's how they did it:
#hapc23
Read 5 tweets
Mar 23
Next up: TH109B- Together is better: a combined #hapc and #psychiatry substance use disorder clinic for patients with advanced #cancer
@AmericanCancer take note of this model
#hapc23 Image
@lauramakaroff thinking of special populations and your work!
Rates of concomitant SUD and #Cancer -
EtOH rates higher than opioids (similar to society)

Challenges in SUD+Cancer
- adherence & transportation issues
- stigma from med teams
- poor coping and PTSD
- mistrust of med system
- poor health literacy
#hapc23 #hapc #cancer
Read 12 tweets
Mar 23
Session TH103A Leading for Wellbeing with @KristinMDCT. Let's go! #hapc23 @AAHPM
Point 1: Wellbeing of leaders predicts wellbeing of staff. There are indices that are specific to leaders. #hapc23
Point 2. Psychological safety is critical to team wellness. (@AmyCEdmondson)
Defn: If you speak up, there is not a threat that you will be punished.
When people need help, they ask.
People can process mistakes, dissent, name problems even when hard. #hapc23
Read 14 tweets
Dec 9, 2022
Kicking off #QMC2022- @arifkamalmd with Top 10 Pearls in #hapc #quality! #pedpc
Speaking of @PalliativeQual - do you do palliative care?
Do you follow the Palliative Care Quality Collaborative? No time like the present! Twitter is still here!
@arifkamalmd on palliative care as a field: "We're kinda badass!"
Wish I felt this way more often! Always good to be reminded! #hapc #pedpc
Read 8 tweets

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