🟣 Scroll to the very bottom to see the Social Media Campaign.

Disclaimer:
Everything below is a mix of what I observed and heard during the event. The goal isn’t to pinpoint "who exactly said what," but to share (usually) an outsider's view and overall perspective on these industries. I’m not here to act as a definitive firsthand source—readers should do their own research. I hope this inspires you to attend events, explore new industries, and hear what leaders are presenting. These notes combine my observations with thoughts on how things could run smoother and how ideas connect (IMO). I’m not an expert, you know? Just hanging out in the room with them. Enjoy!

Topics Covered: Patient Care, Leaving the Hospital, Healthcare Policy, In-Home Care, Advocacy, Staffing Challenges, Ai Technology, Senior Care, Funding, Education, Partnerships

Healthcare leaders face staffing shortages, increasing regulations, budget cuts, and AI-driven solutions. How are these unavoidable changes and innovative solutions shaping the future of patient-centered healthcare? What can YOU do to help?? (Spoiler alert: the answer is ‘educate yourself 😁 and speak up’.) ….. We'll also find that timing (or lack of timeliness) can lead a lot of issues when your guests have a schedule they’ve planned around. What happens when that schedule completely loses track of where it started? This - and more - below.

Initial Conference Thoughts - Why Attend? If I’m being honest, ‘Healthcare’ is one of the most profitable industries in the U.S., yet we also rank among the sickest countries on Earth. This paradox is often made even more confusing by the industry's complexities and hidden realities. Why is this happening, and what are we missing in our pursuit of better health outcomes? I thought this event would be interesting to attend and see what more I could learn from it.

Conference Overall Ratings: Venue (2.5/5) - Food (2.5/5) - Speaker Content (3.5/5) - Networking Opportunity (2/5) - Likeliness to Return (3/5) —- more details below

Photo Collage & Commentary

Notes from Conference—

Speeches have begun… first topic:
Policies in Healthcare

In ‘Healthcare Policy’, things can change on a dime. As new administration enters the office, priorities can change. But this presentation is about the policies of today.
It’s so critical to know what’s going on a large scale.
- Policy systems define our staffing, payment, and other models.
It’s so critical for everyone to get involved “If you walk away with nothing else. —— my main goal is to get you guys involved.”
Decisions being made how we give and receive healthcare, they’ll be made with or without you - so it’s important legislatures know what’s going on and react appropriately instead of us just simply saying “Who made this rule? Why is this the outcome?”
- Regardless of the election outcomes, we need to get involved. Healthcare is a hyper focus of any administration in office.
Especially after COVID … 'hats off’ to this sector of healthcare, this is the Wild, Wild West.
This sector of healthcare is the second most regulated industry in the USA behind nuclear energy.
- We are dealing with a lot of policy and barriers to let us take care of patients.
“In a democracy, the highest office is the office of the citizen”
- Associate Supreme Court Justice, Felix Frankfurter
Advocacy and lobbying are often seen in opposition, but they share the common goal of influencing policy. While ‘lobbying’ may carry a negative connotation, it’s important to understand it as a tool for directly engaging policymakers to bring about change. Advocacy, on the other hand, involves broader public support for a cause, often through awareness and education. Both are essential for shaping the future of healthcare.
Language matters and “lobbying” has become an inflammatory word, but it’s not a bad word depending on how you use it. IT conflates with advocacy. They are two sides of the same coin with different intentions
- Advocacy: public support for or recommendation of a particular cause or policy
- Lobbying: to seek to influence (a politician or public official on an issue)
  - Direct commnication with policymakers to influence legislation or regulations through proposing, supporting or opposing legislation. Urging the public to contact policymakers .
What are we advocating for lately in this industry? Staffing
- Reminds me of how the evaluators event reported they are most likely to help nurses transfer educational credits to get them through schooling quicker. More than any other industry, they are intentional to get qualified candidates through educational programs ASAP and onto being nurses.
  - Their take (from that event): “Nurses don’t need to attend anatomy 101 twice”. My take? Um…. Well, this is a systematic problem. We need more people wanting to become nurses and we need nursing to be a better paid job. How is this industry SO lucrative, one of the top in the world, and yet they struggle to get essential staff because of low pay? 👀 It’s truly backwards and senseless. But idk enough about this all to say for sure.

The Legislative Process (ALL STARTS WITH VOTING!)

(1) Elections: elected officials, voted by costintuents, take office with ideas
(2) Bills Introduced: once a bill is drafted, it is formally introduced by its sponsors
(3) Committee Discussions: representatives meet to debate (first the house, then the senate) and propose changes
- This is where the meme applied (from the picture above).
- Debates, modifications, add this, remove that, ‘only can apply when ___’, “everyone goes crazy with their wording and writing.”
(4) Many bills have language that is very convoluted because it’s gone through the process of various committees where everyone has been elected has a say on what their constituents think.
(5) Vote: once a final version is agreed upon, it goes to the floor for a vote
- Vote for what you do know the info on. There are so many registered voters and so few people vote.
(6) Signed into Law: president has 10 days (excluding Sundays) to sign onto law, a veto is possible
The screen was glitching, she goes “oh! It’s a rave”. It was funny.
- And actually about the first 5 minutes of her speech had technical issues (cause another girl with the same name was speaking later, so they had the wrong slides), she was upbeat, told jokes, and made conversation with everyone while they took ~5 minutes to pull up the slides. She held her composure and it was nice to see how well she responded. Take that as an example of how to behave in this situation.
  - She brought attention quickly to realty, addressing the distraction, then carrying on. Not pretending it’s not there.

“Share ‘Schoolhouse Rock’ with anyone you know,” she said.
- It takes what I’ve simplified in more detail and helps to get people involved.
We had social media attached to us perpetually during this recent election experience. We have a lot of red at the federal level and blue. In my opinion it’s always good to have a balance in government leadership.

PROS and CONS of Each Party (as it relates to Healthcare)

THE GOOD
- Republican Party: decrease in regulation (this is well intended - in the 70’s and 80’s we saw how long-term care is killing seniors, “OMG we need to do something”. Then they had a lot of surveys, pulling on the needed reigns, and let businesses and industries operate accordingly.
- Democratic Party: Increase reimbursement (Medicare rates increase, reimbursement rates increase, it’s a balance, but this is good for our industry)
THE BAD

Republican Party: Budget cuts, no increases in reimbursement (with inflation, it’s killing us with costs. This is the downside to a red administration)
Democratic Party: increase in regulation (a lot of staffing mandates, infection control measures, good intentions but often not seeing the bigger picture)

THE USUAL

Healthcare is a focus with both. It’s always at the epicenter of all policymaking decision
Both want to control costs, better outcomes, change the way we pay people so people go through the system.

Post-acute and transitional healthcare will always be a focus in policy making. That’s why this is so important for people living and breathing in this work. Case workers, doctors, laundry services… everyone involved taking care of a resident or patient needs to be involved
“We are the government, you and I.” - President Roosevelt

Struggles in Staffing

The staffing crisis in healthcare is one of the industry's most pressing issues. While healthcare is an extremely profitable sector, essential workers like nurses are often underpaid and undervalued. With a shortage of 190,000 workers post-COVID and rising regulatory mandates, facilities, particularly those serving Medicaid patients, are struggling to meet staffing requirements. The gap is widening, leaving many healthcare providers stretched thin.
We need more RN’s and more healthcare workers. Our biggest challenge in the industry is staffing. No one has an abundance of RN’s who can help.
Based on what we’ve seen historically, maybe the new administration will get rid of new mandates… but for now:
- Right now we are almost 200,000 workers short since Covid.
- 94% of facilities are not currently meeting the requirements of this new staffing mandate
- Facilities that predominately serve residents relying on Medicaid (chronically underfunded) are less likely to meet these requirements. IF we don’t see more reimbursement it’s going to compound
- The unfunded mandate is estimated to cost $6.5 billion per year to hire the necessary additional caregivers
- More than 290,000 residents are at risk of displacement as facilities may have to reduce census to comply with these new policies
Staffing Impact: increases RN requirements with current workforce shortages already in place. Does not meet patient acuity needs. Rural at highest risk.
- Unfunded: mandate provides no funds to assist with recruitment, hiring and retention
- Potential SNF Closures: the inability to meet requirements will result in lower census
Access to Care: reduces hospitals’ ability to to discharge to community, causing contained back ups and bottle necking
Regulatory: punitive/reactive in nature, SNF exemptions occur after going through a survey, resulting in citation.
Mom and Pop nursing homes don’t really exist anymore. We’re seeing more mergers and corporations take over… it seems to be a reflection of our desperate attempt to survive.
The COVID pandemic falsly advertised we don’t care about patients, so now these regulations are trying to make up for that. It’s well intended but could have very consequential side effects.
- It’s a challenging piece of legislation that is going to impact post acute and nursing homes negatively
- The COVID-19 pandemic reshaped the way healthcare facilities operate, but many of the regulations put in place to protect patients have had unintended consequences. While well-intentioned, some of these regulations are pushing facilities, especially small ones, to the brink, with the potential for closures and diminished access to care.

Get Involved and Help

You guys can speak to legislatures and speak to these important things
Washington State priorities

Budget Woes: expecting to see cuts, requesting maintain reimbursement, but state government travel and hiring freezes are put in effect. There is a warning of. 10-12 billion budget deficit going into the 2025-2027 biennium
Medicaid Funding: Advocate and meet with legislators to work on these issues to continue funding the AL medicate rates and reimbursements for skilled nursing care as the prices continue to rise.
Insulin Injectables: Update outdated statues regarding self-administrated injects for insulin allowing caregivers to assist residents.
Staffing Mandate: Expected new staffing mandates for memory care, TBD
HCA Testing for Home Air Aids: Only 20 sites across the state for testing. This will promote testing integration into training program/curriculm to support more post-acute pair.

When the world is silent, even one voice becomes powerful - Malala Yousafzai
Get involved. There really a lot of obvious ways to get involved - some are really fun ways to get involved:
- Vote - it is your right not to vote… but decisions are being made with or without you
- Association engagement - sign up or association policy lists serve to obtain the lately policy issues and opportunities to contribute (panels, testifying, etc)
- Hill visits - Participate in hill visits: WHCA and WSHA have “hill days” to meet with legislatures and testify
- Legislator Engagement - Send direct communications vis email and/or phone to your legislator to tour your facility
It is impossible for a legislature to know all the issues: farming, plastic surgery, business.. etc - it’s so important people are involved to educate our legislators.
- When they see more people coming from sectors, the more the merrier - they will start to understand better. This will make an impact.
- Invite your legislature to tour your facility. Legislators are always interested in touring facilities and providers in your district. They’ll help you do this, they make it very easy for you. They want to hear from the people doing the work, even more than lobbyists. “Tell me what you deal with every day” that’s what they want to hear, direct from the source.
  - They want to make informed policy decisions that affect our personal and work lives.
- If this staffing mandate becomes a serious rule, there’s going to be a bit of cannibalism, everyone fighting for the same nurses and caregivers.
  - What kind of effect does displacing 60 seniors have on everyone?

BREAK TIME, Time Management Loses All Control

PS, KELLY NOTE: Starting here, the time of this event gets extremely off. idk what happened 😂😅. They hosted a super long break and now the next presenters speech is over 30 minutes behind the plan. They’re supposed to start lunch in 15 minutes, though her speech was supposed to take 50 minutes. So now she’s expected to give this speech very quickly.???
The next speaker is telling a story about a patient but changing his name “because it’s a small industry” — makes me think that’s interesting to hear, maybe some of the people here share the same patient— though the population is huge. So, just seems surprising that the world is small.
Repatriation process: I want him in my hospital, where his daughter can come visit and help with care… fr anyone who hasn’t been in this process, it is very worthwhile to think about what it’s like to transition a patient to another side of care, for the patient. Sometimes they need to move facilities. SO think about what we do and the different specialities available in centers.
- Repatriated patient, he got a high-risk procedure, but was back to playing his harmonica later this week. His daughter was fully engaged in the process, and he died a year later in his sleep.

Stats for People of Advanced Age

The number of older adults over the age of 65 is projected to double between now and 2044 —— we need more staff to take care of people!!
80% have at least one chronic condition and 77% have at least two.
Older adults have higher utilization and disproponate rates of health care related harm, delay, and disco ordination
13.5% of older adults require home health

Discharging Patients

Leave maternalism and paternalism at the door. Adults are allowed to make bad decisions. So when we are in this space for safe transitions of care, it’s very anxiety provoking. At the end of the day we need to talk about autonomy and how we did everything we could to provide a safe discharge. We are still helping them get their meds, walker, etc… they’re allowed to make bad decisions (and leave the hospital) and do whats’ important to them.
- Ideally allow the patients to return to the place that they before hospitalizations/ SNF
- Reduce adverse events, avoidable readmissions (we don’t want them coming back, we want to have done our job well and everything worked as intended), Reduce costs to the healthcare system and patients
Successful Discharge:

Complete accurate and clear discharge information (harder than we think. Do we have it? Did we get a good med reconciliation? Do we know what meds they’re taking at home?
Coordination of Care: good follow up appointment, individualized services, talk to them and make sure it’s timely and convenient for their life. Make sure they have transportation and you’ve faxed the discharge summary and medication to the office. DOn’t give it to them in a folder and expect it to go anywhere except the bottom of their car. Have systems in place for good communication. In a perfect world, all the AHRs would be integrated. TEhy’re not, so do the right thing.
Communication: Ambulatory team has easily accessible and TIMELY discharge information. Direct personal contact with patient, family, caregiver, PCP, ambulatory specialist
When someone is discharged, you have 30 days to submit reports - best practice is “day of discharge” — it shoudl be more 30 hours.

Get as much information as you can.
Hospitals need more pressure on them to submit paperwork and summaries of discharges and people will chose timely hospitals over others.

Hospitals aren’t always great at up-to-date POLST which goes with the patient while they’re transitioning care.

PACE Model of care:
- A lot is rooted in keeping the patient at home, in the community, and avoiding an excessive amount of care. Most patients don’t want to be stuck in a hospital or hovered over.
- A medicare program (PACE) and medicare state option that gives community-based care and services to people 55 or older who would othersiwse need a nursing home level of care. Integrated system of care of rate frail elderly that is community-based, comprehensive, capitates, and coordinated.
- PACE Provides: transportation, meals, therapy, and more - a lot of benefit to these participants in your facility.
  - Also they get 1 ED visit a year or less. This will make people so happy (for many it’s 10)
  - 95% of caregivers would recommend PACE to someone in a similar situation needing this type of care.

-Front row: 1 girl falling asleep, 3 checking their emails. One guy texting, just no one paying attention. Cause we’re cutting into lunchtime. (Turns out some of these people are post-lunch speakers!!!! lol… not good.)

What matters in conversations? Make sure the person you’re speaking to feels like it is the most important things you’re doing. It is, and if it’s not, you shouldn’t be doing it.

MEDICATIONS AND PATIENTS

Medications matter: high quality care means regular reviewing all medications at least annually and with every fall hospitalization or ED visit, - Ariel green, MD, PhD, MHP
Five or more medications a day is polypharmacy (“that is not very many… I love it when people only have 5 medications… “oh you’re only on five!”)
- Sever polypharmacy is 9… that’s where most of our patients lie.
“I hate Benadryl and Tylenol PM” throw them in the trash under most circumstances
Mobility: patients in the hospital —
- If they came in walking, they should leave walking. If they came into the hospital living at home, they should leave this way too.

Assess home for safety by screening for rugs, pets, and clutter

-OMG this speech is going so late. They’re running entirely behind the entire planned lunchtime, this speech cut into the entire planned time for lunch. Idk how this happened, I think the break ran too long - but now it’s crazy. It’s’ their first year hosting this event, but no doubt the organizer is freaking out a bit. Right?

It’s sooooo rude to take Q&A into lunch when it’s already running 40 minutes late (lol i’m hangryyy!) IDK their plan. Cut into other peoples speeches? It ends at 3pm! There need to be better communication about time management. People are hungry and it’s so crazy on your mind, to display the schedule/plan on every table and then not really try to keep to it. It’s never rude to tell people “no time for Q&A and just realize it” when you’re this late. As the speaker before lunch, know it - and invite people to eat lunch with you. Be curteous to the audience… or as the leader, better communicate this to the presenters. Maybe I’m alone in this, but it’s very annoying to know you’re running later and later for lunch- with no plan addressed.

Also this is rude to your sponsors who paid for your table. You’re promising them time to mingle and network with people, but then you cut into their time. Sponsors will not want to return because they were not given that time as they were promised. It’s very annoying to be stuck at a table and not talk to anyone
This is a very difficult balance and situation for everyone involved when the timing doesn’t match up. But modifications and management must step up in this stituation. At least show the audience you’re mindful of them and trying.

LUNCH TIME INTRODUCTION

Finally done. Let’s see their plan. Lunch is now — emcee says, “you guys want to eat food maybe?” — very informal transition of lunch, no acknowledgement of the updated plan now that we’re behind schedule. This venue does not have good acoustics.
They said lunch will last for an hour, see the vendors. If that’s the case, it’s setting the event behind by a whole hour. I think they need to figure this out. Will everyone else just give shorter speeches? That’s so rude to your speakers! If it were me, I’d say 40 minute lunch, first presentation from 12:55 - 1:30, then the next one 1:30 - 2:15 (add in a small break), then the final speech from 2:30-3:00.
But keeping the full hour lunch is very risky. (And they ended up running late with lunch too!)
The host of the event spoke next. Scheduled for a 30 minute presentation but spoke an hour.
It’s awkward to go off the schedule, and I was away when the speech started -so maybe he addressed it, but, sometimes it’s good to have the agenda digital, I guess! Here’s one time it would be good. And save money.

-Lunch was okay. Raw veggies, salad, potato salad, sandwiches with old tasting bread, and tomato soup - I didn’t like how on the pamphlet they showed the catering name too. Called the “Wheel in Buffet Sandwich Shop” and the graphic design formatting on the pamphlets was off too. It looked hurried & within a budget (at an esteemed DOCTORS policy event?!) And not a nice sounding name for food??, “Wheel In”. Everyone here paid for a ticket covering lunch… maybe for a nonprofit, this level of food/service is totally fine, but not this healthcare symposium!!

CARDIOLOGIST

Founder, host of symposium: Specializing in the Post Acute

Cardiologist
Physician presence is very noticed. They get intimidated
Disclosures (don’t have any disclosures) - turns out this statement is popular in the industry

SNF 300-day rehospitalization rates for HF ranged from 27%-43%. Number one cause of readmission.

MedPAC 5 conditions, specifically HF, account for 78% of 30 day SNF rehospitalizations which could have been potentially avoided.
This suggest Medicare spent 3.39 billion in 2006 on potentially avoidable SNF rehospitalization

Care Coordination, Limited Resources, Turnover in staff and limited staff, data sharing, staff training and education, pharmacy-poly pharmacy limited reconciliation

Post covid is a lot of travel nurses.
CNA’s won’t stay in locations. Protocols may sound great, but one of the biggest things in our facilities is turnover. Eyeopening to reality. The postaccute world has issues and gaps.
Data sharing is going from “let’s try to hire the biggest practice in the area and be our medical director and fund all these patients to us” - finally, we’re getting there where it’s about data and metrics. It’s not about what it was back then, old school. It’s about what your measures are. Your data

EDUCATION DEFICIENCY IN THE MEDICAL FIELD

One of the biggest barriers is education. Many people are unfamiliar with guideline therapy and solutions. Some people have no clue.
Honestly, physicians are very busy. They dont’ read everything that comes out. The pharmaceutical reps do that job and help us figure out what we can use.
- This makes me like OMGGGG eew. You just have to trust the pharmaceutical reps to care for the patients, doctors? etc. yuck. I don’t like this policy and standard and “okayness” how the doctors just stop learning and trust the process and then give that to the people!!
“In the post-acute world, for some reason we don’t get that type of help. There’s a lack of education.”
Limited medications at the pharmacy, we change the medication because we can’t provide that same medication. So then at home they have different medications, how do they know which one to take?
The way that the forefathers before us use to treat post acute, it took a while to learn and trust these new methods. To work with new modern partners. Understand the gaps and be sure there’s a new solution.
- Plays a YouTube video with a joke of a medical emergency:
- We’ve got to figure out a way to all work together and meet the standards too. We’ve got to find a middle ground where “ I get it” you’ll get audited but let’s work together in this niche.
- His company’s goals: physician owned, focused on delivering cardiology, nephrology, and pulmonary specialities with local physician presence in post-acute facilities
You can not move or grow without a good infrastructure and staff. You need the right people. We don’t work like a traditional company in the sense we need a certain number of providers or etc. It’s rather: can I find the right person? I know it’s going to happen. Initially, when people come to me now after ten years and ask me, they’re always just like: what’s your model. I tell them and tehy’ertotalyl not impressed. We are nice peopel who brainstorm and grow. That’s kinda our metrics, how well are we doing in our facility? How well our buyers are getting us feedback? I can tell based offf their feedback. I can’t talk more highly about my staff.
- His speech running late too - no time for Q&A - lol. Running over 50 minutes, scheduled for 30. He kinda can do that, it is HIS event, literally… but… also, a bit rude (and he already spoke once earlier in a panel). At the same time, if someone cancelled, this is okay cause there are two more speeches planned and each go an hour and fifteen. So, perhaps now he’s just extending his speech and then letting the other speech be as long as planned. But still weird he’s speaking second when he’s scheduled to speak last and host a “discussion on the key takeaways from this Symposium….” but now there’s not even a discussion. It was worded weird on the agenda.

CONTRIBUTE AND COMMUNICATE WITH HOSPITALS

“Reach out to the hospital system and tell them to wake up.” This is why he wanted to host this symposium to discuss things openly. It doesn’t have to be formal. When he first started in Florida, they always had a panel discussion with physicians and some administrators. I remember one of the hospitals said, “our patients go to you, we don’t see them and we see them in the ER the next time”. One of the physicians said, “well maybe if you gave us a discharge summary this wouldn’t happen.” Then there was a back and forth
- “I love that we are local and peers doing this. We should have these discussions and benefit from this.”
- That kind of communication is what I’m hoping for all of us to have. More than anything, that kind of collaboration . Bringing everyone under one roof and trying to figure that out.
We want to have discussions with each other. Talk about outliers, situations that could be prevented. THat’sthe kind of discussion I want to have more in the future. As we are connecting more data together and getting realtime data, that’s where it’s going and that’s where it’s headed.

Its’ really neat to learn about this technology, it’s going to make us stronger

Top 3 diagnoses for readmission was respiratory distress (13%), shortness of breath (27%), and altered mental status (13%)
Key Positive Results:

Partnerships bringing value to each facility and fully utilize services
Facilities make time for education training with nursing staff
Partnering with hospitals provides direct communication lines to transitional care lead and staff
Medical directors and their staff at facilities are on board and play an active role
Facilities are interactive and help co-manage patients with providers in the building
Hospital systems that have their own providers with a strong TCM program

Sometimes we get desensitized to specialty practices. Things can happen within seconds or minutes. I always tell people, if you like my work, great then let me come do my job then. Let me come figure this out.
So many of his images are squished. Squished pictures of the USA and his staff. It’s really amateur, but… not everyone knows of Canva.com/cropping picture things. Don’t use the SIDES of the pictures, use the CORNERS to keep the proportions on track.
Q&A now, dragging this speech into an hour long experience - when promoted to be 30 min, and already this event is running late. It’s just driving me crazy cause they have the schedule but they break it.
Now you can see the speakers are upset in the front row, the ones who haven’t gone yet. They seem surpirsed he’s hosting a Q&A. They’re annoyed that their time to speak is being cut into.
- This is common and really unprofessional. Are people going to be expected to stay late? It’s far away from Seattle too - but many people live in this area probably. This is near many hospitals.
- I complimented a girl in the bathroom for her incredible outfit, turns out she’s a speaker. But she was wearing a full pink suit with pastel + neon. In response, she said to me “you will wear pink, one day, too” something like that… But, I wear pink all the time, lol. Just today wearing a black dress (that I was even complimented on by someone else). It was little rude for her to assume and say that “I will wear pink one day too”. Like she’s a popular girl in the bathroom. Though she won a 40 under 40 award, according to her bio - and had many other achievements. Just seems like she’s too cocky and assuming. But she’s one of the next speakers.
“These next speakers need to have a speech, but they have a hard stop.” Lots of people here have a hard stop. It’s crazy to run things late and think that’s okay.
Now they want to have three speeches in the next one hour to fix this timing problem!! These speeches were scheduled to last over two hours, all squished into one? The EMCee, also, keeps not speaking up on the stage, just from the floor. He also keeps not getting people to be clapped onto the stage or introducing them properly. The speakers are visibly annoyed. They had to go get their own microphone and prepare microphones. They are mentioning a number of times that they’re frustrated that the slides aren’t up either. I have no clue how they’re going to sort this out, having 3 different speakers.
The next presenter makes a huge deal of the technical difficulties “The slides aren’t up, the slides won’t meet us up on stage” etc etc etc - “when the slides come up, you’ll see” , “I’ll have definitions up there in a minute” - it’s also a bit unprofessional to point this out so much. Just be cool. “She’ll have a slide where she shows things, etc.” “looks like we’ve got the slides up there” - it’s just so rude to the slideshow guy, we get it! he’s trying. You’re not Mariah Carey, chill out and make it more easygoing on the slide guy. “Let’s get moving with the slides so we int keep here this afternoon, there are people after us” - then she realizes that she’s in charge of the clicker and she’s been in charge the whole time. She’s really acting like she’s cool with things but also being so passive aggressive - keeps point out how “keep moving” etc. Which is professional, but it’s all awkward.
This makes me think about the role of a presenter and how to react in this situation. The first girl with her same name did a very good job with this same situation, much better than this one 😂. I know that’s rude, but you have to admit it’s a funny joke just a little. hahaha. It’s like a metaphor.
- Feels like she’s just throwing this speech in the trash a bit. Being so fake nice about it. Instead, I think you just can be more friendly about it. More joking.
- What can you do, you know? Don’t make us suffer with you, “I’m happy to share these slides cause I know I’m moving quickly”. It’s just really uneasy.
11 years later, only about 10% still on the board of managers for their quality committee at Evergreen Health Partners.
- She had a positive tone to this, but I wonder if this is good or not. Seems like a high dropout for “quality committee” accountability

SUCCESSFUL STRATEGIES in the INDUSTRY

Cost/Utilization: one example was looking at the generic pharmacy dispensing. Give score cards to each provider, particularly with their patients, how many times provided a drug with a generic you could have prescribed. Show them something forward facing showing how costs could have been saved without affecting patient care. Assume generics work as well, so try them.
- Quality: strengthen, education, focus on preventative cancer screening, diabetes maintanences, well-care visits
- CM = care management
Some of the “highest priority patient” indicators:

3+ ED visits in past 6 months
Active diagnosis of depression
2+ hospitalizations in past 12 months with high provability of becoming persistent
Hospital readmission within 30 days of previous discharge
Patient with existing care gapes and possibly care coordination issues
Diabetes with no test in last 12 months

Partnership w/ Overlake to become Eastside Health Network (evergreen health + overtake)

All I know is it was insanely expensive for having a baby. I owed $8k after my daughter was born, then we owed an extra $8k for her, as a patient too. It was nuts. That was including what insurance covered….. $50k or more to HAVE A BABY??? wild.

Their slides are legit confusing. The charts don’t make sense.
The next speaker (pink outfit madame) says, “You already learned a lot about value-based care today. So some of these slides I can go through quickly since we discussed this earlier”
- This was a graceful way to bring this up and explain how you’ll brush through.

Though she does keep saying “I’ll talk more about that/I won’t talk too much about that” - it’s like… okay, just talk about it then. LOL. Idk if it’s too much previewing.

Data is so important to us. We have to have data for our entire patient population. We use a system that has data flowing for all 100+ EMRs in our network. All this data into our system, at any given time I can open up the system, pick a patient, and know everything about them. Manager their risk coding, see upcoming appointments, previous appointments, payer data, outside of network care… all the data flows in our system so we can properly care for the totality of these patients.
- Post acute clinics participate in our network because lots of our patients receive care there. Our providers want to know how their patients are doing, so we provide that info so they know what’s happening with each of their patients.
- We produce score cards that we provide to every single clinic and provider on a monthly basis, showing all of their patients and their insurance, providing information on how their patient population is performing in regards to cost/quality/outcomes.

Maybe 50 ppl in attendance at this point, people really are leaving early.

Organizational Communication: monthly newsletters, marketing team, stories from patients which are amazing, upcoming events, information for providers, education for each of them.
- outreach to patients is often postcards and letters. Usually co-branded or fully branded by hospitals, but we are responsible for sending them out. We work behind the scenes to make sure the patient is being cared for by their provider. Even though we’re the ones who send the letter.
SUMMARY: Why should we care? Value based care is the future of healthcare. Instead of having to go to the doctor to treat the illness or conditions, we aim to prevent it.

Let’s improve patient outcomes, patient satisfaction, quality, healthcare transparency, savings for patients & health care systems.

“Last speaker of the day, not only that - I’m a stand in” — this speaker 😂 (omg, I just feel like this type of comment gives the audience no confidence in you!!! Kinda. It’s like, why are we being given, self-deprecating themselves, Plan B for the last speaker??)

FINAL SPEAKER HEALTHCARE COMMISSIONER

Final Speaker: I’ve been in public policy for a very long time. Health commissioner, state agency director, I kinda like legislation and politics… it’s an opportunity to influence and change things. You all can do this and sometimes we don’t even know of the possibilities until we start networking.
- “There’s nothing more uncommon than common sense, especially in the political world, in rules and regulations.” - Mindy Schaffner
- “The difference between for profit and not for profit, I can’t tell much of a difference when it comes to the bottom line.”
- “I’m a fan of taking risks but it has to be based on something. Intelligent risks.”
Longterm care, post acute, has not had the reputation for providing really good care sometimes. It especially came clear in covid, in our skilled facilities centers. It’s been an uphill battle in a way but there are a lot of really good things going on.
Many of our nurses are not trained in healthcare settings. Maybe at a community college, disconnected. My challenge to all of you in this room, reach out to your educaiton programs - social work and nursing. These students need experiences. Get a partnership with Universities and hospitals. Start apprenticeships to get people experience and help add to the pool of knowledgeable staff. Give students a great experience and help them see the picture much broader. There are many opportunities when you look at your schools.
Typically for nurses, “apprenticeship” is not in our category. That’s usually electricians or plumbers, we didn’t usually think about nurses - or even hospitals totally educating nurses. So, send staff to apprenticeship - statewide, to see what it’s about. Holy moly… she came back pretty excited. The education really worked. This idea of apprenticeship, we do, do it in nursing. We call it other things.
In 2022 the legislature gave money to develop an apprenticeship program for longterm care. Accute care would like to do the same, you could do the same (maybe not right now0 but very soon. This idea of training people in settings where they’re going to practice is an important one. There is a lot of money in this. Lots of federal and state money available for apprenticeship type programs. If you’re a creative person with agency, and you could really give the clinical experiences to students, it could be a great partnership.
The temperature is freezing in this facility - everyone is cold. I can feel the cold air blowing. It’s crazy cold in December. Everyone is wearing their jackets and cold the entire time.
Nurses in Washington, the number of hours they’re required to have is only 300 hours of practice. Not many. If you look at ADN, they’re required 500.. that’s it. So, the idea of “now, the job working and going to school” is really appealing to many educators. Here you are, taking a profession and putting it into kinda an apprenticeship model.
We have money to get us through from the government.
If you’re a provider, you know about rules and regulations. Education has a lot of rules and regulations.
- A lot of these nurses have never been to college, and their GPA isn’t what it takes to get into a nursing program. But they are good, caring healthcare providers.
- Their job is so important, and many of these people had spent a fair amount of time in practice already and loved their work.
  - New nurses coming in are generally not interested in longterm care.
  - But if you don’t practice nursing in nursing homes, I don’t know what you do there… at the same time, you don’t have the resources there that you have in acute care. You have to get creative.
- Sometimes you have to go the route of where the money is. In this case, that’s taking in apprenticeships. We have 8 now, next time we want 25. We will keep building on it.
- Providers have very qualified nurses and people that would qualify to teach in educational institutions. You can have join appointments and share responsibly of bringing practice and education back together again. Provide thousands of hours of on-the-job training.
The presenters are having so much trouble with these remotes and presentations.

Charting

“Charting is one of the most burdensome part of charing for, comforting, and improving the lives of our patients “ - {Phylicia Hancock Lewis ARNP, MSN, MS, RN

Nurses spend 35% of their time on documentation alone - American Nurses Association, 2023
- There’s an interest (and already started) for using Ai to help with this.
- Charting is a burden. For skilled facilities, it’s even more that people are spending time on documentation. We need to free up that time and be more efficient. The charting is off the chart.
- Taking student from the UW IT department (best thing we ever did, I think, not done yet— a bit of intelligent risk taking) but it appears that the effects of so much documentation are: decreased direct patient contact, inaccurate charting negatively affects care and reimbursement, and burn-out is contributing to low retention.
- Turns out that the charting probably isn’t even very good… based off auditing, and the charting negatively impacts reimbursement. It’s a mad circle. As a results of the IT UW group at two of our facilities, now working in a whole new world: learning AI + IT language to solve these problems.
The goals of suing AI in Docmentation include:
- Amplify the efficient with AT-driven voice documentation (voice activated charting) to simplify the charting
- Minimize screen time maximize patient/resident time
- Increase productivity and care quality
- Streamline decision making with on-demand data access

This is so chaotic and unprofessional having the clicker not work or the slideshows. They totally forgot a tech rehearsal. And the formatting is off. Just a bit amateur, but genuine. It’s their first year and this is a lot of presenters. But I really wanted to leave on time, or close to it. It’s just crazy how this is running so late. Seems lots of people already left early.

“We are very short of nurses. It’s scary. We can’t get faculty. It’s a cycle. We can’t pay for faculty. I don’t know how it’s going to be 20 years from now. But colleges and universities would like to talk to you.” - Mindy Schaffner, PHD, RN
“Think about all the colleges and universities and places you have out there, even the IT school at UW… my affiliation is primarily with healthcare. I stepped into the IT world, it’s a different world and I sure enjoy it. I sure enjoyed this conferences, it’s been very refreshing. I didnt know as much about this”

Its strange too cause the two different screens give two versions of the presentations - like one screen its formatted and the second screen its poor formatting.

Q&A at the end - just none, simply people saying “Thank you” and clapping. It’s just rude to the presenter to be bad with time, it creates a tough time for the presenter. You have to just sorta accept the situation and rejection of no questions cause everyone wants to go. Time is a currency and you need o pay respect. People are so eager to leave. SO many people leaving.

SURPRISE FINAL SPEAKER

WOWWW still one surprise speaker - already running 5 minutes over the scheduled time. “Not on the agenda” but they asked me to speak a little about experiences. Insane. Many people are talking amongst themselves and leaving. Just really trapping people and disrespectful of time.

So much trouble with slides. It has so many issues pulling up slides.

TIME TO GO

Finally I left. I just couldn’t wait anymore. It takes so long (or so much money if you wanna take a taxi) to get home - or both. I really wanted to get home on time.
But I also wanted to get a drink to-go (like tea or coffee which they had at the buffet earlier) but then it was all cleaned up and put away!! Seemed like a missed opportunity there. Just leave out drinks a little longer and let people leave with a treat for heading home on a positive note!

Conference “Overall Rating” Further Elaboration:

Conference Overall Ratings: Venue (2.5/5) - Food (2.5/5) - Speaker Content (3.5/5) - Networking Opportunity (2/5) - Likeliness to Return (4/5) —- more details below - - -- - -

VENUE - 2.5/5
- Allow Me to Elaborate: This is so far from me, extremely cold, and also very hard for taxis to get to. I had two taxis quit on me after it took 5+ minutes for them to try and figure out the navigation to my location (and I took public transit most of the way here till the end!) Also, the doors were setup so strange, along with the stage so by mistake you walk in and you’re on stage . The layout was backwards. It could be better setup. And the vendors were scattered all over, too. Some had the most awkward table locations which would require a greater salesperson/people person to attract people to stand there for long.
FOOD - 2.5/5
- Allow me to Elaborate: The advertised “break” had no food (usually breaks have food). The drink selection was good, but then the lunch was promoted as, like “wheel in sandwich shop” and then the bread/croussiant was super old tasting for my sandwich. On top of that, the assortment was uncooked veggies and salad… healthy but also low effort. Then everything was cleaned up before the end of the event, so you couldn’t get a last minute snack or drink for your walk home. That was really a let down as well.
SPEAKER CONTENT - 3.5/5
- Room for Improvement: I was going crazy over these speeches. At first, they were really good - but then the time started to get chaotic and the second half of the speeches were so awkward. It was rushed, no Q&A, too much Q&A, technical difficulties everywhere. The event’s technical difficulties were constant, and as time went on, the chaotic schedule undermined the overall experience. Presenters had to rush their speeches, and the lack of time for Q&A left attendees with more questions than answers. Despite these setbacks, there was still valuable information shared, though the disorganization made it hard for participants to fully engage.
NETWORKING OPPORTUNITIES - 2/5
- Room for Improvement: They did almost too good of a job allowing networking, to the point it cut off the speeches and really upset some of the speakers. So many people left the event early or were chatting in the halls. But also we were not really encouraged to network or anything. So, idk. It wasn’t mission accomplished for networking unless you went out of your way.
LIKELINESS TO RETURN - 4/5
- Room for Improvement: I would be willing to give this group a second chance on this event. It think they probably learned a lot this year. The problems were very distracting, so it made the event experience take a big nosedive. Just how many issues they had. But I think if some of those issues had been avoided, it wouldn’t have all compounded so much. There was good info to be learned at this event, but there were many obstacles in the way to prevent people from thoroughly learning from their time here.

Kelly’s Remaining Questions:

What different “types of care” do people usually receive in this industry? What is some data on it?
What would a “healthy elderly” look like into their elder years?
How do people start intentionally planning for something like this today? Whether it’s just assisted living as an elder or unexpected medical emergencies?
How are the doctors planning for their care in their elder years? What are their “insider tips”
What types of changes would this group like to see in their own industry?
How can we solve this staffing crisis in a quick but quality way?

EVENT SOCIAL MEDIA CAMPAIGN

Until next time, I wish you the motivation and success to search for opportunities around your area. Search and explore: Who is out there giving talks? There are new things happening all of the time.

Find relatable or interesting topics you like and check them out! Maybe even something hosted at a cool venue, if there’s no other reason to go. Let’s see what you can learn and discover not too far from home. 😊

Transitional Care Symposium, 2024