Elevate Eldercare

Innovation is a big part of the conversation this week on "Let Me Say This About That." In Episode 69, Susan Ryan sat down with Alice Bonner, who has been a geriatric nurse practitioner caring for older adults and their families for over 30 years. She is currently adjunct faculty and director of strategic partnerships for the CAPABLE program at the Johns Hopkins University School of Nursing and senior advisor for aging at the Institute for Healthcare Improvement (IHI).

Marla and Mary discuss Project ECHO and the role it has played in healthcare. Bonner's work with IHI involved Project ECHO and she is a big fan of the model, as is The Green House Project. Mary shares the number of initiatives Green House has launched using Project ECHO and the impact it has had on those learning through that model.

Bonner also speaks about the barriers to innovation and Marla explores a report from Canada on effective innovation for long-term care. Both Mary and Marla discuss the benefits of the report and utilizing the perspective from another country.

They examine Bonner's greatest hope, fear, and her call to action. Plus, Marla adds an Irish proverb in the mix. Hear what it is and how it applies to our discussion today!

Find out more about Project Echo here: https://hsc.unm.edu/echo/

Read more about the Element of an Effective Innovation Strategy for LTC in Ontario here: https://neltoolkit.rnao.ca/sites/default/files/Elements%20of%20an%20Effective%20Innovation%20Strategy%20for%20Long%20Term%20Care%20in%20Ontario%202011.pdf

Susan Ryan sits down with Alice Bonner, a geriatric nurse practitioner who has been caring for older adults and their families for over 30 years. She is currently adjunct faculty and director of strategic partnerships for the CAPABLE program at the Johns Hopkins University School of Nursing and senior advisor for aging at the Institute for Healthcare Improvement.

Bonner describes how she has used her clinical, government, and community experiences to inform her work and perspectives on how to create age-friendly ecosystems in her quest for quality and coordination across the continuum. She further shares her work at IHI and the significant role the organization has played amid the pandemic: from early on in convening virtual huddles, to their current work in collaboration with Project ECHO and AHRQ to support nursing homes.

Alice is a thought and action-oriented leader who approaches problems head on by tapping into her network to identify and mobilize solutions.

Bonner provides a well-articulated vision for eldercare, with a clear and compelling call to action.

Find out more about CAPABLE here: https://nursing.jhu.edu/faculty_research/research/projects/capable/

Today we take a deeper dive into Episode 67, where Susan sat down with Lori Porter, co-founder and CEO of the National Association of Health Care Assistants (NAHCA), a nonprofit organization that elevates the professional standing and performance of certified nursing assistants (CNAs) through recognition, advocacy, education, and empowerment.

In today's episode of "Let Me Say This About That", we take a closer look at a couple of educational and workforce programs that NAHCA has developed with partners. Marla discusses "The Enclave Principle" that was launched in 2018 and Mary explores their most recent initiative, the National Institute of CNA Excellence or NICE.

We also share their "Statement of Standards" and Marla looks at a recent PHI study and the five pillars of Direct Care Job Quality and how they reflect both NAHCA and the Green House model.

Porter challenges us to rethink our vocabulary and provides a call to action that leverages the power and influence inherent in the CNA profession.

Find information on NICE here: https://www.nahcacna.org/

Find more on PHI workforce research here: http://www.phinational.org/resource/caring-for-the-future-the-power-and-potential-of-americas-direct-care-workforce/

Read the article on CNAs here: https://www.seniorlivingforesight.net/stop-giving-lip-service-to-cnas/

In today's episode I talk with Lori Porter, co-founder and CEO of the National Association of Health Care Assistants (NAHCA), a nonprofit organization that elevates the professional standing and performance of certified nursing assistants (CNAs) through recognition, advocacy, education, and empowerment.

Porter is a nationally sought-after speaker on team building and transforming workforces into "care forces." In 2020, she was appointed and served on the Coronavirus Commission for Safety and Quality in Nursing Homes

Porter shares her incredible journey from being a disgruntled CNA at 18, a nursing home administrator at 27, and, eventually, founder and head of NAHCA. An exceptional storyteller, she describes in detail her path to where she is today and how some very special people she has met along the way helped to shape her destiny.

Porter has a unique way of infusing humor into her stories, which are full of potent lessons as well as profound insights into the power paradigm that exists in long-term care. In this episode, she talks about why NAHCA exists and what the organization is doing to address the workforce challenges of today the issue.

She challenges us to rethink our vocabulary and provides a call to action that leverages the power and influence inherent in the CNA profession.

Find Lori Porter on Twitter here: https://twitter.com/loriporternahca

Join the April 7 virtual CNA March on Washington here: https://www.nahcacna.org/cna-virtual-march-on-washington/

Could we take what we learned with the HIV/AIDs global health issue and apply it to our crisis with COVID-19? William Haseltine, PhD, scientist, researcher, author, philanthropist, and currently president of ACCESS Health International says YES!

Susan Ryan sat down with Dr. Haseltine, who is perhaps best known for his work on cancer, HIV/AIDS, genomics and currently, COVID-19. He is an internationally recognized expert on the COVID-19 pandemic.

In this recap, Marla and Mary discuss why Dr. Haseltine believes those learnings from the HIV crisis could be used today. We also explore his candid thoughts on the Biden administration and the pandemic—such as, what has been good and what needs to be more robust moving forward.

With her philosophy 'hat" on, Marla takes a closer look at social solidarity, which Dr. Haseltine mentioned several times. Marla helps unpack what it means and how we might apply it with our healthcare system. Finally, we take a look at a book he co-authored that offers eight lessons for social inclusion and high-quality sustainable elder care.

Find out more about HIV/AIDS lessons learned here: https://www.thinkglobalhealth.org/article/covid-19-investment-our-economy

Read more about the Biden administration here: https://www.thinkglobalhealth.org/article/weighing-bidens-first-executive-orders-address-covid-19

Read more about the eight lessons here: https://library.oapen.org/bitstream/id/c484fc63-3395-4326-bf5e-f79a052ba83b/1006963.pdf

Susan Ryan sits down with William Haseltine, PhD, scientist, researcher, author, philanthropist, and currently president of ACCESS Health International. Perhaps best known for his work on cancer, HIV/AIDS, genomics and currently, COVID-19, he is an internationally recognized expert on the COVID-19 pandemic.

Dr. Haseltine is dedicated to ensuring that quantum advancements in medical technology translate to improved health outcomes around the world. He is the author of more than 200 peer-reviewed manuscripts and 11 books, including two on COVID. His new book, Variants! The Shape-Shifting Challenge of COVID-19, addresses the questions and issues around the virus, variants, and immunity.

Dr. Haseltine offers his perspective on the pandemic, including what the U.S. got right, and what should have been done differently. In addition, he offers his thoughts on herd immunity, vaccines and variants, as well as strategies he identifies as essential to controlling the virus, and the brutal consequences of not controlling it.

His thoughts (and warnings) are sobering and likely controversial, but definitely worthy of a listen.

Finally, Dr. Haseltine casts a vision for eldercare that incorporates his perspectives gained from his career and global observations that places value on elders and their integration into the community.

Find Dr. Haseltine on LinkedIn here: https://www.linkedin.com/in/whaseltine

Follow him on Twitter her: https://twitter.com/WmHaseltine?s=20

In Episode 63 Susan Ryan sat down with Anne Montgomery, co-director at Altarum's Program to Improve Eldercare, where she oversees a portfolio of quality improvement research and policy analysis focused on older adults. Montgomery has more than two decades of policy experience working on Medicare, Medicaid, and related programs.

Mary and Marla explore a number of topics Montgomery raised during her talk with Susan. You may have heard the term "Failure to Thrive" but what does it really mean and how does it connect to elders?

Much has been said and written about social isolation during the pandemic. Montgomery and her colleagues wanted to do more about it, so they launched an online survey asking residents directly. Mary and Marla take a look at the results and recommendations, while Marla takes a look at a workforce report Anne mentioned.

Mary and Marla also discuss why Montgomery is "hopeful" about the Biden administration and which members in the U.S. House and Senate will help move nursing home issues in a positive way.

Click here to watch Anne Montgomery in GH Webinar on Social Connectedness

Find out more about the workforce report here: https://leadingage.org/sites/default/files/Making%20Care%20Work%20Pay%20Report.pdf

Susan Ryan sits down with Anne Montgomery, co-director at Altarum's Program to Improve Eldercare, where she oversees a portfolio of quality improvement research and policy analysis focused on older adults.

Montgomery has more than two decades of policy experience working on Medicare, Medicaid, and related programs. Prior to Altarum, Anne served as a Senior Advisor for the U.S. Senate Special Committee on Aging, where she developed hearings and numerous bills enacted as part of the Affordable Care Act of 2010. She has also served as an analyst for the House Ways & Means Committee, the Government Accountability Office and the Alliance for Health Policy in Washington, D.C.

Montgomery talks about her personal passion and motivation that has shaped her career trajectory in research and policy and how she has used her expertise to improve quality broadly in home- and community-based services and long-term care environments. Today, she provides a comprehensive analysis of COVID-related challenges that she has observed, and specifically discusses the research that Altarum conducted on the social isolation that occurred among nursing home residents.

Montgomery shares recommendations in addressing social isolation and discusses the need to negotiate risk and balance that with safety when addressing this very challenging consequence of the pandemic and visitation bans in nursing homes.

Finally, Anne offers her perspectives on the Biden administration, policy champions, and the positive opportunities that lie ahead to elevate eldercare.

Find out more about Altarum report on social isolation here: https://altarum.org/sites/default/files/uploaded-publication-files/Nursing-Home-Resident-Survey_Altarum-Special-Report_FINAL.pdf

This week's recap highlights the return trip to microphone for David Grabowski., PhD. In late summer, Susan Ryan first sat down with Dr. Grabowski to discuss his insights into the pandemic and his role and experience on the Coronavirus Commission for Safety and Quality in Nursing Homes. In Episode 61, he offers a retrospective look at the results and recommendations.

Marla and Mary take a close look at the ten themes and recommendations in the commission's report, and Mary takes a deeper dive into the Dutch care model for long-term care, a system Dr. Grabowski visited prior to the pandemic and left him very impressed.

Marla looks at the Dutch funding system and a recent article authored by Dr. Grabowski that discusses a false dichotomy.

Find out more about the future of LTC here: https://www.nature.com/articles/s43587-020-00018-y?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+nataging%2Frss%2Fcurrent+%

Review the Dutch care model here: http://www.teresahappycare.cn/en/dutch-care-model-introduction/

David Grabowski, PhD, professor of health care policy at Harvard Medical School, sits down with Susan Ryan for his second episode of this podcast. This week, they examine recommendations made by the Coronavirus Commission on Safety and Quality in Nursing Homes, whether they went far enough in achieving the goals for improving quality and safety and what has happened since those recommendations were released in early fall 2020.

In addition, Dr. Grabowski talks about his concept of aging in the "right" place and what that means for home- and community-based services, reimagining nursing homes, and why it's not an either/or solution.

He shares his observations from a global perspective and the comparative healthcare spending patterns for long-term care among different countries. Dr. Grabowski recounts a visit he made to the Netherlands (pre-pandemic) where he was able to see a traditional nursing home and shares that experience, from the moment he walked in the door to the insights gained on the workforce and the built environment.

Finally, Dr. Grabowski challenges us all to use our collective voice to be a part of generating the big changes that are sorely needed in eldercare.

Review the Coronavirus Commission report here: https://www.cms.gov/files/document/covid-final-nh-commission-report.pdf