Following a federal grant in 2009 to support new immigrants, SickKids setup a New Immigrant Support Network. The NISN is an important family centered initiative and was highlighted in the 2009-2010 year in review under "improving access for newcomers" to Canada. The work is currently focused on translating family support guides and cultural competence education workshops for staff.
Parents volunteering on SickKids committees and members of the Family Centred Care Advisory Council are encouraged to consider attending a workshop on Cultural Competence. Please see the workshop descriptions below provided by Karima Karmali, the NISN Director. Jan/Feb schedules will be forwarded to the FCCAC co-chairs and Karima is hoping to meet and present to the FCCAC in early 2011.
Cultural Competence workshops at SickKids Hospital
Session A examines the settlement-related stressors experienced by new immigrant families and the difficulties they face when a child is ill. The social determinants of health are reviewed in this context and a cultural competence framework and cultural assessment tool are presented. Participants will have an opportunity to reflect on how personal values, assumptions and biases can impact on the healthcare provider-family/patient relationship. Learners will gain an understanding of how cultural competence links to patient safety and family-centred care.
Session B will focus on developing skills in collaborative communication and cross cultural communication with a particular focus on working effectively with medical interpreters. Participants will have an opportunity to learn about cultural differences in parenting practices, mental health perspectives, and the expression of pain. A cultural competence lens will be applied to clinical case studies.
Session C will focus clinical cultural competence in situations related to the use of complementary and alternative therapies as well as bereavement and grief. Participants will have an opportunity to apply and enhance cultural assessment and cross cultural communication skills with Standardized Patients.
Cultural Competence for Non-clinicians examines the challenges that new immigrants face as part of the settlement process and the difficulties they encounter in the health care system when they have an ill child. Participants will have an opportunity to reflect on personal values, biases and assumptions and learn about how all hospital staff can play a role in providing culturally competent service.
@sickkids newsletter
I just received my first new SickKids Hospital e-newsletter called @sickkids and I opened the email like it was a present, which it was. I really am happy to see this quarterly roundup - this issue included eight articles which link to website stories and one Did You Know tip. Here is the link to the latest issue and to subscribe to the newsletter you can email At.SickKids@sickkids.ca or subscribe online. And so we read that:
SickKids has been inducted into the Palladium Balanced Scorecard Hall of Fame for Executing Strategy, one of the preeminent awards in enterprise performance management which has been presented to only a few hospitals in North America.SickKids was inducted along with the Federal Bureau of Investigation, Cisco and other companies you may know, and some you wont. We learn from the fact sheet that:
"Most hospitals have a set of key performance indicators focused on clinical measures. SickKids wanted more than a measurement tool; they were looking for a new way of managing. They implemented a comprehensive strategy management approach. SickKids strategy maps and scorecards drive management meetings, with agendas that focus on a rotating set of strategic themes. In three years operating margins jumped 80%, international revenue increased fivefold, medication reconciliation improved from 33% to 78%, and MRI wait times improved 34%. Patient satisfaction and employee engagement are also up. “We are at the leading edge of the curve in health system performance in key areas,” says Mary Jo Haddad, president and CEO. “Our Office of Strategy Management has been instrumental in cascading the Kaplan-Norton approach. We have developed strategy execution as a core competency across the enterprise that has helped us achieve an execution premium.”Those working on patient and family centered care should mind the scorecard's "simple premise".
The Hall of Fame award honors organizations that have achieved execution excellence through the use of the Balanced Scorecard (BSC), the world’s preeminent strategy and performance management system. The BSC is based on the simple premise that “what gets measured is what gets done. (emphasis added)”What are the measures we will use to chart family-centered care improvements?
Patient reported outcomes
Pauline Chen's recent New York Times article titled "Listening to Patients Living With Illness" is a good news story for patient and family centered care which also strikes some odd notes. The article begins by introducing an adult experiencing severe side effects from radiation that he considered to have been understated in earlier discussions; the patient would now definately choose surgery. The problem is that "medical research has long been driven by a single overriding goal — the need to find a cure."
Couple thoughts. Overall I love the concept: more patient voice in the data stream will lead to research themes identified that can help more patients. However there is an element of compulsion implied by "in some cases requiring the information for reimbursement" that wouldn't occur in Ontario presumably.
There are also different routes to this end: here the method is "doctors will be able to order patient surveys". What about collaborative narrative medicine (written up here and on BLOOM's excellent interview with Dr. Rita Charon) where staff and patients write their stories to learn each others' perspectives.
It also isn't the case that doctors suddenly woke up to the fact that not all patients are cured, or that all patients depend only on doctors for information. These surveys seem like a medical world catching up to and trying to rein a horse that has bolted the clinic. After centuries of medical centered care and little more than a decade of patient and family centered care, new web portals allows patients to share their own information. The wildly successful PatientsLikeMe portal has 60,000 patients logging their health details and communicating on options. The site's tagline is "Learn from the real-world experiences of other patients like you."
U.S doctors also face a compensation problem. Dr. Robert Martensen in a blog entry titled "Talking and Listening to Patients" suggests conversations (the most prolific procedure of all) is poorly compensated.
Perhaps surveys will be better compensated too. Back here in Ontario we can also work to ensure medical and nursing and allied professional education teaches the art of listening and talking and being accountable to those conversations. Part of that work is educators inviting parents to talk to students.
Most published studies are marked by a preponderance of data documenting even minor blips in laboratory values or changes in the size of a spot...
Few studies, however, focus on the patient experience.
The result of all this emphasis on cure has been a nearly embarrassing richness of choice for patients with diabetes, heart disease, H.I.V. infections and even some cancers. The increasingly sophisticated treatment regimens that now make up medicine’s armamentarium have transformed once life-threatening diseases into chronic ones, but in the process have given rise to a group of individuals who are caught in the unenviable position of living with an illness that never quite goes away. No longer forced to make once-in-a-lifetime life-or-death treatment decisions, they instead struggle each day with the side effects of the very treatments that keep them alive.
“To some extent, we’ve conquered death,” said Dr. Albert W. Wu, lead author and a general internist and professor of health policy and management at the Johns Hopkins Bloomberg School of Public Health in Baltimore. “Now we have people living with chronic illnesses, and how they experience quality of life every day has become an important part of how they are doing and whether the treatments are worthwhile.”
To effectively capture the patient perspective, Dr. Wu and his co-authors propose making patient-reported outcomes a more routine part of clinical studies and practice and administrative data collection, in some cases requiring the information for reimbursement (emphasis added). For several months now, they have been incorporating data about patient experiences into routine medical practice at Johns Hopkins. Using a dedicated portal called PatientViewpoint.org, patients can, at the suggestion of their physicians, fill out surveys about their energy levels, social functioning, mental health, nausea and pain. The information is then handled like more traditional clinical testing; access is reserved for the patients themselves and their doctors.
Currently, the site is open only to patients diagnosed with breast or prostate cancer, but Dr. Wu and his colleagues hope that eventually all doctors will be able to order patient surveys that measure experiences like levels of pain, physical functioning or depression, proactively identifying results that are high or low, then reviewing those results with patients. And despite initial concerns that patients might feel overburdened by the questionnaires, most have been enthusiastic.
“Patients want to have more conversations with their physicians and other providers about these kinds of issues,” Dr. Wu said. “Sometimes it’s difficult to cover all this information during the medical encounter, and these surveys may be another opportunity to do that.”
Couple thoughts. Overall I love the concept: more patient voice in the data stream will lead to research themes identified that can help more patients. However there is an element of compulsion implied by "in some cases requiring the information for reimbursement" that wouldn't occur in Ontario presumably.
There are also different routes to this end: here the method is "doctors will be able to order patient surveys". What about collaborative narrative medicine (written up here and on BLOOM's excellent interview with Dr. Rita Charon) where staff and patients write their stories to learn each others' perspectives.
It also isn't the case that doctors suddenly woke up to the fact that not all patients are cured, or that all patients depend only on doctors for information. These surveys seem like a medical world catching up to and trying to rein a horse that has bolted the clinic. After centuries of medical centered care and little more than a decade of patient and family centered care, new web portals allows patients to share their own information. The wildly successful PatientsLikeMe portal has 60,000 patients logging their health details and communicating on options. The site's tagline is "Learn from the real-world experiences of other patients like you."
U.S doctors also face a compensation problem. Dr. Robert Martensen in a blog entry titled "Talking and Listening to Patients" suggests conversations (the most prolific procedure of all) is poorly compensated.
“I can spend an hour and a half talking with the patient and the patient’s family when the patient learns they have a life threatening diagnosis. We can spend 2 hours together which is perfectly appropriate – it’s the way to go I think to find out what matters to them, relevant medical history, do a physical exam, etc. In New York State, Medicaid pays $18 dollars for that service. If, on the other hand, I said with the patient, you have this problem we think, it looks like….today we are going to be doing a lot of tests, spend 15 minutes with the patient, maybe do a procedure myself – that procedure would be well compensated. But my time to listen, that is not compensated and yet that makes all the difference in what people experience as they are navigating this very daunting set of circumstances.”
Perhaps surveys will be better compensated too. Back here in Ontario we can also work to ensure medical and nursing and allied professional education teaches the art of listening and talking and being accountable to those conversations. Part of that work is educators inviting parents to talk to students.
Patient safety resources: Safe To Ask, Chasing Zero
Do you know how to keep your child safe in hospital?
Read about how to be a patient safety partner with staff at SickKids.
Check out these five very short patient safety videos on Manitoba's SafeToAsk website.
And for those who want more, here is a link to the 53 minute film Chasing Zero by Dennis Quaid which moved audiences at Patient Safety Week this summer. I defy you to watch any amount of this video and not be shocked, inspired and a little teary. The Quaids have done a great job of focusing and ramping up the patient safety crusade and they follow in the footsteps of many other parents who over the years stuck their necks out to advocate for a culture that focuses on eliminating preventable harm and that prioritizes the emotional needs of the family and staff to communicate transparently and honestly above institutional fears of professional liability.
Read about how to be a patient safety partner with staff at SickKids.
Check out these five very short patient safety videos on Manitoba's SafeToAsk website.
And for those who want more, here is a link to the 53 minute film Chasing Zero by Dennis Quaid which moved audiences at Patient Safety Week this summer. I defy you to watch any amount of this video and not be shocked, inspired and a little teary. The Quaids have done a great job of focusing and ramping up the patient safety crusade and they follow in the footsteps of many other parents who over the years stuck their necks out to advocate for a culture that focuses on eliminating preventable harm and that prioritizes the emotional needs of the family and staff to communicate transparently and honestly above institutional fears of professional liability.
Celebrate "It Was Midnight On The Ocean" and NICU storytelling
This Saturday night, The ParentChild Mother Goose Program® presents Talking You In , a story created and told by Dan Yashinsky with music composed and performed by Brian Katz. This is the story of a family’s journey as they make their way through the neo-natal intensive care unit, hoping that the sound of their voices telling stories, rhymes and songs will connect them with their fragile “starchild” and possibly help with his healing and theirs. It is a performance not to be missed by a very gifted storyteller and musician.
And the night also celebrates the publication of It Was Midnight on the Ocean, The Neonatal Intensive Care Unit Book of Rhymes and Stories inspired by Dan Yashinsky’s experience when his child was in the NICU, edited by Celia Lottridge of The Parent‐Child Mother Goose Program, published by The Hospital For Sick Children to be given to parents with babies in the NICU, and funded by the Neonatology Department and the Sasha Bella Fund for Family Centred Care at SickKids Foundation.
Saturday, October 30, 2010 at 8:00 pm
Doors open at 7:30
Refreshments and Reception to follow
The Hollywood Theatre at The Hospital for Sick Children
Enter at 170 Elizabeth Street and go to the Black Wing
Tickets $25
Donations in addition to this amount will receive a tax receipt. All money raised will go to support The ParentChild Mother Goose Program® which also helps parents connect with their babies and young children through rhyme and story.
To purchase tickets, phone 416 588 5234 x10, email pcmgp@bellnet.ca or order online.
And the night also celebrates the publication of It Was Midnight on the Ocean, The Neonatal Intensive Care Unit Book of Rhymes and Stories inspired by Dan Yashinsky’s experience when his child was in the NICU, edited by Celia Lottridge of The Parent‐Child Mother Goose Program, published by The Hospital For Sick Children to be given to parents with babies in the NICU, and funded by the Neonatology Department and the Sasha Bella Fund for Family Centred Care at SickKids Foundation.
Saturday, October 30, 2010 at 8:00 pm
Doors open at 7:30
Refreshments and Reception to follow
The Hollywood Theatre at The Hospital for Sick Children
Enter at 170 Elizabeth Street and go to the Black Wing
Tickets $25
Donations in addition to this amount will receive a tax receipt. All money raised will go to support The ParentChild Mother Goose Program® which also helps parents connect with their babies and young children through rhyme and story.
To purchase tickets, phone 416 588 5234 x10, email pcmgp@bellnet.ca or order online.
Comments on "A Shattered Trust" - "Actions speak louder than words."
BLOOM blog recently published an anonymous article called "A Shattered Trust" by the mom of a young child who is on their 4rth care manager. Please read and share with colleagues. How do professionals remain accountable to all families? Who will go to bat for the family that has been struck by lightning repeatedly? Who ultimately repairs the breach in a parent's belief that some staff do not care?
I have heard many stories of care successes and challenges over four years and some of the details are mind-boggling. We can spin off easy suggestions. Shop around for a better, more understanding pediatrician, and get the foundation of care off to a good start. Go to the new coordinated complex care teams designed to help exactly these families. Go to patient reps. Speak to parents who volunteer in the hospital for ideas. We can in theory enlist any number of new supports. I would suspect this family has tried some of these routes as well if they logged 30 contacts with one unit about one proceedure. Yet for many families, care is a minefield, and this seems to particularly occur when the syndrome is not well understood or straddles several disciplines. When a parent feels they are the only true advocate for a child and are scared to bring that complex child into the institution because nothing seems to go right we all need to look long and hard at the miss and then act.
For almost a year I’ve made over 30 calls and worked with six hospital departments to find a way to better handle my daughter’s g-tube changes. My daughter is petrified of the procedure. Her hips are strapped down but I have to hold her arms while she screams, twists her upper body and turns bright red. The first time it happened I had flashbacks to when I had to restrain her for procedures in the NICU. So I've spent months trying to come up with an alternative. I’ve asked for sedation, but been given conflicting information about whether it's safe. I've asked for a child-life specialist to provide support. I've sat outside the procedure room, listening to my daughter (with my husband) scream inside. I've asked if the ‘comfort kit’ is in the room with them, only to be told it’s sitting behind me in the waiting room. I’ve asked if I can take the kit to the room and been told "No." We’ve left in a g-tube that should be changed every six months for 15 months because we can't find a solution to managing our daughter’s pain and anxiety....I hesitate to ask for help because I’ve become more disillusioned with each failure. Our professionals don't work together to solve problems and give conflicting information. And because actions speak louder than words, increasingly I’m convinced that the bigger problem is that they don't care.
I have heard many stories of care successes and challenges over four years and some of the details are mind-boggling. We can spin off easy suggestions. Shop around for a better, more understanding pediatrician, and get the foundation of care off to a good start. Go to the new coordinated complex care teams designed to help exactly these families. Go to patient reps. Speak to parents who volunteer in the hospital for ideas. We can in theory enlist any number of new supports. I would suspect this family has tried some of these routes as well if they logged 30 contacts with one unit about one proceedure. Yet for many families, care is a minefield, and this seems to particularly occur when the syndrome is not well understood or straddles several disciplines. When a parent feels they are the only true advocate for a child and are scared to bring that complex child into the institution because nothing seems to go right we all need to look long and hard at the miss and then act.
Family Centered roundup - Nursing education, Palliative Research, FCCAC, Liver, Bio-bank, Baby Book for little angels, CCCU, CFAN
Mid September I had the privilege of speaking to about 50 nurses (including just 2 male nurses), most new to SickKids, returning for extra education after 3 months of practice. I introduced Sasha, offered highlights of our nursing experience and shared a tip sheet of suggestions. We generated a good discussion particularly on ways that staff and families can work together on patient safety (e.g involve parents in medicine reconciliation and empower parents to speak up if they have any concerns). The nurse who organized the sessions remembered Sasha from 4D.
The 2010 TRAC-PG Pediatric Palliative Care Research Symposium, titled Listening to the voices of dying children: raising awareness and emerging research, was held September 29 and featured renowned anthropologist Myra Bluebond-Langner as keynote. I promise a report shortly when we get the links to the videos. Posters are being uploaded at Trac-PG.
The Family Centred Care Advisory Council engaged in a facilitated brainstorm and values clarification exercise in June and have established Education and Communication sub-committees to focus initiatives. The committee is also looking for new family and staff participants and if you are interested in working with other families and staff to help improve the child and family's experience, please read more about FCC-AC. There will be two family positions on the New Immigrant Support Network's "Champions of Cultural Competence". SickKids has also received a generous donation to the Family Resource Center and is exploring a new space to combine the reading room, About Kids Health, family centered care and research in one area for families. I also volunteered to review the Bereavement Committee final draft report and got that this week; it is an important call to action to develop a more consistent and integrated practice and to increase resources for bereaved family support. We also have the SickKids Family Education Day fast approaching in February, more on that soon.
A first Liver Program Family Education Day is being organized by Dr Binita Kamath and clinical nurse specialist Constance O'Connor to be held March 2011. Biliary Atresia and Alagille Syndrome have been picked as the foci and Binita and Connie invited The Sasha Bella Fund to participate. We are excited to be working with the Liver Program for the first time to help other children with Sasha's primary diagnosis, Alagille Syndrome. Binita and Connie are also interested in a family committee and helping with online supports for patients and their families.
Parent voice at the Labatt Family Heart Centre Bio-Bank conference was provided by Laura Celsie. Laura celebrated her nephew Wyatt, recounted his complex and very difficult life including his 11 month CCCU intensive care journey and offered feedback to staff about helpful and stressful conduct. Watch her presentation on Youtube especially the final third video for Laura's list of 11 things that doctors should know, starting with "Please don't ask me to leave my child's side" and "I need to be a part of my child's care team". Kudos to LFHC staff for responding to this difficult story with a standing ovation.
And a beautiful palliative story I have been meaning to share for many months. Four years after the death of her first born Tyler, Michelle Murray has produced a baby book for still born and palliative babies called I Will Hold You In My Heart Forever: A baby book for little angels. It is a heart-warming story. She received permission from Robert Munsch to reprint some paragraphs from "I Will Love You Forever". Thanks to a request from NICU palliative care nurse Lori Ives-Baine, the book is stocked at the 5-55 Shop at Sickkids. The book has generated great buzz. Comments from the over 1700 fans on the Facebook group shows the book is a rare resource to give a friend whose baby was still-born or died very young and it is of particular interest to midwives. The baby angel book was a labor of love and a family affair; Michelle took a loan to make the book a reality, her sister-in-law Stephanie of Trapdoor Design designed the beautifully illustrated binder and insert pages, her dad serves as bookkeeper and shipper and her brother helps with marketing. Based on the very positive feedback, Michelle is adding sections for older palliative children. You can buy the book on the Forever Heart website or in the 5Fifty5 gift shop at SickKids. There is also a video presentation of the book and a television news interview.
The Cardiac Critical Care Unit "Vital Smarts" communication training continued last week to help staff support parents, resolve issues and be accountable to families and other staff. After the training of a handful of staff earlier in the year, training was rolled out to another 50 staff. Dr Steven Schwartz confirmed there is no family council or parents currently on committees but hopes the ground work laid by this communication training will lead to new forms of staff-parent collaboration.
On October 17, the annual Canadian Family Advisory Network (CFAN) daylong workshop, that traditionally starts the annual conference of the Canadian Association of Pediatric Health Centres (CAPHC), was held in Winnipeg. I was asked to present and spoke about three related topics: a celebration of Sasha that linked her highs and lows to the hospital priorities for her family fund; initiatives we have undertaken and how they have done; and new technologies starting with this blog that assist family advisory in an age of potential mass collaboration. As families need a secure, accessible platform to manage their child's health care, we also need a platform to work with staff and other families on family centered initiatives. There were many takeaways and I am working with three other FCCAC members on a report to share. It was clear that the growth of family advisory has been challenging across the board and also that family and patient centered care advocacy and delivery is growing beyond councils and committees toward networks of linked teams and groups that need to be integrated into hospital leadership, learning and practice in a very focused way. This was my first health care conference, first keynote and first time meeting other family members outside SickKids who work within pediatric hospitals so naturally it was an amazing learning and networking experience and I promise a fuller report. It was really fantastic to spend some quality time with Kariym, Jodi and Venetia from FCCAC and Janis from NICU FCC.
The 2010 TRAC-PG Pediatric Palliative Care Research Symposium, titled Listening to the voices of dying children: raising awareness and emerging research, was held September 29 and featured renowned anthropologist Myra Bluebond-Langner as keynote. I promise a report shortly when we get the links to the videos. Posters are being uploaded at Trac-PG.
The Family Centred Care Advisory Council engaged in a facilitated brainstorm and values clarification exercise in June and have established Education and Communication sub-committees to focus initiatives. The committee is also looking for new family and staff participants and if you are interested in working with other families and staff to help improve the child and family's experience, please read more about FCC-AC. There will be two family positions on the New Immigrant Support Network's "Champions of Cultural Competence". SickKids has also received a generous donation to the Family Resource Center and is exploring a new space to combine the reading room, About Kids Health, family centered care and research in one area for families. I also volunteered to review the Bereavement Committee final draft report and got that this week; it is an important call to action to develop a more consistent and integrated practice and to increase resources for bereaved family support. We also have the SickKids Family Education Day fast approaching in February, more on that soon.
A first Liver Program Family Education Day is being organized by Dr Binita Kamath and clinical nurse specialist Constance O'Connor to be held March 2011. Biliary Atresia and Alagille Syndrome have been picked as the foci and Binita and Connie invited The Sasha Bella Fund to participate. We are excited to be working with the Liver Program for the first time to help other children with Sasha's primary diagnosis, Alagille Syndrome. Binita and Connie are also interested in a family committee and helping with online supports for patients and their families.
Parent voice at the Labatt Family Heart Centre Bio-Bank conference was provided by Laura Celsie. Laura celebrated her nephew Wyatt, recounted his complex and very difficult life including his 11 month CCCU intensive care journey and offered feedback to staff about helpful and stressful conduct. Watch her presentation on Youtube especially the final third video for Laura's list of 11 things that doctors should know, starting with "Please don't ask me to leave my child's side" and "I need to be a part of my child's care team". Kudos to LFHC staff for responding to this difficult story with a standing ovation.
And a beautiful palliative story I have been meaning to share for many months. Four years after the death of her first born Tyler, Michelle Murray has produced a baby book for still born and palliative babies called I Will Hold You In My Heart Forever: A baby book for little angels. It is a heart-warming story. She received permission from Robert Munsch to reprint some paragraphs from "I Will Love You Forever". Thanks to a request from NICU palliative care nurse Lori Ives-Baine, the book is stocked at the 5-55 Shop at Sickkids. The book has generated great buzz. Comments from the over 1700 fans on the Facebook group shows the book is a rare resource to give a friend whose baby was still-born or died very young and it is of particular interest to midwives. The baby angel book was a labor of love and a family affair; Michelle took a loan to make the book a reality, her sister-in-law Stephanie of Trapdoor Design designed the beautifully illustrated binder and insert pages, her dad serves as bookkeeper and shipper and her brother helps with marketing. Based on the very positive feedback, Michelle is adding sections for older palliative children. You can buy the book on the Forever Heart website or in the 5Fifty5 gift shop at SickKids. There is also a video presentation of the book and a television news interview.
The Cardiac Critical Care Unit "Vital Smarts" communication training continued last week to help staff support parents, resolve issues and be accountable to families and other staff. After the training of a handful of staff earlier in the year, training was rolled out to another 50 staff. Dr Steven Schwartz confirmed there is no family council or parents currently on committees but hopes the ground work laid by this communication training will lead to new forms of staff-parent collaboration.
On October 17, the annual Canadian Family Advisory Network (CFAN) daylong workshop, that traditionally starts the annual conference of the Canadian Association of Pediatric Health Centres (CAPHC), was held in Winnipeg. I was asked to present and spoke about three related topics: a celebration of Sasha that linked her highs and lows to the hospital priorities for her family fund; initiatives we have undertaken and how they have done; and new technologies starting with this blog that assist family advisory in an age of potential mass collaboration. As families need a secure, accessible platform to manage their child's health care, we also need a platform to work with staff and other families on family centered initiatives. There were many takeaways and I am working with three other FCCAC members on a report to share. It was clear that the growth of family advisory has been challenging across the board and also that family and patient centered care advocacy and delivery is growing beyond councils and committees toward networks of linked teams and groups that need to be integrated into hospital leadership, learning and practice in a very focused way. This was my first health care conference, first keynote and first time meeting other family members outside SickKids who work within pediatric hospitals so naturally it was an amazing learning and networking experience and I promise a fuller report. It was really fantastic to spend some quality time with Kariym, Jodi and Venetia from FCCAC and Janis from NICU FCC.
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