Thread by @RThienprayoon

Day 2 @theNASEM workshop
The highlight from day 1: LaToya, a CNA, gave a moving, honest, courageous account of being a direct care worker. “The ice cream truck should not be a luxury.”
- hours & pay are bad, the work is hard & they love & care their patients & their dignity

@theNASEM First up- @EspinozaNotes from @PHInational
The intense focus on direct care workers, paying people a living wage, improving working conditions so that we can also improve patient care during this event has given me so much hope

“Social determinants of success at work” is one phrase that stuck out to me yesterday.
@mad_sters doing critical work in this area for direct care workers
But I think about it for others who work in our system too.

Homecare workers feel
Undervalued & overworked
Communication & care are fragmented
Caught in the middle
Love for their jobs @mad_sters citation

What about #dementia? They are working on that too. We need so many more dementia care specialists.
Both of my grandmothers died with dementia. The boomers are aging. This is so important.

@EspinozaNotes finished with mention of the need for career ladders and opportunities for advancement- LaToya discussed that at length. She’s in nursing school, has 2 kids and is working multiple jobs to advance. It’s impossibly hard but she’s doing it.

@MollieBiewaldMD talking about innovative approaches to mid-career training in #hapc. Time-variable, competency-based program. Hooray!
(Not available in #pedpc yet. Boo.)
@Dingfieldl worked hard on this

How does the mid career fellowship program work? It’s very cool! #hapc

Local context is key to success. Sounds like QI! #hapc

Next up Dr. Bradley T Rosen from @CedarsSinai
In FY14 they defined egregious harm at EOL
And have embedded goal-concordant care work into their QIC group
The cockles of my QI heart are so very warm 🤓

They found that lack of communication skills were major driver of poor goal concordance.
They created a standardized serious illness care curriculum.
They found that #burnout decreased when clinicians were better trained.
#hapc

Group C least likely to have these convos- they get program C
Group B more likely- they get B+C
Group A most likely- they get all of it
🤯🤯🤯
I love this! #hapc #pedpc
@CedarsSinai Partnering w @CAPCpalliative and @AriadneLabs

Now for what you all know is my jam: Dr Beth Lown with @theSCCH regarding the Healing Healthcare Initiative!
Did you know @CincyChildrens is a pilot site for HHI!?

“At best we are suffering, at worst we are dealing with psychological distress and at time suicidality.” - Dr. Beth Lown
She also invokes the financial model of healthcare in the US and conflict with the values of HCWs

HHI is for healthcare leaders, to reimagine operations to take better care of clinicians- so we can take care of patients
#organizationalcompassion in action. @theSCCH

“The goal is to make healthcare trauma-preventative rather than trauma-inducing.”
Working in healthcare is often trauma-inducing.
It’s rare to hear it acknowledged so openly.
Thank you Dr. Lown. ❤️❤️❤️

Learnings: C-suite leaders are hungry for guidance. They need practical, concrete steps.
But the decision about where to put $$ remains difficult.
What about when mental health and well-being aren’t core values? Time to raise them up!

“You can’t do anything without enough time. If you want nothing to change, give people insufficient time to make a change. We need reimbursement models that allow for the time people need to spend (with patients).” - Dr. Beth Lown

I’ll start a new thread for the next panel! @threadreaderapp unroll