 Good afternoon, ladies and gentlemen. I can't tell you how thrilled I am to be here today. I'm with MedStar Health, the system in in the DC and Baltimore area, but I'm really here today as a co-chair of the working group that has put together a new actual patient safety solution that we're going to launch and share with you today in a wonderful panel. It's about to join me on the stage and It is on-person and family engagement. That is the new apps that we'll be sharing with you today My co-chair for the working group was Vonda Baden-Bates will be joining me on a second here on the dais Vonda came to the patient safety movement because of the loss of her husband to a preventable event But I've gotten to know her here and she's a very interesting person She's an expert in organizational change culture and communication and I use her as an example because we are trying to shift I'm gonna build on Sir Liam's comments a little bit We're trying to shift the needle on language Sir Liam and Winston Churchill's comments To really focus on the users of care as people so it's person and family engagement not patient and family engagement That's the shift. We're trying to do because when we think of people as patients We often think of their disease condition or their burden or the gaps in their skills such as health literacy Challenges they face we don't often enough see their strengths Michael Sears will also be joining us. You just saw a beautiful video Michaels is an inventor Wanda is a culture change expert Alicia Cole who we heard from this morning is a formidable communicator and these are strengths that are able to that you can use in your organizational work to really escalate and accelerate your work in achieving our common goal on zero deaths by 2020 So the premise of this new PFE apps PFE is person and family engagement is that it it is an underutilized natural resource that exists in all of our backyards that we can tap and I want to call out the World Health Organization that has been doing workshops on person family engagement since 2005 and whether you're in the UK or Argentina or Singapore or Uganda or the outback of Australia You find people who want your health care system to be the best it can be in that are eager to step up and help you so there's an incredible gratefulness out there and a Drive and a sense of urgency that we heard from Alicia today that is just out there waiting to be tapped It's low cost low tech and you can bring it into your organizations in the United States We have the sound bite for this is that person of any engagement is the blockbuster drug of the 21st century We've gone past thinking of person and family engagement as a way to ensure patient-centered care and Dignity and respect those are all very foundational and important But increasingly the literature is Reporting out ways in which person and family engagement is actually helping us improve outcomes and can help you and all of your organizations improve outcomes The literature is just mushrooming you cannot go a month without seeing some new exciting development in person family engagement being published and There are multiple frameworks that are coming forward. So the framework that we're building on in this apps really poses the opportunity to engage patients and families persons and families at three different levels One is at the point of care. So there is ample evidence now that when you engage Patients and their family members at the point of care They'll often become experts in their own condition They get better outcomes and that's true over a wide wide wide swath of health care conditions The second level of engagement is really in improvement work. It's safety work. It's it's zero by 2020 It's our work and bringing the wisdom of patients. They're they're their Skills as persons professional persons and just people with life experience with that sense of urgency that Alicia mentioned is a Great Opportunity for us right now and the third is really at the policy level. So it's it's engaging Users of care from the get-go as we design our programs We saw a beautiful little clip of Alicia who was tapped by President Obama When he was launching the major patient safety initiative in the United States called the partnership for patients campaign When the World Health Organization under Sir Liam's leadership launched the patient safety program at the World Health Organization He tapped a phenomenal Patient advocate by the name of Susan Sheridan. I'm sure many of you have met her to come in and Be a partner in this and within weeks after starting the patient safety program Who assembled 21 patients from around the world to come together to London for a workshop and come up with a Declaration of their pledge of partnership and on behalf of patients who had already died who were at risk in the healthcare system Now in generations yet to come there was this eloquent document produced that we at least in the United States and probably elsewhere in the Northern Hemisphere think of her as the North Star for the work that we continue to do on patient and family engagement person and family engagement So those are the three levels that you'll see in those very rich apps that will that we're launching today Leadership is important. I'm gonna just say a word about it without leadership Person and family engagement drifts and it drifts into cynicism if you say it's important It's the brochure language that Alicia used but you don't walk the talk and that has to happen at leadership level Patients will figure it out and their families will figure it out and And it will not feel authentic to them Culture we've also talked a lot about I'm gonna just say one word about culture because when you start with for those of you working on a culture of respect and Dignity and openness and transparency and moving beyond blame for your staff When you start there and you bring patients and families into it They reinforce they pick up on it and they will actually help you escalate the penetration of those values and those behaviors and those norms in your culture They will challenge us sometimes the way Josephino clue did today by pointing out things Like embedded racism, but they push us and they they do that in a way that is almost universally respectful and appreciative Um There are results that are beginning to accumulate so we saw Joe share some of them earlier this morning in the United States We are tracking this closely as part of the partnership for patients, which is a big big national campaign that was launched by President Obama and The data is showing that we are making real progress in reducing harm and reducing the cost of harm both deaths and And complications of care but in the interesting in that data There are very interesting patterns in the hospitals that are more robust in engaging patients and families are making more progress at a faster rate So we're still teasing out, you know the cause developments there But the commitment to patient family engagement brings in that natural resource and we're seeing that begin to be Actually since about 2015 reflected in the data, so it's not beginning anymore We're sort of well in the way to seeing that story being told in the data I'm going to call up a phenomenal panel up to with us right now But as I do that, please join me here as we move forward as I As my panel joins me, I'm going to introduce them as they come up I do want to remind you all that we're going to have ten minutes at the end of this panel Where we're going to be eager to entertain any kinds of questions that you have sent us in the app so we want to engage you as Part of our audience today as we work through what brings us all here today so on the panel with me today is Neelam Dengra from the World Health Organization a colleague of mine who I met for the first time I think Coming to London. It's even though we've had a fun relationship for many years Edwin Lofton who is the CNO for Healthcare System United States Parish Medical Center also Parish Mission Control we learned from him Because of its connection to Cape Canaveral and the Kennedy Center and they have made a commitment to Implement all of the apps and have been very very active in improvement work and person of family engagement work in the United States Michael Sears who we just met on video is with us today as well. Let's give Michael a Wonderful hand Carolyn Stade from Switzerland who is Totally passionate and committed to a person family engagement, especially engaging children and their families in Getting those outcomes and those self-management skills that we want to see and then my co-chair for the working group on evading baits So please join me again and welcome you all of them and we'll move forward into our discussion Okay, so we have a conversational format planned for you today We didn't want to stay up here and give many speeches So we're gonna build this around some questions and hopefully get some conversation going on here, and I'm gonna start really with a question to Michael because Michael you told us a powerful story about your experience as a patient and your creativity or creativity and innovative Innovation as an inventor But when we gathered as a team to talk about this session and planning this session The thing that I heard that was the most passionate coming out of your voice was the importance of empathy and respect Not just from providers for patients, but from patients and their families for providers Do you want to say more about that? Sure? I mean as you've all heard I've been a patient a long time and I think for me what defines healthcare more than anything are relationships and the human to human element and as a 16 year Old I got taken to an eminent physician. He ended up becoming the Queen's physician So I was in good company and and he said to me something that really stayed with me that he said I'm only gonna treat you if you take as much responsibility for your care as I will I'm gonna teach you things that you need to know But you're gonna teach me what it's like to be you and together We're gonna grow and that has been echoed throughout my patient journey and and I think that you know as a patient I have as much responsibility myself to play an active role in health care And it's a partnership and I think you can only have those partnerships You can only affect change if it's underpinned by by by empathy Respect trust and I would also add curiosity the ability to be able to ask questions And and and I think to get to that point though you have to have bravery and That's what I would urge more than anything with change is from the leadership from everything You've got to be brave and I think the bravery isn't from patients and caregivers I think actually the bravery is from the institution and health care professionals. So, you know, we've got in the room We've heard leaders from everywhere. We've got chief medical officers. We've got chief surgeons pharmacists nurses CEOs there's no chief patient officer Why is there no chief patient officer in every company in every trust on every board in every hospital in every political? Entity because if you come together and you're brave enough to come together That's where change happens and that's a mutual thing Yeah, so Michael, thank you. There's actually in in the change package I'm going to be a relentless promoter of the apps today the solution there is a piece for organizational and system rotation of of person and family engagement that says do you have a place in your organization? Whose role it is to really engage with patients and families to kind of make sure that that's embedded So it is a really important point that you you raised there Also, the bravery point really struck me that, you know, it does take courage Especially when we think about what it takes for a nurse or a physician or Organizational leader to come and have a conversation with a patient family who might not have had it I think it's much harder for The health care system if our health care professionals to Take that leap of faith and have a conversation, you know, you're your most vulnerable often There's often things that the tragically have gone wrong. I've experienced, you know, difficult times and difficult issues But if you're brave enough to take that that that leap of faith much as you said in your your earlier dialogue Actually, you build that relationship and and fundamentally change doesn't come through new technology or Policy or or if you want to get to zero you have to build a relationship with people to make it happen So who's brave enough to take those first steps is what I would argue Yes, and that relationship also creates more opportunity for communication more opportunity to get the input of a patient or family Into what they might have seen go wrong. So your root cause analysis the ways in which you learn from from those events I'm gonna turn to Vanda now my co-chair who I've just So enjoyed getting to know because you've been in a situation of having to have communication with an organization once Something went wrong What do you think about? Well, you know what stands out for me is in your story Michael Is that and in your opening comments that we we are individually every single one of us in this room is a natural resource in That particular physician knew enough to look at you and say look we're in this together and you got to do your part and I think that there's not quite enough support for that to actually happen and I think I saw evidence of that in the hospital where my husband developed an HAVTE a hospital associated venus thromboembolism The care that he received was Extraordinary there was no question whatsoever for 13 days that Nearly every single person that we worked with was Attempting to engage him my big question was are they and I don't mean to be Provocative although maybe I am but you know were they to engage? They were not that the environment is not conducive for people to use their own natural resource There's not enough sleep You're trained from the very beginning to not sleep to push your boundaries to try to be a high performer in an absolutely impossible environment with the most stressful high-risk circumstances that I can imagine and So I Think that when we think about engagement and we look at stories like that and we look at Yogi Raj's story my husband's story They were truly Engaged until The day he died. I had a 45 minute notice between the time that we learned about a blood clot and he died from that blood clot and As soon as that happened and you can see it in the medical records the guards go up the environment that that is set up and is conducive for us to Not use our own natural resource to not be our sovereign selves It immediately starts to happen when we when we move into that position of of not honoring that important individual responsibility We've all expressed our appreciation for Joe and for the patient safety movement Foundations work, but one of the things I'm particularly grateful for is the highlight on candor which happened at last year's event Which really does speak to the importance of supporting physicians and nurses and other people who have to step up and have those Difficult conversations and then go home and sleep at night. We look at the statistics on burnout and fatigue and trauma that Dedicated health care workers Experience and you know, we have to take care of them as well. I think Michael you bring you bring that out really well We're gonna move through some more questions here Unless is there another comment that people want to make before we we do move. I don't want to cut off conversation Okay, then Carol and I'm gonna come to you because you have a story for us About engaging a six-year-old boy and being a manager of his own care a true partner at that point of care and Share that story with our audience here today. Thank you very much So this is a really a very successful story that I'm I'm also very proud of it It's a six-year-old boy as you mentioned He he has a hemophily and he he suffers Well beginning and as you know hemophily The most important thing is to to have a good long-term outcome to have a good quality of life and This is pending of bleeding in atrosis. So You have to you have to inject the missing factors and Yeah, that's actually the normal treating now. What what did we do? So the six-year-old boys had to inject these these factors three times Three times a week and the mother was like She was a little bit scared to do that till the boys said I'm gonna learn it I'm gonna do it by myself. I don't want to hang in the hospital every every second day to get this injection I can do it by myself. So everyone was Shaking the head and said that's impossible a six-year-old boy imagine. I have a six-year-old boy at home I think he's running around to you. I don't know if he could do that. Well, I would teach him but and So the the interdisciplinarity not only the nurses the physicians everyone does it the therapists They they teached him they teach the boy first thing was teaching the rules of asepsis and Then they teached him how to punch his vein how to inject this factor and It was a great success. So this boy knew how to inject it Normally he was informed what he has to do when he has an injury because then he has to Inject also a second dose or a third dose or and the most important thing is that to enable a child And it's only possible if you really talk a lot and you give every information you have For a long-term outcome the children don't don't understand long-term outcome, but they understand how they can play football and What they're gonna do after injury the Caroline Can you also when you were debriefing with us before this or planning with us before this you were also saying that that Conversation that does sound extraordinary with a six-year-old boy about actually taking care of himself Was only possible because of the mother's relationship with the system and her confidence and you also mentioned his teachers in his community Can you just say a word about that? Yeah This is very very important. Well the mom the family and that's that's really the base So if the mom has to trust in us so we can build on that trust and this is very important but imagine you have this boy at school first class of school and He has an injury and then he goes to the bathroom and he does the injection You have to inform the whole class the students the other children the teacher The grandmother who's taking care of him when the parents are going to the cinema and the whole the whole Setting around that boy must be informed so everyone can act and he is responsible for himself So he's he's dealing with himself. That's very important. That's fantastic So Michael I want to bring you back into this conversation because in some ways you must have Lived a similar journey in that you were a patient as a young boy And when we met last night one of the things that you said that really struck me is that This job was harder for your family than it was for you. Yeah, all you had to do was survive But for them they had to do other things were you Yeah, I mean I think I'm probably no different to a lot of patients in in the sense of You have to have utmost trust in your health care teams that they're gonna look after you But the impact on your family your loved ones your wife your kids your family is almost greater than it is on you And and and you know, I do think probably, you know, some of the under most under Utilized resources in health care are patients and family members patients and caregivers Because the role the support mechanism that we provide in the case of Caroline said, you know It affects home for me as a youngster much like the six-year-old boy. I just want to get back in place bored I wanted to go back to school. There's a wider community that has to be engaged in in in your health and I think Sometimes not always but sometimes we The community gets forgotten, you know, your loved ones get forgotten and actually, you know A lot of my job was sitting in the hospital bed being treated It's the impact as Vonda's talked about, you know, my wife and my kids that is is far more reaching I think probably the greatest impact for me was my daughter at sort of 2 a.m. Would text me are you okay? I can't sleep. I just want to check that you're okay as I was going through transplants and you know, you just stop I'm okay because I'm being treated. I've got people around me. They need support Yeah, and what I want to really underscore about that comment Michael is that I think again in our language We've tended to lump patients and families together as if they're the same role and the roles are so different So we really have to think about how to support the family members as well as As well as our patients Well, yes, I would jump in I was saying along that line There's a similar event that happened at my organization in 2008 in which we were caring for the physical needs of a young man from a traumatic brain injury and I won't go into the details of the story Patty his mom Stood up and stood out for him and reminded us This is Sam It's not a traumatic brain injury. His name is Sam and that similar event Has helped lead our focus on person family-centeredness and recognizing the role that every individual plays along the health care journey Yeah, I love that. This is Sam The whole person Okay, we're gonna move on to our next question because we have a lot of territory to cover here And I'm gonna turn now to my colleague Neelum. So Neelum, we heard certainly I'm already talked about the new global challenge on medication safety and I know that you've been Involved in many pieces of that but also the piece of developing the person family engagement piece of that and I do Also want to say that every one of the earlier Global challenges that the whose patient safety program has developed has engaged patients and families very very again very early on in the process So you're you're continuing in that tradition. Tell us how Persons and families will be involved in the the goals of the global medication challenge Thank you very much. I must say that one of the fundamental problems In this whole issue of medication use The patients are not fully aware or knowledgeable about the medication themselves They are most often or not. They are passive recipients even in my own family, you know, my sister my mother My father they when they're given medications. They basically don't know anything about it So if they're passive recipients, they are just they do just what's being told to them and This many times they can't even name the medication which they are taking and you know these medications may even sound alike or look alike as well and In addition, they may not be even clear why they're taking these medications So I think this whole issue of you know involvement of patients so vital For for the challenge and as part of the challenge. We are addressing this fundamental problem in a systematic manner at the systems approach and What we are doing is that we're advocating for patients and families and persons to be Empowered and engaged in direct care and also in a policy level organization level and also at educational level in educating Medical and nurses and pharmacists, you know as as they're sharing their experiences and you have a tool that I think you're going to share too It's like five questions. Is that correct? Absolutely. So I think just you know to to give the context that I truly believe that Patients actually hold very important information, which is vital for improvements in processes systems and policies and we should really tap into that That resource which we have not done effectively, you know throughout in all the countries. Yeah, and I mean It's been said several times But I want to just you know emphasize it that patients actually are the only consistent factor in the entire care pathway So nobody else knows about the patient than they themselves So, you know, how can it be that I'm not involved in my own care and As part of you know this the challenge implementation We actually are developing a tool which is a patient engagement tool To catalyze the involvement of patients and families so that they are more involved They are they participate and they even are empowered and ask questions They think and ask questions that do I know about the whole treatment? I'm taking you know Why do I need to take it and so we've structured it around five moments five moments and these five moments would easily be remembered as stars So stars is basically starting a medications when you start a medication, you know Can my problem be solved in some other way? Do I really need to take this medication? And you know, what is it for what's going to do? And I would like to know more about it, you know, what are these sort of side effects? What what do I have to be keeping in mind when I'm taking this medication? So the next one is taking the medication. Do I know the doors and the schedule and you know What type of capsules and pills are they how do I store it and if something really happens to me? You know, how do I what do I do when some side of it comes? The other one is adding a medication So if an if some some new medication is added, you know, why is it being added? How does it interact with other medications? I'm taking and do I will I be you know able to maintain the dose? Should you that I have to take this one now and that that later on and then the next one is looking into actually reviewing so You know, I mean, I'm taking on multiple medications But who's keeping of you know over an overview on it Are the doctors and pharmacists are going to be involved in the review Do I may have to maintain some sort of a checklist what all medicines I'm taking and do I need to continue taking all of them? Maybe I have to stop something and you know start a new one So this whole issue of reviewing the medications and then last but not least is basically stopping the medication when do I stop the medication do I just keep continuing taking it and Sometime what happens is that if you run out of the stock you just stop it Yeah So, you know what what impact it would have if I just stop it if I don't have a medicine and You know if I have to stop it was just stop it immediately or do I stop it in a tapering manner? So I would like to know at all these steps of starting taking adding reviewing and stopping Which are the crucial steps that so that I become more knowledgeable and informed and then can take Proactive steps to prevent error to prevent medication related harm and then improve my own health So this is the direct involvement of patients and and these questions actually a very thought-provoking So they really engage the patients and I must say just in closure for my this thing that I think it's high time It's very important that care should be put into health care Mm-hmm, and care here actually means compassion accountability respect and empowerment Wonderful. Wonderful. Yeah, compassion, accountability, respect, empowerment spells care So you gave a stars in care two things that I think will will take away from this today Also wanted to say when will it be published because I've been hearing about it through Helen Haskell one of our colleagues in the United States So I know has been very involved as a patient advocate. Is it almost done? We had extensive review of it after December, so I think Couple of months, okay, because we're all on pins and needles Yeah, I would say I would say you know first quarter or maybe early second quarter of the year Ed when I wanted to also just turn to you on this question too because one of the things that parish Medical Center has really done and I would emphasize in our planning was Patient family engagement person family engagement not just in the hospital But across all the continuum of care and when you think about Medication use at home, you know in ambulatory care and you know, not only the starting but the stopping How are you engaging patients and families? In that continuum a couple thoughts without especially related to your comments As you were talking about stars that reminded me I did a one of those moment flashbacks in life Back to before my father died several years ago, and he like many 89 90 year old People had many comorbid conditions and one of the times that he came home from the hospital My sister who is a pediatric intensive care nurse my brother-in-law who is an anesthesiologist And I sat around the table and pulled out his two shoeboxes full of medications And when you talk about review it took us six hours To understand what those medications were so I think the the application of stars is a absolutely Mandate for what we have to do as a system As we've taken it across our system within there it is to truly integrate care And integrate is a term that we need to use very differently than coordinate coordinate means you still have different places Integrate puts the person as You just as you well said as the only part of the continuum that has any value Okay We hold it Michael to me Yes, we're running from in time. I've gotten that already so Edward but Michael is gonna be around for the Duration so we'll have a chance to talk more Edwin since you've got the floor your organization has made the systemic Commitment to not only implementing every apps, but also to person and family engagement, and you've been recognized for that work So speak to the leadership issues and the culture issues. How do you make sure that that happens? And you also I'm gonna just tee you up here the literacy challenge because that comes up over and over again in this space What is your organization doing to address those this morning? Is has been great because it reinforces everything that we as health care Experienced people I don't want to call us experts because that puts up a sense of Knowing everything and we don't know everything But our journey through our cultural chain since 2002 has had to be a very intentional Purposeful journey in which we take the voice of the customer the voice of the person the voice of the patient Into consideration for everything we do Locally the mission statement for parish medical center is seven words Healing experiences for everyone all the time and those seven words can seem very superficial at first But those are very intentional and drive every strategic decision that our organization makes So when we say everyone and all the time we have to do a gut check every single time Michael's organization also has Adopted this concept that is sort of in the rhetoric in the United States about safety across the board I think it's very very similar to zero by 2020 It's like we have to build that into everything we do at a systems level And I know that's also been a real focus for the For who's patient safety program to really seeing this and re-educating Not only patients and families and persons but the whole workforce on the systems approach to safety So safety across the board and I don't come back to Sir Liam because I think his challenge to us to imagine is Is a fairly remarkable challenge? Imagine changing math To get to zero We have to take one plus one and make it zero Only when the person the provider make it one plus one plus one and the family come together Can we create zero harm? That's beautiful. That's right up there with stars and care. We're gonna remember that as we take this away Any other comments? I'm not feeling like we've got a minute or two Michael Do you want to jump back in with the comment I cut off before? No, I was I was just gonna it kind of dovetails what you were both saying is Is to your point about about understanding the medications at the transplant unit that I have at Oxford's You know, you know when you go through transplant you're on medication for life There are challenges getting supplies of medications There are a number of patients that when they don't get them they assume the doctor has stopped them and Then they become and then they end up in the ICU and they end up as an inpatient because they just think it's been stopped and and that kind of dovetails with what I was just Were desperate to give you a hug was you were saying because We're in a rarefied atmosphere here of people that I've learned so much in a few hours I'm like my brain's bulging with everything but We have to we have to do it for the lowest common denominator on a literary perspective because people don't always understand as Cultural differences, there's language barriers. There's literacy. There's education. Yes, I'm very lucky. You know, I've got a family If I don't get my medications I'll get on and make sure I get them but that, you know, we've seen direct action when people don't get that and and you know Social media there are Facebook groups out there where people trade Medications because they run out they literally trade have can I borrow some of your pills? Can I do some of that? And it's how we embrace that Absolutely, and then with literacy one of the things with health literacy that we have to remember Health there's literacy at the person level changes day by day My not if I'm a diabetic and I understand it I'm the six-year-old who goes through life giving my own education That's fine But when I become an adult and I have a co-morbid condition, I may have been very literate on Managing diabetes, but I may be absolutely ignorant on managing disease X. So we as health care partners Have to understand that literacy changes Throughout life and literally minute by minute because based on the stress level based on the events that are happening our understanding our ability to speak To it may change completely May I say something to that two minutes? one minute No, and I See the time there and I think I like the word you said the expert and the experienced person because if I See the children setting there's always the family around always you have always second pair of eyes and I always think the the Family the child that's the expert and the nurses they can have experience Some of them have just a tiny little bit some have more but the expert is the family and I think this is this is the goal we nurses have to have to step back and Don't be ignorant or don't be arrogant to know everything because The knowledge is with the patient the family Sorry Thank you I In my excitement to get this panel up here and to have this conversation for this panel I realized that I didn't really give you the basics of the apps So I'm gonna summarize it in about 30 seconds here It really has four pieces to it This is the leadership checklist for the leaders in the audience I'm teeing you up to Vanna so you're on deck But it really has four components. The first is is just culture You have to have this culture of respect and honesty that involves listening and inviting that patient voice in as part of Your readiness to do a person family engagement in a really authentic way The second is assessing just assessing, you know where what you've got going already on where the opportunities are So bringing your staff bringing your patients bringing your families Really? Have them tell you what you think what you're doing well and what more you can do and then bring back your staff after you've done that that sort of Scanning of your systems your programs your protocols your training bring back and brainstorm with your staff about how to assess Then of course you have to implement and in implementation. We all know this It's it's an important part of that is measures So there are specific things in the in the apps. It's very very pithy There's a lot of tools about potential metrics you could use and different ways to bring that patient voice into all sorts So all parts of your organization and the fourth piece is sharing It's it's share your lessons learn share what worked share what didn't work But you learn from so it's a transparency piece and that's the leadership checklist for for the apps I'd encourage you to Really come to the workshop on Sunday if you want to give us some more input on it But you're gonna find a lot of pith in this apps as we go forward And now as we kind of move towards some Q&A I want to turn to my co-chair Vanda because Vanda We have a group of leaders here And we have wisdom here, so I'd like to actually ask you to Share any advice you've got for the leaders in the audience here or following us online or on Twitter about how to best make use of this natural resource I Will try to To do something something potent in a very short amount of time so First of all, I just want to say I probably wouldn't be sitting here if I felt like the post Engagement process had gone well if I had gone in and said hey what happened here Our family is asking questions. I'm doing some research. This doesn't look like it was just something that happens If I had been engaged at that point, I probably wouldn't be sitting here and quite frankly I don't think a lot of us would be sitting here So I want to acknowledge first that there are a lot of things that leaders are getting right today and Many of those things have been mentioned earlier today the the advancements in human factors, which is sort of my my area of interest and Also, there's this almost every day There's new science coming out in other arenas someone earlier was talking about sort of cross pollinating Teams it was on the education side to bring those those teams together in the education process and not wait until they are in the operating room or the theater to do that work together in teamwork and For me, I think if if we start to look at biotechnology Neuro-imaging we get pictures of the brain right now and you can see very very clearly What happens when we just take a simple pause? And there is just a simple way to just take a minute and go. I just got to take a breath here We think it takes a long time When I sit down for a meal, I try to remember and I don't always do this But I try to just remember hey this thing's whatever this is. It's getting ready to go through my system And I just want to take a minute to just acknowledge that I Think it's gonna take a long time. It doesn't take a long time to pause and just make a little eye contact or make a personal relational connection and I think if if I were talking with leaders from that perspective I would just simply say do all the things that you're doing well and do more of it. Thank you. It's helping it matters It's making a difference and additionally Let's try to every once in a while Not be so cognitive about this and give ourselves the opportunity to just have a moment of rest Because I think if the administrators do that they set the conditions the modeling for everyone Associated in their care field to do that and there are numerous new Studies almost every day showing and demonstrating how a little bit of rest goes a really long way So that is I mean I've heard the importance of listening emphasized respect But I don't know that I've ever heard a patient. I could say take a pause That's a very very human tool that you've left us with today Okay, we're gonna Turn to questions in just a moment from the audience I'm gonna grab this and see what you've queued up for us But killin you were gonna make a last comment about Your words for advice for this audience as we move to see what we've got here. Yeah, I I thought them Competence and knowledge is not everything well in my in my Example it's the combination of competence knowledge with Empathy with kindness with trust with engagement with empowerment. So in this combination It's the base of success. So that's that was very important to realize that's the most important thing here Okay Well, thank you Carolyn Please join me in giving a hand of applause to this Group as we take a pause here and look at questions We've got several questions and we're not gonna be able to get to all of them But thank you for engaging with us One question is how can technology be a tool to provide value to the apps of person and family engagement? slash captain Capacitation so capacity plus engagement. Does anyone on the panel have examples that they could share of a technological tool Well, I do have but not with the with the Example of the six-year-old, but we do have the app with with children with diabetes because Years ago, they they had the booklet they they punctured the and they knew the glucose and then right they were writing it down That's pretty uncool. So and today they they they do the special with the iPhone they they have the sugar and they Put in the dose and the person who is taking care the nurse who's taking care of that She said perfect. So it's it's the same app They both read and they both write and then you know where your patient is and there you have it Have it running. So that's a pretty good app for for also education for the patient Okay, yeah, and I would say you know in in the technology that we're building We build it around this everyone included model. So there isn't a screen. There isn't a button that you press on the app That hasn't been built with a nurse a patient the caregiver The hospital the IT system that it's got to interact with or the or the or the doctors coming together to build that Solution because what works for you as the patient or the information you need to give to your family member is very different to the Number that perhaps the surgeon or the doctor is dealing with and so that that model Which plays into to what you're doing of everyone included if you build if you don't even design and you don't start Creating without everybody in the room. You can't build a solution that's scalable to everybody And I just add one more so a sir Liam was speaking about self empowerment and there are very excellent tools on Anybody's phone in here. You can pull one out and look up something like you know self pausing or self meditation Breathing there are really really cool apps They seems like a new one comes out every month around just helping individuals find that moment of and it actually monitors your heart rate monitors your breath rate monitors at an Individual level so that you are setting the conditions at an individual level to work at that systems level. I Love how holistic you are I mean you want to jump in on this Yeah, just to add tools that technologies have a very important role to play in medication use and patient engagement. I would say I'm aware that they are apps available for polypharmacy patients to adhere to the medication and also you know schedule different timings of the medication and that you Know once patients are used to Being friendly with such apps. It can prevent, you know Overdose and misuse and so I think particularly in data polypharmacy and they are already apps available But in general, I think you have to look into areas where you know technology would help medication use and and help patients to Sort of be more engaged and make make it less prone to errors And then increase adherence and and compliance as well fantastic and I think there is a section of our Actual patient safety solution on PFE that does address technology to including some very simple forms like Texting and employment reminders and the telephone is a piece of technology So we have we run the gamut from the the new app every day that can help us Take our medications correctly to some really simple things that many even the people who are not Familiar with a lot of technology can do I know we're at time I'm not quite getting the the neck here because people are being nice But it has been a phenomenal panel and we're getting a number of questions here about problem solving So I know I speak for all of us in saying that we'd be happy to continue this dialogue over the course of the rest of the conference as we If you've got particular issues Cases where it wasn't done as well as it could be We'll be a resource for you here and going forward So thanks again to this Thank you