It's Wednesday, it's 11 o'clock. It's September the 15th, 2021. Welcome to What Now America. I'm your host, Tim Appichella. And I would like to start off with a title of this one called Rig Election, GOP's Mainstay Slogan. Remember 2016, this thing called the presidential election, Donald Trump. And well before the election with Hillary Clinton, he was proclaiming that the election was already riddled with fraud and inconsistencies. And I think he was doing that because he knew he was gonna, in his mind, he was gonna lose the election.  And then a funny thing happened. He won. Well, it wasn't that funny, but he did win. And the bottom line is he still clung to the fact that he'd been robbed because the poplar vote was in favor of Hillary Clinton and not Donald Trump. So Donald Trump created what is called the Voter Fraud Commission. And that commission from May, 2017 to January, 2018 investigated Donald Trump's claims that dead people rose from the grave and voted in favor of Hillary Clinton. All sorts of crazy conspiracy theories. The Secretary of State for Kansas, Chris Kovash, completed the report and said there was glaringly empty of any fraud. So that was pretty much the end of it. Then we go to 2020, the presidential election. And as we all recall, much before the election, Donald Trump was claiming that there's no way he could lose. And if he did, it was gonna be riddled with fraud. And he was particularly taking issue with ballots. And then on July the 30th, 2020, he tweeted that the 2020 election will be the most inaccurate fraudulent election in history. And then a funny thing happened. He lost. Fast forward to Monday of this week, where Larry Elder, a candidate trying to unseat Governor Newsom of the California recall election, had set up websites that were pointing towards fraud and to report fraud. And then he himself said that the fraud had been detected. And this website was called Stop California Fraud. So what we're seeing a pattern here now is the big live course, but also we're seeing a pattern that every time there's an election, the GOP starts crying foul and fraud before the elections even held. And I think they believe it. To quote from Seinfeld, an episode where Costanza is giving Jerry some advice. He goes, remember Jerry, if you believe it, it's not a lie. And I think that's exactly where the GOP is. So without further ado, let's dive head first into this topic. With me today is Jay Fidel, Winston Welch and on assignment is Cynthia Lee Sinclair. Good morning everyone. Morning, Tim. Nice to be here. Thank you. Thank you for joining us. Hey, you know, Jay, we're starting to see a pattern now emerge. It's not with this with Donald Trump and his acolytes supporting the big lie that the election was stolen from him. We're starting to see other candidates do that now in their elections. And Larry Elder comes to mind because that was the most recent. Will this pattern of claiming fraud serve the GOP in any way? Or is it a matter that they're just trying to imitate Donald Trump to satisfy would-be voters? The whole subject wraps around so many issues. I am so glad you brought up the 2016 campaign. And I remember how shocked I was when a reporter asked him, are you going to accept the results of this election? And he said, only if I win, only if I win. So let me get this right now. There's going to be fraud if the other guy wins, but not if you win. I mean, and that is so obnoxious. It's not only- He did the same thing in 2020. He said, there's no way I could lose. And if I do, it's fraudulent. But if I win, it's not fraudulent. And then we've had all these commissions and they found no fraud. So what you get is a guy, and this is out of his real estate practice in Queens. This is out of the sharp dealings that he's had all his life. You always keep your options open. You never agree with anything. It's never a win-win, it's always a win-lose and you must win. It's a business approach, but in the lowest possible form of business you could imagine. That's where he gets it from. But it has an extraordinarily damaging effect on our society, on our democracy, to not accept the results of an election. When you have no reason whatsoever to question those results, it's really horrible. You know, what could be more important than the peaceful transfer of power? What could be more important than voting? What could, you know, free and fair voting? What could be more important than accepting the results of a vote?  And what is, to answer your question more fully, what has happened is he's created this virus of lies, a pandemic of lies. And this is one of them. Then he's got the whole Republican party or at least the new Republican party. Republican party created in his image, all of whom are his acolytes and follow his pathology, he's got them all accepting this lie that they never lose elections. They always win elections. And if they lose, they come up with these phony baloney broad stories. What's interesting is the people were speculating a few months ago when he first raised a big lie, you know, is this going to pervade the Republican party? Are they going to raise this again and again? Are we going to see the Republican party try this ridiculous strategy in future elections? And nobody knew. I don't think it happened really, although maybe there was some noise about that and the Georgia senatorial race races back in January, but I don't think it was really that much of a threat. It was a possibility, but not a threat.  He's going to accept Trump's strategies, lock, stock and barrel, and he trots this out. And you know, when he did, my reaction, I'm biased about this, but my reaction was, is he kidding? Is anybody going to believe this? It is so obviously a copycat maneuver. Nobody would believe this. You know, to say that if I win, there's no fraud, but if you win, it's all fraud and say it in advance like that. Well, California is a fairly educated, fairly progressive state. And I think people saw that for what it was. Even Republicans saw that for what it was and he did not make traction with that argument. I think he lost points, certainly with the Democrats in California and with probably a lot of Republicans too. So my answer to your question is no, it didn't help him that much. It probably hurt him because it's obviously irrational and unacceptable. It's part of the big lie. But the question is not so much California. It's other states, it's other Republican parties, it's other Republican candidates. So although I feel he didn't make traction in California, there are others who will try it again and they may make traction. Okay, well here's a follow up to that because you mentioned Georgia, I think. And Donald Trump was not well liked for claiming a fraud of the Georgia election before it took place. In fact, they say that was a contributory to the fact that GOP voters just stayed in their lazy-boy chairs. They didn't get up and vote. They were discouraged because they listened to Donald Trump and they thought it was fraudulent. So why bother? This may have happened to Larry Elder in California but it's certainly a valid point that if you're gonna call something fraud, what's the use? Why get engaged? The whole system quote unquote is rigged. And so therefore I sit home and protest in silence. How is that gonna serve the GOP party? Well, I suppose it depends on which Republican you're talking to, which voter you're talking to. Some of them may have been discouraged by that and not gone to the polls. But others may have said, wow, we better do something. We better take them at face value. We wanna beat the fraud. So we're gonna go and vote. It's hard to say that there's a tilt either on one side of that question or another. I rather think though that the Republican acolytes to use your word are gonna accept what he has to say and they're gonna get on board and they're gonna vote to win. This is all a ballgame in which you cheat and they're gonna do everything they can to elect Republican candidates. So I think we'll see it again. And I think the Democrats may get discouraged and not vote, but the Republicans will vote. They'll see it as a ballgame that you can cheat in and it will have an effect in some places, some candidates. All right, thank you, Jay. Hey, Wednesday, I'm gonna throw some numbers at you. So hang on here. A poll by SSRS, the CNN poll, found some interesting numbers and that is 78% of the GOP, 78% of the GOP feel that Biden did not win properly, that he is an illegitimate president of the United States. 54% of the same GOP say there's solid evidence to prove it, yet there is none. And there hasn't been any but they still cling to the fact that there's solid demonstrated evidence that Joe Biden is an illegitimate president. So that's some of the background. Other numbers, 56% believe in the country, believe that democracy is under attack, where 51% believe that in a future election, there will be an overturn of the results because one party didn't win. These are pretty shocking statistics. Now a poll is a poll, but your thoughts about these numbers and what it seems to indicate about future elections and the pessimism that is demonstrated by this poll. Well, we've taken it on the chin a little bit the last few decades here, but you think back to Bush v. Gore in 2000, there was no clear answer for a while and people remained pretty calm when you think about that relatively, they thought, well, I want my fellow to get in, but if the other fellow gets in, we'll concede magnanimously. And they had their fleet of lawyers, of course, you remember the hanging chat and the fellow looking at the hanging chat, that seems so idealic and calm and rather quaint by today's standards where, like Jay said, when you have presumptively said that any election where I don't win is fraudulent, you're completely dismissing the system and that is where the real danger lies. It's not on the platform or what they are believing. Should we have higher taxes? Should we have more access to abortion or less? Should we legalize pot or increase the debt? None of those things matter. It's all about that there's the big lie that our elections are fraudulent and when you have that presumption going into that by any percentage of the population that matters, you're really dealing with some danger there and that's where I think we need to focus is on election security, but we've had the most secure elections that we ever had in 2020, but if you don't believe that that took place and you believe in fact that that was fraudulent because you're getting your news source from one or two news sources that's a self-referring feedback loop despite all evidence to the contrary, it really doesn't matter what the truth is. It's like Kellyanne Conway said, it's alternative truth or alternative facts or whatever nonsense she said, because that's where we're at. One thing that I saw yesterday that I was particularly taken with when Governor Newsom, it was clear that he had defeated the recall for him and when he got up there, he really was speaking to all of Americans and I think actually what I saw was a preemptive sort of stump speech for 2024 or beyond and he was feeling very presidential to me honestly where he was saying democracy is, he said we can't have this nonsense where every election before we even have it is presumed to be faked by one side because it's not. He said democracy is not a football you can toss around like this. He said it is like an antique vase or vase that if you're holding it and if it drops, it gets shattered and you can't put Humpty Dumpty together again like that. You can't put that vase together again. So we need to go back to the basic principles that our elections are sound, that they are also fair, that they're secure and since we have two party system, we need to have the buy-in of both parties of this because otherwise we will have a constant battle of this idea like you just mentioned in those polls that these are always, that whoever is in charge is an illegitimate leader. I don't think that the liberals or Democrats felt that Trump was unfairly elected, were they destroyed and crestfallen and horrified? Yes, but did they accept it that it was a real election? Yes, they did and Hillary Clinton did too and she didn't go in saying, oh, well, if I don't win, then it's fake. But the opposite is not true. So we have to really work on fundamental civics, training and education for our adult population as well as the kids coming up. You have to add a point to that that I think we have to have in the conversation here is that we believe that Trump, if you look at it as to the vote in the electoral college and all that legitimately won in 2016, I don't actually just between us, us boys. I don't really think he handled that in a fair manner. I think he brought Vladimir Putin in. I think he did all kinds of unfair stuff, which was never really raised and people as you say Winston, they accepted the result but Trump was gaming the system all the way through. He was gaming the system as much as he could. And he claims to have received all these votes including a majority of the popular vote. I think he was manipulating that in every way he could. Hey Jay, they had a Department of Justice investigation over the involvement of Vladimir Putin in 2016. And a lot of those results were pushed to the side because they were looking at other issues for impeachment. But remember Mueller basically brushed aside all credible evidence pointing to what you just said. And it was basically set aside and then post-mortem autopsy was reported. And yes, Russia had been involved in the distraction and the influence on social media for Donald Trump. So you're absolutely correct. It did occur, absolutely. So Winston, I just have one comment. You mentioned rightly so the election of the year 2000 and what kept a lid on it I think was Al Gore graciously accepted loss. And I think that's the key, that's the crux that the standard bearer of the party who's running for office acknowledges that it's a win-loss situation. There's no do-overs unless there is fraud and he was willing to accept that loss. And I think that lowered the temperature nationwide quite a bit, but even days following there were a lot of angry Democrats. I recall it very distinctly, but had it not been for Al Gore to say, I accept this defeat and we'll move on. He said he accepted it in order to preserve national stability. Correct. At the very policy point we're discussing today he did it for the country. He did it for the country. Which leads me to my question to you Jay is will this strategy serve the GOP in 2022? If this continues, will this work or will it drive away GOP voters and will it shove the independence away from GOP ideals and policies? I wish I could say yes, but I really don't think so. And maybe somebody will be more optimistic than I am about this, but I feel that the notion of truth, the notion of democracy, the notion of fair voting it has been lost in this country. And there's an enormous number of people who don't care about these things anymore. They only care about winning and supporting their cult leader Donald Trump or other cult leaders if any appear. And we've lost touch with the idea of diversity. We've lost touch with morality if you will and democracy in general. I don't think this is going to change their minds. They're probably gonna do it again. And other things, they are also doing other things like stopping voting rights legislation and doing state voting rights legislation that is ridiculous and taking all these draconian steps against fairness, against voting, against minorities. Why would this, why would what happened here affect them? I think they'll do it again. And worse, I think they've learned by their own success. In fact, I would add one other point is they'll just try to, didn't they? And he had some traction with some voters. After all, he did get some voters. I don't know how much that was depended on his remarkable statement over election fraud. But I think in fact, he warmed up the issue the later and it will come back. I think our voting system, our democracy is broken. And I would really like to be in a brain session with you guys at some point to figure out what if anything can be done? Because right now, despite this lot at the end of the tunnel voting rights bill that was suggested yesterday, we're compromised with the progressives in the House. I really, I don't think any voting rights bill is gonna pass and therefore we're gonna be stuck with the bills in these Republican states that are dedicated to try to stop people from voting. Together with all the other tricks the Republicans are playing, I would not be optimistic about a fair vote next time. Okay, Jay, you took the question right out of my mouth because that's what I wanted to ask Winston. And that is this new bill introduced in the Senate that has Joe Manchin's signature on it or his footprints are on it. He was part of the nine senators that got together over the summer to say, how can we work out a voting rights bill that everyone can live with? And it's now up to Joe Manchin to get 10 Republicans to get on board with the bill. And of course, yesterday, Senator Mitch McConnell said there won't be one GOP voting for it. Is this a setup? Is this laying the groundwork for Joe Manchin to agree to modify the filibuster? Well, we'll see, won't we? This is what we've been waiting for, is when he had his time to get his coalition of the 10 or the 20 willing and say, we need to have bipartisan legislation to push this through. And once that, he found out that that wasn't there because their top priority is just not having a Democrat in the White House. And he could see that rather than just for what it is, then this is his time to move forward and say, this is more important than having a bipartisanship because there won't be anything left if we don't do this. I can understand why he has some reticence in that, but we're also at a point now where if we don't do something that ensures that people do have the ability to have free and valid elections, people are gonna be so disenfranchised, not that they already aren't, but let's face it, there's a demographic time bomb going off in this country. You can only suppress this for so long and people are sick of it. They don't want another four years of what we just suffered through. They see the result of that and if they don't, well, just take a look around, are you better? Are you happier than you were four years ago or your relationship's better with your family and your friends and I think most people could say, well, I don't talk to this person or that person anymore and we got divided, but one thing that I thought Governor Newsom did yesterday was he said, look, all this division, so much of it is just fake. That's the real fake news here. He said, I'm paraphrasing, but he said, we have so much more in common, so much more in common than we don't and that is the message that he needs to hammer home, that every governor needs to hammer home, that every politician that wants to bring, that, you know, who was it that asked, do you hate the other party more, do you hate America more than you hate the other party or something to that effect? Like what's the end goal here is is, you know, at the end of the day, we're Americans and we need to support the best ideas coming forward in a fair and reasonable manner. And when you look at how our elections are carried out, you know, with the manipulation of Facebook and that whole, you know, psycho drama that they pulled and was it with the Russians? Probably, but Facebook didn't need much help in that with the Cambridge Analytica. They were doing that on their own and the vast sums of money that are poured into politics from special interests, it's hard for the average Joe not to feel a little bit manipulated or more, but I think Governor Newsom was right. And I felt that also strangely in, this was the 20th anniversary of 911 this year and I just felt like there was something different about, you know, and we commemorate these anniversaries for Pearl Harbor and significant events in this nation and rightly so, but 911, if you think about it, I think it wasn't George Bush's approval rating 92% or something right after those attacks. This is when Americans felt American. They felt United, they felt together, they felt our basic sense of values and our nation were attacked, which they were. And we came together in that moment and realized this is more important. What we have here is precious and unique and worth seeing. That was 20 years ago, Winston, everything has changed. And that's why it was so poignant this time to look back now and say, wow, we really took some wrong terms here in the last 20 years so that we're so divided now that we look back at that time with the sense of nostalgia and almost a longing for the, well, definitely, for that unity that was there. It might have been false and it might have been... No, I agree with you, Winston. We took a reflective moment in time on this 20th anniversary than I recall years prior. America did kind of look inward and say, how did we get here in the last 20 years? And I will say that a lot of the news agencies did a great job highlighting some of these points. And more important is how do we get back to something where we're not, of course, this is not a nation where we have, surest ideas where we're all lockstep. We're not North Korea. We're not the Soviet Union. We're a land of diversity and diverse ideas where the best ones should come to the top. And that's what we're about, is a competition for the best ideas, but we have to have a level playing field for that to happen, whether it's business or in politics or whatever it is. This is, that's one of the great things about America.  This is fake. And he called out Donald Trump specifically on this and said, he didn't say stop it, but he was just saying, this is where this is coming from and we need to stop it collectively. I agree with you Winston. I think he is a good candidate for president. He really presented well. He's got vitality. He's got it together. And I agree with you also on this very important point that the celebration of 911 actually created at least an echo of togetherness for a lot of people and they felt very patriotic watching the media, as you say Tim, watching the media over a week period or so. On the other hand- It was that in combination with Jake Tapper's special documentary about Afghanistan the 20 years, interviewing every general that was involved in that war and their candid opinions about how things went wrong. So between the 911 remembrance and this Afghanistan look back, I think a lot of people said, wow, how did we get here? But the question remains is whether that's gonna stick around. It didn't stick around after 911. And my thought is it's not gonna, it was a great nostalgic experience, a retrospective on togetherness for a while, but not for a long time. Sorry. And we can have these aspirational thoughts about how we have to come back together again. That's nostalgia too. Bottom line is the vote. Bottom line is what happens on the 18th coming up this Saturday in Washington. Bottom line is what happens to all the 70 million acolytes that Trump has somehow gathered. Not clear to me they're going away. Not clear to me they are of the same mind. Not clear to me that Congress, especially in view of McConnell's statement there the other day, Congress is ever gonna pass a voting rights act. So we can be aspirational, we can be idealistic, but wow, there's gotta be some measures taken. I don't know what in order to reverse a trend that is totally destructive. Trump set these things in motion. He found vulnerabilities in the country. He exacerbated them. He laid in booby traps. We've seen that in news recently too, haven't we? Booby traps that would blow up after he left office, many of them. And now what's left? Are we gonna be able to survive? All right, thank you Jay. Winston, we're out of time, but I wanna get last word from you. And also unfortunately we didn't have time to cover some of the news events regarding Bob Woodward's and Jim Acosta's book Peril. Some fascinating, scary things that have come out of that and maybe we have time soon to discuss a dedicated show just for those revelations coming out of that book. Anyway, you have the last word Winston. Absolutely, so folks, if you're watching, read the excerpts about this book where you have the top general in the United States basically saying that he was certain that Trump had gone to a serious mental decline in the aftermath of the election where you have the joint chiefs of staff issuing a statement that the U.S. military will not be adjudicating the election. This was a bizarre and sad time in American history. No one's saying that about our current President Biden. He may have stumbled on Afghanistan but how do you extricate yourself from that situation? I never thought of it. We gotta talk about that one next week but what I wanna say, Jay, is also where's the aspirations? We have to have lofty aspirations where there is no vision, the people perish and we have to build our castles and we have to put our castles in the sky and build our foundations.  Thank you, love that. See, Jay, there is optimism. Nice work, Winston. Nice work, Winston. All right, we've run out of time and I'd like to thank Jay Fiedel, Winston Welch. Thank you for joining us on What Now, America. Please join us next week at 11 o'clock Wednesday. I'm Tim Appichelle, your host and I hope to see you again. Aloha.


Oh man this is a big one oh yeah this is a big one oh my god look at this it's the ticket link for the I have to do this show tour yeah this thing's on sale now you can get your own if you go to I have to do this dot show but you know if you're not careful if you're not careful though slip away just like that so don't have slippery fingers like me get yourself some tickets hello everybody welcome back today we are here with a very different video hello thank you so much for letting me come would you like to introduce yourself yes I'm madam Pamita and I am a witch and a fortune teller and a candle maker and a magic maker and a mischief maker all kinds of stuff so sweet so today we're gonna do a couple of different things I've never had any other than tarot a couple of my friends have read read my tarot yeah is that the correct term yeah but I've never had anything like professionally done I'm brand new to this world I wore this moonshirt because I thought it would be thematic do you call yourself a psychic do you call yourself a different term I like the word fortune teller the phrase fortune teller because it's old-school like magical old-school I don't mind it if people call me a psychic I don't take offense that I just don't refer to myself that way so how did how did you get into this world when did it start well when I was 10 my parents went to Salem Massachusetts and if you you're in the East Coast you know Salem yeah super witchy witchy right I went there for the first time over Christmas isn't that fun yeah I saw two of my relatives I saw their graves because they were witches and they got amazing they got stoned and hanged it was kind of sad that messed up yeah Rebecca nurse and John Proctor well sweet if you want to start with tarot reading and then we can go to whatever else you want we can kind of do a few different things but again this is kind of my first time doing this professionally so I don't know how it's gonna go I don't know what my future holds hopefully good yeah well let me tell you a little bit about I'm gonna shuffle and while I shuffle I'm gonna talk a little bit about this so when you're getting to tarot reading people have different styles of reading and my style of reading is really solutions oriented so people come usually with a question a problem or something and when we do the reading it's like Google Maps or ways right you can take whatever route you want but we can see the map of how to get to what you want okay so let me ask you what is on your mind what would you like to look at what aspect of your life are you curious about not to be a narcissist and not to just chill for my own thing but I'm about to go on tour next month I'm doing a show across the US so I would like to know how that's gonna go or is there like a specific way that I should ask a question how it's gonna go works for me yeah how is it how was the tour gonna go yeah we're gonna see how it's gonna go and we're also gonna see how to make it the best that it can be I would I would like that that would be cool okay so I'm gonna shuffle and what I'm gonna ask you to do is listen to the shuffle watch the shuffle and when you feel like the cards are shuffled you tell me to stop cool so I'll keep going and going just like we're playing a card game you'll go yeah they're good now okay that's when you tell me to stop so I just tell you when to stop shuffling whenever when you feel like good let's do one more all right now with your left hand I'm gonna have you cut into three stacks three stacks okay one two three and then with either hand restack back into one okay all right every deck is the same right as far as I mean not the design of course but like of the cards okay so this deck is from 1909 not this particular deck but the design of this deck is from 1909 so over a hundred years old yeah all right so before we begin I like to say a blessing over the reading and what that entails is me for sending you love and light and then I open up to divine wisdom and then I set the intention for the reading that it's for the highest good with the highest love and for the highest enlightenment cool so it's gonna be a reading that's gonna show you great things that you're gonna go to how to get toward them anything you need to avoid and all of that cool I would love to know what to avoid so if you don't mind me asking what when you're just saying that in your head what do you say I'm just opening up it's more of a feeling like I open up and I connect to you like I connect heart to heart to you just open up that top of my head I guess it's kind of feeling so yeah that's what that's what's happening there so cool all right so so and let me know if I'm interrupting no you tell me to shut up whenever but I've seen this done like a couple of different ways where like one of my friends my friend Morgan she would just like shuffle and anytime a card jumped out then that would be like the card but you just pulled from the top so is there like a bunch of different ways that you can read tarot is there a way that you prefer yeah so when the card jumps out I do pay attention to the card that jumps out because it might be a message for the person but then I stick it back in the deck when it jumps out for me I don't lay it down as I was reading some people do that where they shuffle real loosely and then cards fly out and that's what they use and that's totally a legitimate way I shuffle and kind of keep it controlled and then pull them off the top but you cut the deck so you had influence on the shuffling you told me when to stop and you cut the deck so you chose the cards your subconscious you know chose the cards okay so what we're looking at is we're doing a real condensed sort of reading here but the center card represents you and the essence of this tour night of cups is a great great message about travel because we have a guy on a horse you're not gonna go too fast that's one of the things and the night of cups is being on a mission like following your destiny or following your holy grail searching for something but really going with your heart's desire so there's something about this tour that yes I think you're doing it for practical reasons there's definitely that influence in the back the practical stuff in the front and the back but I think that there's a part of this is like things that you love or things that your heart's desire you're following that hearts desire a part of the night of cups that's very creative as well and so utilizing your creativity sharing personal things as you go along it's going to be really important of course and to be authentic and to really I would say to really follow your heart's desire oh my gosh what is this cat's name Glinda the witch kitty Glinda hi the good witch hello yes so the night of cups is really about following your heart's desire and so when I see that it means travel will be smooth you're not going to have travel issues or difficulties in the travel and pay attention to that heart's desire you know there's an economic part of it because we have king of pentacles and page of pentacles they're both holding gold coins is there a reason that you laid them out the way that you did like is there a reason that this is in the center so in this layout that I use this is like the main card in the center and these are the cards that are influencing it this is the card of the past this is the card of the future this is what the higher self wants and this is what you need to pay attention to on sort of the more mundane level okay so as I look at this I see money involved in it and I actually see a new opportunity opening up for you out of this like new things are going to come from this so we have the king of pentacles what are you doing so king of pentacles is saying you're coming from a really strong place like a really strong place economically it's established you've reached a high level like that's like really King it's a king level so you've reached a really high level but now you're searching for something new and as we go forward on this journey on this tour page of pentacles is saying you're going to discover a new opportunity or something new that's also going to bring in money for you because these are both holding coins around you so following your heart in this whole journey is really important because it's going to lead you to the new thing that's kind of cool because the show is something completely different I've never done before so good so there we go at the foundational level we have the four of cups and that means opportunities coming to you from a sort of a sideways thing like I think you have an idea of what this is going to be but when I see this four of cups pay attention because there's going to be some opportunity or offer to you that isn't in your like line of sight it's going to come off from the side so what I would say with all of this on your tour you're going to discover something that's going to be fruitful and lead you in a new direction that you can't see from the point of where you are right now okay okay hanged man card shows up as your high yourself the attainment this is the card of discipline and diligence leading to a reward so in Norse mythology the god Odin he's hanging by a foot on a tree and he receives enlightenment I think that this tour is going to require that you be pretty disciplined you're going to have to follow through on things you're going to have to do like check all the boxes do the things that are going to lead to the you know result that you are wanting and it may feel at sometimes like it's not moving but you're still working but it's not moving but then it will kind of get in gear and start moving that's what my whole life feels like it's that I'm just working all the time and sometimes it feels like there's nothing going on but I'm constantly working yeah even when it doesn't feel like I'm working I'm doing this with your heart invested in it it's like the perfect thing be creative invest your emotions into it it's like you're following your dream and that's like such a good thing cool alright so next we're going to do a past life reading the idea is that your soul is eternal that after you die your soul doesn't go to heaven and you get angel wings you may go to like a place of refreshment but then you come back down again and have a new life experience reincarnation right and so if we have these experiences where we have many lives sometimes we still have memories from our old lives that we carry but we can't really identify them right like why why am I afraid of the water I've never had a bad experience of the water but why am I afraid of the water it could be you don't deep ocean is terrifying like I'm fine it's weird I'm fine with like I would swim with sharks that's fine but if you drop me like in the open open ocean where there's nothing there at all right and that's not and have you ever been out in the open ocean I've swam like out in the open ish waters but there's a beach there and stuff but not like the middle of the ocean where there's nothing and then you go into water and you open your eyes and there's just eternal darkness forever and I'd rather there be a shark because at least there's something but it's that fear of like what's lurking below I have no idea because I can't see it but I feel like I'm about to die okay so why would you have this intense emotional experience about something you have never experienced in this lifetime right you have an intense fear of something you've never experienced why past life stuff do you want to find out so now when we look at a past life that has like let's say you have a phobia you have a phobia about it right yeah if we look at that past life I'm gonna tell you something it will heal that phobia then I'll be able to go on yeah yeah it's funny because like this fear of the open ocean didn't even really exist before the pandemic but then the pandemic started and I started just like reading more about like the ocean and how much we don't know about the ocean and that's when the fear sort of is like oh yeah that's terrible it's bringing up a memory from a past life is what it's doing okay that's something about the the pandemic and what we're experiencing triggered that and it reminded you of that and that's why you're having those strong emotions about it so we're gonna find out when this happened and we're gonna find out about the lifetime that you had so the first card that I'm gonna have you do this one's different so we're not shuffling you're gonna pick a card so just look at the cards sometimes people look and there's one that's like oh pick me or sometimes they hold their hands over and they feel it so whatever that I'm gonna do a little feely guy so okay so then just turn it over okay ah okay so the lifetime mezzo-american Aztec okay definitely you know Aztec is the Mexico area and definitely water around there let's find out about that lifetime what your sort of role was in that lifetime and experiencing that cool let's go the victim okay so one with these cards these open up for me like the story of your lifetime so that I can access that right so the two decks I'm using this is called it's your karma cards the round ones and then these are archetype cards okay the combination of these two tell me when you lived what culture you lived in and then sort of what was your experience in that lifetime okay well what really came forward for me as I as you pulled up this card is the immediate impression that you being out in the ocean was not your choice okay someone dropped you off as some sacrifice of some kind so I see you yeah so I see you being taken out in a boat that's that scenario is so horrifying like somebody just taken me on the open ocean and just like dropping me off yeah that's terrible yeah which is why this experience is so you know that the trauma is there from that that's a traumatic experience being left behind left behind with no like you said I if there was a shark there I could feel like something but you were left completely alone abandoned like the worst kind of abandonment and it's even double kind of betrayal too because you were blamed for something that you didn't do you were blamed for some negative thing happening to the ruler the king or we would call the king and you were blamed and you were seen as you were like the scapegoat you had nothing to do with it but it was some treachery on somebody's part they wanted to get you were male in that lifetime you were in sort of what I would call the court of the king and this person that sort of saw you as a threat then pointed you out as like oh you're bringing bad luck or bad fortune or you're bringing a bad negativity we need to get rid of you and then we'll get rid of the negativity and the king bought it and it was interesting because you didn't know that you were being brought out there but you were being brought out there as kind of a sacrifice so like I was tricked you were tricked and then left behind just left and then I died and that you draw you drowned in the ocean yes so you are someone who is now resistant to having a boss that's funny because I'm my own boss yes working for someone else would not especially where you would have to like kiss their butt would not work for you in this lifetime probably in many lifetimes actually because in having that you've probably been entrepreneurial through many lifetimes because of this because this idea that somebody has control or power over you and would have the ability to you know like here's this other let's call a middle manager that's like throwing you under the bus you don't want to repeat that cycle again so by being your own boss you'll never have to repeat that cycle you're super sensitive to betrayal or super sensitive to alliances and being allied with somebody can really be like a careful thing that you do you don't jump into alliances without consideration okay so as I look at this and how you how it has benefited you in this lifetime is your own resources how you're going to heal it is by bringing in more trust and bringing in people but always at a sort of equal level okay not having people that have control and power over you I think that's going to make you still have this kind of wariness about that so now here's a question that's kind of off the path a little bit but in the same realm when we have dreams do you think that dreams maybe are associated with said past lives because sometimes like weird stuff happens in dreams you know like I don't really know what just happened this doesn't make any sense do you think that maybe those dreams are tethered to past lives I've had past life dreams too where I've definitely been a different time place I'm a different person and if you have those kind of dreams that you can identify that helps a lot you can do it in meditation reflection you can do visualizations you can go back a lot of ways I mean people do it under hypnosis all the time did you pass that precious no this is something that I'm fascinated about you should do it I've always wanted to because it's one of those things where I'm like are they actually being hypnotized or because I'm I'm skeptical about it yeah because I mean maybe this also goes back to what you're just talking about is I especially of my own body and self I like being in control so the like me giving up that control to somebody else is like I don't know about that but I've always wondered about hypnotism have you ever done hypnotism I've been hypnotized I'm not a hypnotherapist I don't do it but I've been hypnotized many times it's really wonderful and helpful and it can be like if you want to make changes like you kind of have to be on board for it if you go in with like a resistance like they're going to make me you know to balk like a chicken or something like that you're not going to do it but if you're like oh I want to quit this habit or I want to you know make a change or get rid of some beliefs that I have it can be an amazing thing so if you have like a limiting belief or if you have some kind of habit that you want to get rid of it's a fantastic thing so interesting yeah let me know in the comments what bad habits that I show on camera that I should get rid of so as we look at this lifetime I think that there's it plays out in your reactions to things and how you live your lifetime I think there can be a lot of healing that you're going to experience now that you realize that your fear of the open water is really tied to this lifetime it isn't a problem for you in this lifetime right I hope not who's going to drop you off in the middle of the ocean I hope nobody is and that's why we're going on a tour bus and not a tour boat because I don't want to be dropped in the middle of the ocean so that's a past life reading so then we looked at that we looked at what the incident was and we found out where it came from so the third thing we're going to do is working with a pendulum I was just about to ask about that so a pendulum I'll teach you how it is done and then you're going to do it easiest thing in the world so a pendulum can tell you the answer to yes and no questions now it cannot tell you something that you don't already know so you cannot ask are these lottery numbers going to come up because you don't already know that it has to be something that your intuition would know so I wouldn't be able to ask if the tour is going to sell out you might actually be able to ask that and I'll tell you why because you have a sense of it right it's not like picking a lottery number where it's random there's a part of this that is in your control and a sense that you might have about it right okay so that could be a question that you could ask right okay so the way you work with a pendulum is you rest your elbow and are you right handed or left handed I'm right handed okay so you're going to hold it in your right hand and you're going to rest your elbow and hold your hand as still and steady as possible and whenever we're working with a pendulum the first question that we ask the pendulum is show me yes and so we keep our hand as still as possible and then we wait for the pendulum to start swinging now it's not super magical it's not spirits yeah I think so and it's going to get bigger and bigger as it goes so the thing with the pendulum is it's micro movements in your hands right your hand is making the movement but you're keeping your hand as still as possible you're not consciously making the movement right so this for me is yes right I this pendulum always shows me this way is yes for some people yes could be clockwise and then no would be counterclockwise or for me like no is side to side like this and yes it's like this do you want to try it I will try it okay okay so hold it like this yeah and you can hold this little even there and you rest your elbow and then we get it nice and still and you'll hold your hand as still as possible and then you ask the question show me yes show me yes okay so when you're back and forth okay all right if it's this way it's yes and if it's anything else it's no okay so it's only yes and no yeah so you can only ask yes and no so then we steal still it again okay and then you ask a question that has a yes or no answer and your question that you wanted to ask is the tour going to sell out is the tour going to sell out oh it's kind of gone the other way isn't it do you have multiple dates on the tour 35 so we can ask are some of the dates going to sell out because we're seeing oh it's going yes now so here's a question though is it going yes because you just asked the question is maybe or does it have to come from me it usually should come from you is the tour gonna sell out I mean I feel like that was unfair because it was already swinging well it would stop and would go a different direction it's slowing down that's looking like a no well so maybe is it possible some of the dates sell out and then some don't maybe that's up to you well buy your tickets well let's see I can ask a different question should I go and get hit and test it's kind of weird how it just like slows down it's kind of going counterclockwise it's kind of saying no at your own peril maybe that won't be a video that then you can it's like a little no no it's a no this is it's really cool to watch I'm trying to think of another oh I have a question for it I've been thinking about getting a lizard but I'm like do I have time for a lizard I don't know should I get a lizard hey it's looking like a yes lizard on tour maybe I'll bring a lizard on tour I shouldn't bring a lizard on tour that would be a bad idea maybe after tour I'll give me a little lizard oh that's a yes for sure yeah oh look at that I like the pendulum the pendulum's cool no hypnosis but yes get a lizard no hypnosis but maybe the next video will be me getting a lizard probably won't be the next video but maybe I'll get the you're gonna do the tarot reading now so before you get started oh my goodness wild child so what are you going you can ask a question it doesn't have to be a yes or no question it doesn't have to be something that your intuition knows you can ask anything with a tarot card so what would you like am I asking for myself or am I reading for you well you can read for me or do you want to read for yourself I'll read for you that sounds fun I don't know how to do it oh you're gonna be totally good okay great okay so then I have to come up with the question okay so my question is I'm supposed to go to Ukraine in June whoa so what do I need to know about my trip to Ukraine in June let's find out okay so I shuffle first yeah so shuffle the cards okay I haven't I haven't shuffled like this in a sec so we'll see all right so this is my last shuffle this is your last shuffle okay then you're gonna have me cut them all right and then put them back all right you're gonna hold the cards and then you're gonna focus okay then you just lay out three cards we're gonna just do a three card read just one two three so when you say what should I be focusing on I would say like get into your center like be focused like trust in it trust your intuition and just pulling from the top or pulling any cards pulling from the top pulling from the top okay okay so we have oh is that bad wow you're gonna tell me seems bad and this way so we've got the knight of swords the devil and I don't know this is the two of pentacles the two of pentacles okay now now don't know what any of these mean okay when you look at the cards think about the question uh how does my trip to Ukraine in June look and now what do you see let's look at the knight of swords first what's going on in that card he's going into battle but is this past present and future we're not doing that we're just gonna look at three cards okay cool so he's he's charging into battle he's getting ready for probably the fight of his life okay um so I mean at first glance it's like first glance what are you thinking well maybe it's not a good idea to go to Ukraine in June yeah off of this and this the what's what's happening yeah exactly the devil card what's a devil card look like what's going on there um okay so the devil is you know he's he's sitting above these people he's got these two people chained up is this adam and eve yeah yeah there we go you I don't get good vibes from it yeah yeah yeah yeah I do get good vibes from this guy though I kind of like this guy yeah what's he doing he's kind of dancing he's playing with some balls I don't know there's infinity you're natural look at you great so if you were to say to me oh what do I need to know about my trip in June what would you say well uh maybe you're going into battle yeah yeah well no say it say it because your instincts are right I think you're holding back because you don't want to be saying no or being rude but that's the first rule of being a reader you need to tell the truth yeah maybe you you will get involved in something that you didn't think that you would be involved in yeah yeah and then the devil one is like just bad vibes like you know maybe maybe something not great is going to happen yeah but maybe on the other side you'll get an infinite amount of perspective maybe I don't know I would say here's I'm going to do some arm care reading for you I would say yeah probably not a good time to go in June but you're going to go later right oh right juggling it it's like juggling the time right he's juggling yeah and there's these ships back there yeah you can go another time you don't have to go in June June probably isn't great this is not looking great this is like oppressive energy well yeah if there's a war going on and you know all kinds of shenanigans happening over there then yeah you'll go but you will go and you'll go later you liked this card and I think I do like that card so based on this on what just happened here do you think that you're not gonna go in yeah I don't think it's gonna no I had the plan but it's probably not going to happen yeah so here's a question also with the cards do you read your own cards is that a thing people people can do it it's really hard it's like being your own therapist a therapist there's kind of like a bias exactly exactly so when you do it for yourself you're kind of like well I know too much about it right so if you had to rate my card reading on a scale from one to ten ten being the best that you've ever seen in your life one being the worst that you've ever seen in your life where would you rate me and I'm not going to take it personally for your first time you're a ten best ever for the first time yeah you're trusting your intuition you needed a little coaxing to like be able to say you know what you were thinking like that's probably the skill of like to be able to get it out there but yeah and if I can do this as best as you've ever seen think about the tour that I worked on for a year I'm so sorry well this was fascinating thank you so much for one having me here and and doing this with me if people I don't know if you're currently doing things with I teach tarot now I'm teaching classes mostly teaching classes in magic and witchcraft and tarot so that's what I'm doing mostly and if people want to find me they can find me at parlorofwonders.com my name is madame pamita cool and it was such a pleasure having you here thank you so much um and if you want to learn more uh the link that you just said and that will also be in the description down below um so if is it only for people that are in the la area are you doing things online everything's on zoom now all over the world we got people all over the world which is fantastic yeah there you go you don't even have to be local anymore well thank you so much I really really appreciate it this was super fun so thank you and maybe next time I won't get hypnotized based on what the card said so yeah


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