Hello everybody today. We are here again with near-early about How to manage the cash flow in your drop shipping business and what is the cash flow? We decided to create this video after the very very very Successful video which we released a few days ago about the PayPal reports and how to work with them and why we need them So today near will show you the next step in the finance management for our drop shipping businesses Enjoy. Hey Neil. Hi guys Thanks, Leo so As Leo said hi, my name is near from my profit and Today I want to talk to you and discuss about positive flow of cash I call it the subject flow of cash because it Divided to two direction positive flow and negative flow and today I want to focus on the positive flow The the positive flow of cash Means every transactions that come into your business That means all the amount of all the money that defines your monthly revenue So basically there are three sources of a positive flow of cash And I want to talk to you guys about them. The first one is a PayPal all the payments from the Customers the second one is a PayPal again That's all the positive fees in case of a refund to your customer We talked about it in the previous video video I will show you the numbers again And the third one is the credit card or any other way that you pay your suppliers Because in cases of refunds your suppliers pays you back and the best way you can see it is in your credit card In your credit card monthly files So first I want to open together again the PayPal report and drill down to the data And I will show you the most important Numbers that we should See together. So just let me share my screen So I want to show you again Two important numbers that we talked about it in the previous video if you remember I put it in a green remark The amount received please I want you to take this notice and to write down the numbers so you can understand the example there perfectly So the first number is in the amount received. We've got from our customers 1,560 euro. This is the amount received the second one from PayPal is in column G Refunded fees. This is the refunded fees that PayPal gave us back in cases of refund and it's The amount is 50 euro. So this is the two numbers that you should write down and remember So now I want to take you to the third source third source is Credit card and I want to you I want to show you how you can sort the data Just let me share my screen and I will drill down to the numbers Okay, so there are all kinds of credit card the download Excel I will show you a mine. It's the differences are minor. So there are five Columns we see here the date we see in the column see the name of Suppliers the name of business that you paid money for and the amount of money So you have to remember that there are two kinds of sellers There are two options. Maybe you just use your card only for to buy a From suppliers like Amazon like Aliexpress and there are options, of course that you use your the credit card personally This is why there is a potential of a big noise in this credit card And we have to know how to sort the data in a perfect way So first we're gonna take the first row and to filter it You go and to the Excel file you touch You click the data and filter it. Why do it? I will explain it to you I want to find all the negative number Why is that because the negative number represents all the money that your supplier gave you back So I will go to the filter. I will click number of filter less than Zero I click enter and then I see all the red numbers are negative number This is the first step you can see these are all negative number the first step I will go to column C and I will sort it by a to Z This the reason that I'm doing it because I want to Gather together all the name of businesses because I want to look for something suspicious It's it's not my supplier in this case I work only with the Amazon and with Aliexpress and When I drill down the numbers I see suspicious line here. This is not This is my name. This is a Personal payment that I pay so it's not Amazon. It's not Aliexpress. I will delete it right away That's it. Now. I will look for another suspicious row. I see none. So everything is clear Everything is good. So the only thing that is left is to take all the numbers and to calculate it together to make a sum I will sum all together and I see it is 594 euro, I will write it down 594 euro and that's it I will mark it in a green color and that's it now. We have three numbers and we can Calculate it together. It's 594 and we go back to the PayPal. It's two numbers. It's 1560 from the paper a month received and the 15 15 euro from the fees and After we add it together the result is 2169 euro. So basically, this is the only way to calculate the revenue This is your real revenue of the store of your business. So Basically, that's it Leo. This is the summary of the Flow cash of in a positive way. This is how I do it every month. I don't know another way to do it and That's it Great. I think that we can also do another video later about how to Organize all this together and like Excel files hosting like this So I think it will be like a set of videos Great. Thank you very much, Leo. I will put a link to Your system here under the video of my profit so people can also check the description and see our system and there We will also attach a blog post when we will create about this topic. So see you in the next videos Thank you very much for being here today. Thank you. Thank you guys. Bye. Bye


Welcome to Wales, Megan. Welcome to the world. A new life is a time to be optimistic. But what does Megan need to justify our optimism? The NHS has already helped her healthy birth and health services will continue to support her for the rest of her life. As she grows up, she will need a good education, starting at home, then at school, then maybe university, or taking up an apprenticeship. Megan will also need a good job where she's happy and prosperous. If Megan is to succeed, whatever her background or circumstances, she'll need to live in a more equal Wales. She'll need to live in a community that has everything she needs to thrive and prosper. For Megan to be happy in her community, it will need to be attractive, safe and supportive. She may enjoy visiting museums, watching a film, a local show, dancing or other art. As a Welsh speaker, she'll want to do so bilingually. She'll be proud of her heritage. Whether it's simply getting to school, work or the shops, she'll need to be physically active throughout her life to keep well. And she'll need to live in a community that promotes good health. Megan will also need fresh water, clean air and healthy food. This means maintaining our beautiful environment and using our natural resources in a sustainable way. Growing up, Megan learned more about the planet and the importance of being a responsible global citizen. So, over her life, Megan has many needs. The good news is that these needs can be met. However, there are a few challenges in the way, such as poverty, an increasingly global economy, an ageing population, poor health and the inequality of health between people, climate change and pressures on our natural resources and rising demand for quality public services. We know that we cannot face these challenges by doing things the way we always have. We need to take a different path. We have to live and work differently. That's why we have a new law in Wales, the Well-Being of Future Generations Act. It's unique in the world. As someone from the United Nations has said, what Wales is doing today, the world will do tomorrow. It's based on the knowledge that the environment in which we live, the economy that gives us jobs, the society in which we mix and the cultures that we share are all connected, to Megan too. This is why the law requires 44 public bodies covering the whole of Wales to work towards seven interconnected goals. Four, a prosperous Wales. A resilient Wales. A healthier Wales. A more equal Wales. A Wales of cohesive communities. A Wales of vibrant culture and thriving Welsh language. A globally responsible Wales. This gives us all a common purpose, but we'll need to work differently. This includes public bodies working together in public service boards to prepare a single shared plan for action. There are five ways in which we need to work differently. Decisions made today must have a positive and long-term impact for the future. We need to understand the effect a decision may have on the goals and honour the public bodies in an integrated way. We must involve the people we serve in all their diversity. We must collaborate to find common solutions. And we must actively prevent problems appearing or getting worse. Prevention is better than cure. The law requires us to do all of these things. This is a big change. But it's not just for public bodies. This is the third sector. You and your community can also play an important part. The law has set up a future generations commissioner to encourage, advise and promote this change. The commissioner will act as a guardian for our future, for Meghan's future and for people of all ages. This is the Wales that Meghan wants. It's the Wales we all want. To find out more about the Act, you can visit the Wales we want and Welsh Government websites.


Welcome to the JFK Neuroscience Institute here at JFK University Medical Center, home to our neurology residency program in Edison, New Jersey. My name is Sean and I'm one of the PGY IV academic chiefs. I'm going to give you part of the tour today as well as show you how much our program has to offer. Our residency program has 27 slots and it's categorical, so your prelim year will be here with us in internal medicine. Aside from working with all the different residents, you'll have the opportunity to work with five different fellowships in areas such as sleep medicine, stroke neurology, clinical neurophysiology, neurocritical care, and endovascular surgical neuro radiology. We'll start our tour here in the neuroscience conference area. We spend a lot of time here as we have morning report and new conference every day. Here we have resident, fellow, and attending run lectures and with the interactive whiteboard we're able to open up patient charts, review imaging, and draw out neural pathways. When you're on call, one of the most common areas you'll be is in the ER code stroke retrieval area. This is where EMS drops off re-hospital code strokes to be seen by the ER attending and the responding code stroke team immediately upon arrival. Here we get a brief history, a quick physical exam, and rush them to the ER CAT scan. Here in the ER CAT scan area, it's residents who get to decide what CT studies to order, whether that's non-contrast CT, CT angiogram, or more cutting-edge CT perfusion studies. Since we have a nursing team respond to each code stroke with us, we're able to give blood pressure medications, stabilize the patients, and even prepare TPA to give to patients while they're still on the CAT scan table. For patients presenting with large vessel occlusion within a window, residents can call the code neuro intervention. Then they're rushed here to our neuro intervention suite where we have two neuro angiography suites with physiologic monitoring. We also have two neuro imaging stations to review neuro imaging. Everyone graduating from our program has confidence in reviewing all types of neuro imaging, including non-contrast CT, CT angiograms, CT perfusions, digital subtraction angiography, and MRI. For anyone being admitted for a TIA or stroke breakup, they come here to 3 North, our stroke unit. Here we have specialized nurses who take care of each of our stroke patients. These nurses also come to any in-hospital code stroke with us to help stabilize the patient, get imaging, and even give TPA. For our sickest patients, they come here to our neurocritical care unit. For in the day, we have neurocritical care fellows and residents working here, and at night there's an on-call neuro resident senior who's watching after the neuro ICU. At any time in the neuro ICU, we have neurosurgery patients, neuro intervention patients, and patients being treated for hemorrhagic or large ischemic strokes, status epileptics, Guillain-Barre syndrome, and myosinic crisis. Some of the cool things we have in the neurocritical care unit is our portable CT scan and the portable hyperfine MRI. Behind these tours is our epilepsy monitoring unit. Each week, the pediatric and adult epileptologists have elective admissions where their patients are connected to long-term video EEG. Here, we adjust their anti-epileptic medication regimen, and we can see real-time how their EEG is affected. We also have 24-hour EEG capabilities for anyone presenting with status epilepticus. Hi, I'm Denysette Torres, administrative chief resident, and I'm here to show you around our outpatient clinic area. Here, residents have their weekly continuity clinic and attendings also see their subspecialty patients, which gives us as residents the unique opportunity to work with them with this patient population. Here, we also work with a sleep neurologist and help read sleep studies. We also, as residents, manage our own weekly lumbar puncture clinic. Here we have our neuro ophthalmology suite where we do our visual field testing and have our fundoscopy machine. And for patients experiencing dizziness, our neurotologists have a camera which captures nystagmus on film. Here in the neurophysiology room, the neurophysiologists guide us through conducting EMGs and nerve conduction studies. By the end of our training, we're able to conduct these independently. Here in the EEG room, we read and discuss EEGs with the attendings who then oversee us. By the end of the residency, we read these independently. During this rotation, we also work very closely with the neurophysiology fellow. Here's our last stop, our resident lounge. When we're not seeing patients or attending lecture, this is where you'll find most of us. Here, we take advantage of the computer workstations where we have access to various research databases. We also partake in impromptu group study sessions here. Our residency program has a strong focus on research. Since we have many subspecialists, we're able to take advantage and collaborate with the neurophysiologists, neurointensivists, neurocritical care physicians, sleep physicians, and a lot of other various subspecialties to work on research together. Residents submit abstracts for publication and are actually able to present their own work at national conferences like the American Academy of Neurology and the International Stroke Conference. Now that we've reached the end of our tour, thank you for taking the time to visit with us. We're proud of our program's history and the constant changes we are making to make it even better. We hope you'll consider our program as part of your professional journey.


Welcome traders to another Tick-Nill Charter with me Patrimonely, I want to draw your attention to the sterling dollar on the hourly time frame. We have just completed a five wave sequence into the lows on the 22nd, got some nice momentum divergence on that 5th wave, now I've got this initial advance off the lows in what should be a corrective phase here and note the momentum breakout so I'm looking for this ABC correction to hold above the pivot here 136.94 looking to be long through 137.40 targeting a quality objective up to the 138.50 level. As always traders, plan the trade, trade the plan and most importantly manage your risk. Until next time, thanks very much.


Good morning, everybody. Welcome to our part three of CANDOR. And today what we're gonna be talking about is evaluating CANDOR implementation, the impact effectiveness and sustainment of this great program. I'm Donna Prosser, I'm the Chief Clinical Officer here at the Patient Safety Movement Foundation. And I'm really excited to get started today because we have a lot to cover. So today we're gonna be talking about what the key elements are for successful CANDOR implementation, the evidence behind CANDOR, and looking at the challenges of caregiver burnout. Also looking at successful interventions for peer support. And then we'll talk about how you can evaluate strategies in your organization after CANDOR implementation. So lots to talk about today. As always, we are gonna be offering continuing education credit for nurses, pharmacists and physicians. This credit will come from MedStar Health. So if you indicated in your Zoom registration that you are interested in continuing education credit for either nurses, pharmacists or physicians, you will get an email from MedStar with an evaluation that you'll need to complete in order to obtain that CE. Respiratory therapists can also in most cases claim CNE credit in their state for, but check with your state board about that. We're also gonna offer ACAG credit for healthcare executives, CPPS, BCPA and CPHQ. So if you are looking for either CPPS or BCPA credit, you will receive a certificate from us. If you are looking for ACAG or CPHQ credit, we will be notifying those organizations and they will log your credit for you. As you can see on this slide, we have no conflict of interest to report for any of the panelists. We will be using Slido today, so get your phones out. And if you would, you can go ahead and get set up so that when the first question comes around, you are ready to go. You can either go to slido.com and type in this number, 923717, or you can use this QR code to access the app. So I'm gonna turn it over today to our moderator, Marty Hatley, and Marty, of course, you all know him. He is the co-director at MedStar Quality, Institute for Quality and Safety, and he is also a member of the board here at the Patient Safety MIMA Foundation. Welcome Marty, thanks so much for being here today. Thanks, Donna. It's always a pleasure to work with you, and especially today as we do this third in a series on candor, which I know we've had a lot of interest in. And we have a great panel today. It's just a fantastic opportunity for us to work with some old friends of mine. So just quickly, the panelists today are Heather Gok, who is the vice president of forest management and safety at Beta Healthcare Group. Beta is the largest liability insurer in California. I hope I have that right, Heather. That's what I always say. It has been a real innovator amongst liability insurance companies in supporting candor-like programs. Alan Frankel, I've known for years. Alan is with Safe and Reliable. And welcome, Alan. It's a great pleasure to work with you again today. Carol Hemmelgarn is an old friend who has just a distinguished record in patient safety. She came here because of a family event that impacted her family and has just done amazing work. And I'm proud to say she's a new member of the leadership team at MIQS, Master of Superquality and Safety, running the Executive Master of Program that MIQS does in partnership with Georgetown University. Tim McDonald is one of my oldest and dearest friends. He's currently the Chief Patients Safety and Risk Officer at Arle Dadex. And he's really been an architect of the candor program, did some of the original demonstration work on this that really has shaped this program. So we've got a great group of people with us today. Next slide, please. Tim, we've done two programs before on candor. The first one we did in January was just an overview of the program. And then just a month ago, we did a session that was really focused on the gap analysis and assessing your readiness as an organization to move forward. Can you just quickly, for those of us who, for those here who weren't at those two events, quickly describe what candor is and its components? Sure, Marty. So candor is what we would call a communication and resolution program. It is comprehensive, it's principled and it's a systematic approach to preventing harm but also responding in a very principled way. And it has at its core some very basic things that every CRP should have, where you identify events, you activate a system. In fact, when you see number three there, Marty, that's been one of the evolutions over the last five years is we don't even use the word disclosure much anymore. We talk about it as communication. And that's communication to patients and families as well as caregivers, the care for the caregiver component. And then while you're looking into these events, doing your event analysis, the circle in the middle indicates as you learn more, you share more with patients and families. And you also learn people who may be suffering a new peer support. And all of that leads towards resolution, although we know, and you and Marty, you and I've talked about, we need a better word for the R in resolution, related to that. But the goal is to kind of get to that point where with patients and families and others, that we are able to find ways to make it right financially for patients and families, but also hopefully engage them in the process improvements related to that. And so with the next slide, Marty, that's a paradigm shift, but this is fundamental to every communication and resolution program. And some add a whole lot more to it as we'll hear from Heather. Beta has taken that core, they put it on steroids, they've added other elements to it, but all those elements are contained in it. And it is his paradigm shift, Marty, where to be able to do this well, you need to immediately report and activate your system and begin that process of communication with patients and families. And then Alan's gonna talk a lot about the human factors process, redesign we need and not to rely on shame, blame and train, which has been kind of the history of what we've done. And then of course care for the caregiver has been critical in the times of COVID. And so that's kind of the fundamentals of it, Marty, doing the background again to where we've been the last two webinars. Great, and Tim, thanks for reminding all of us that this is a dynamic field right now. So the Canada toolkit that HRQ put together was published in 2016? Yes, in May of 2016 at MPSF, yep. And it continues to evolve through the experience of the hospitals and systems and other organizations that are implementing it. So we'll dive into that today. Just for those of you who wanna look at the toolkit, it is at hrq.gov slash candor, very easy to find there. There's a whole toolkit, but again, we're gonna talk about how those tools are being used and modified as we move forward. Okay, let's go to our first slide of question today. Thanks, Tim, for that overview. So what is your organization's level of interest in candor or a similar communication and resolution program? CRP is the acronym we use for that. So if you haven't yet done it, join Slido, let us know whether your organization is very interested, somewhat interested or not interested. Okay, and it looks like we have some very strong interest on this phone call coming up. Okay, let's move forward. Heather, can I start with you? And Donald, let's move to the next slide. Heather, I mentioned that beta healthcare has been an innovator in this space. You've taken, one of the innovations you've taken is sort of the guts of the candor program and reinvented it for your members and your clients. Can you tell us a little bit about beta heart and what you're doing to support a candor-like approach? Absolutely, thank you, Marty. And first up, I wanna say that all of these people on this phone call today, all of the panelists have informed our work. So we certainly don't wanna attest to the fact that we've modified anything over time. It's all been the input of everyone here on this call. Beta heart stands for healing, empathy, accountability, resolution and trust. It is our holistic approach to respond to harm and healthcare. And what we've seen over time is it truly has transformed culture in our organizations. Of course, the cornerstone of this whole body of work is to reinstall trust in healthcare. And the goal and objective is to heal both patients, patients' families when we've harmed them and also our caregivers. So again, just kind of moving around that entity. It's all about really learning about the defects in our systems where we can eliminate that risk and protect patients all along the way. Next slide. So we introduce this in five domains. We actually split it out in five domains and work through it methodically. What we believe is that culture is kind of just that foundation that we need to lay and make certain that we understand the organizational culture before we actually move forward with programmatic design. We administer a validated and integrated culture survey called the SCORE instrument. And what that does is it helps us look at not only the aspects of safety in the organization, but the level of engagement and also burnout in the organization, which I think we'll speak to at a later point. We look and actually look at that data. And of course, in healthcare, we always assume that when we survey individuals, just providing them with the data might inform them of where the organization sits. But we'd like to go a step further and we actually promote that through these conversations at the front line where we debrief information with particular individuals in the front line in focus group sessions to further learn about the defects or the pebbles in their shoes. The goal and objective of learning about this particular information is that culture really sits at the unit level. So actually doing focus group sessions in the units where both scores are high and scores are low in culture, it enables us to really understand how we might promote best practices in those high scoring units and perhaps actually move those best practices to the low scoring units as well. So we debrief the data with the front line, we further learn about the defects. Of course, all of this sits on a foundation of just culture. So if we don't respond to error in a fair and just way, we ultimately need to hear that voice. And if individuals don't feel psychologically safe to speak up, we wanna make sure that we're actually responding to them in a fair and just way when errors occur. We do like to disseminate those lessons learned. So ultimately, all of these domains connect to one another. And Tim will talk a little bit about that interconnection. But of course, we have again, another domain of an analysis and which is actually looking at the timeliness and the ability for organizations to respond to error when they occur. We apply human factor science and cognitive interviewing techniques, which is a bit different a way to investigate and collect information from individuals. We call them witnesses. And ultimately take that information that we've collected one-on-one with these interviews, which are actually near to immediate after an event and which helps us understand those human factors and those defects that exist in the organization. We can't forget the importance of collecting the input from patients and patients' families. Because the goal and objective of this is really to understand what they saw and what they can actually offer in terms of perspective to healthcare. And oftentimes we ignore that fact, but that is a key aspect of what we teach throughout Beta Heart. The communication and transparency we'll talk a bit more about. So I won't go into that in detail, but ultimately we want to make certain that it's timely, it's open, and we actually move toward the patient and family when they've been harmed almost immediately after the event has occurred. So we open that lines of communication and ultimately establish that trust that can go back and forth over time. But again, as Tim talked about, the communication component of all of this is really an ongoing process. It's not an endpoint of disclosure. Care for the caregiver, we can't ignore that. We know that individuals feel emotionally traumatized when they've come in an error. And ultimately that can lead to burnouts. We'll talk a little bit more about burnout, but this association between emotional exhaustion and our ability to learn in an organization is really key. So we must heal our own as well. And then ultimately early resolution, we always kind of think about the financial aspects of all of this, but there are non-financial means to help heal these individuals we've harmed. And again, we need to actually meet them where they are at when we have harmed them. And so talking through and really understanding what's meaningful to them is very important in terms of early resolution. Great. Thanks Heather. And again, just it's surprising to me still and I think just kudos to your organization that you as a liability insurer, prioritize this as a program that you wanna offer your clients. We've spent a lot of time in the last session talking about the gap analysis process. And I know you've worked with Tim to design that for the heart program. Can you sort of give the listeners a sense of how you use that data from the gap analysis either quantitatively or qualitatively to help organizations implement? I mean, what's the next step? Actually, I'd like to hear from both you and Tim on this quickly. Tim, you wanna start? Well, sure. So I do believe Marty the gap analysis is the opportunity to gather the qualitative sense of what's happening in the organization like we talked about on the last webinar where we had Amy speak to what we discovered at Samaritan. But there's also a big quantitative part which is what I love about that first domain in heart. It's what really sets it apart from all the other CRPs. And it's kind of more of that quantitative part. So Heather, over to you. It's just been really fun to see the two of these kind of sources of data come together and the organizations really appreciate the feedback Marty that they get from doing this process. Right, we really can't underestimate the value of the gap analysis process because it's sort of that lens into the organization where we really understand, okay, well, here's where we really need to meet organizations in order to implement, right? Where are their weak points because we do hear from the front line that information is critical. But what's actually really connected to the gap analysis as well because the gap analysis, again, just a slice of information. And when you feed that back to executive leaders, there are sometimes a little doubt about what we heard in terms of voice. The quantitative piece where we use the score instrument and deliver that information actually is the proof. So that's actually showing a larger sample size. It really actually brings the story to life. And ultimately with the gap analysis in combination with a culture survey and that information, it really kind of shows the organization where they need to head and it serves as a catalyst for change. Okay, good. The other thing Marty, I know we're gonna talk about hybrid liability later. The key to this is if you're going to implement this and as our talk is about sustain it and measure it, getting this early upfront data, remember, you're gonna repeat this.  You're gonna do a follow-up gap analysis. Any program that looks at implementation has to have that component or it's not really looking at it in a high reliable way to do that. Okay, great. So what I mean here is that the gap analysis gives you really good information to help an organization know where to start but the importance of support throughout the implementation process is crucial. And BetaHeart is a program that offers that support including the inputs from patients and families along the way. So it's a fantastic model and it really does feel like a paradigm shift, especially coming from a liability insurance company. Okay, we're gonna move on to one of our next panelists. It's Alan. Franco, Alan, welcome. When you're with Safe and Reliable, when I think of Safe and Reliable, I think of just the phenomenal work you've done to support the development of culture of safety. Can you tell us a little bit about Safe and Reliable and that culture of safety focus that you've got? Marty, I appreciate being on the call and it really is, it's wonderful to listen to Tim, to Heather describing the work they're doing. In large part, we've been fully and highly integrated in that work. So much of what Heather was describing is to some extent the piece of what we do. The reference to score is actually the name of the survey that we use. We think of it as kind of the, well, it is just about the only validated, holistic survey of culture in the industry right now. We publish around five publications per year on it and my group has surveyed a little under 15% of the healthcare employees in the United States. We're heading into the 2.5 million respondents. So we have a very interesting picture of the attitudes and perceptions of healthcare workers and participate in the heart program to support CANDR through the beta efforts that Heather was describing. We're a company now of about 60 people. What we are interested in is indeed the high reliability transformation. We came to exist in the mid 90s because the two folks who started this, Michael Leonard and myself were involved with major catastrophic events, the death of a child, in Mike's case, in my case, the death of two women right after giving to moms, right after giving birth. And the question we asked is, how do we make sure those things never happen again? So in essence, if we were successful in what we are aiming for, we put ourselves out of business, but we put CANDR out of business too because we get rid of terrible events. The problem, of course, is that if you take human beings and put them into a complex environment, errors are inevitable because human beings are fallible. And then the question is, how do you create an environment where the events that occur become increasingly less frequent? And you begin to approach what you see in the middle of this slide, which is this concept of failure free operation over time, which is the engineering definition of reliability. The cultural definition of reliability, I'd say is mindfulness, which comes from Wike and Sutcliffe's book, Managing the Unexpected. And the combination of those two was beautifully described by Heather in the CANDR and hard effort. We intervene in organizations small and large, small and very large, some of the biggest systems in the US, but small, you know, turned to bed hospitals to create the internal leadership and management systems to support mindfulness and the engineering definition of reliability, failure free operation over time. So SCORE is the instrument we use. We have an academy where we train senior leadership, middle management from the front line, and we've created a visual management software system that we embed in organizations as essentially the foundation or the skeleton structure on which we then build the management systems that predispose to higher reliability. And we're doing that across the US in Canada and England and now heading into Europe also. So I'm delighted to be on this program. I'm the one trying to avoid these events from ever occurring as is Heather and but then also making reliable that when events do occur that the candidate type response is equally reliable that you act immediately are able to have the conversations in a psychologically safe environment. So while we want the events to never occur, we want the reliability of the process when they do to be highly robust also and we help to support that process too. Alan, thank you for those thoughts. I often hear people ask, what is a culture of safety? I mean, you spend a lot of time thinking about this working in the space. If you had to summarize sort of the indicators of a culture of safety, how do you know when you have it? What are, I mean, mindfulness you've mentioned, the different tools that you've mentioned but for those of us who just kind of wonder how far they are in creating that culture, what would you say are the key indicators that you're there or you're moving in the right direction? Yeah, let me reshape it slightly. I was a patient safety officer with a large health system for partners healthcare, the Harvard hospitals. If you asked me to title myself today if I went into that role, I'd wanna be the chief reliability officer. And then if you said to me, so safety and reliability are linked because of operational excellence is great and you're reliable. When you walk into an organization and you walk up to people one by one and you ask them, what's the experience like of working here? And they turn around and they say to you, it's in healthcare especially, because we have a, there's the mission to help patients. When those people turn around and they say to you, this place is really special. I feel better about myself because I work in this organization than I would feel if I worked down the street where they could actually pay me more money. And I work in a community where people care about me and the combined effort is in service of operational excellence to get things right for the patients when they come in. You're getting the firsthand description. Imagine if every single person said that across an organization from the CEO to every discipline, through all the clinicians, through environmental services, the dieticians and if they all said this place is special because of what I do here, it makes me feel special about me because I'm able to deliver the best of myself to this organization. And then you add to that the leadership and management structures that make things transparent and visible the package together is likely to get you a culture of safety and reliability. So I mean, I could go in a more detail about organizational design and management systems and psychological safety, but what I'm describing requires all of those things to happen and when you see them, the organization seriously hum. Yeah, yeah, that's interesting to me, Alan, because as you know, I do a lot of work in patient and family engagement and I would sort of say the same thing when you walk in and can talk to anybody that you see in the hospital or the organization about how they're engaging patients and families and get some kind of a response, you know that the culture is there. I know it takes a lot of practice and training to around communication, also to really implement this and sustain this. So, Tim, we're gonna take a look now at one of the training tools that you used or helped develop to really help people understand the importance of communication to a culture of safety and to implementation of candor. Do you wanna set that up for us? Sure, thanks so much, Marty. And we do refer to it as experiential learning. It's a lot of what we developed with Heather and the team at Beta, which is really connecting the heart with the head. So taking these real events like Alan described and demonstrating how do you respond empathically knowing for all too long, Marty, a wall of silence has gone up and everybody in this panel has helped us. Like we've heard from Carol, every hour that goes by without effective communication, following a serious harm event is another harm event and it feels intentional. So we use these cases to drive that home and also lessons learned when we don't quite do it well, which is kind of what happened in the real case. But if we go to the next slide, I'll go through these quickly. I just wanna give those attending kind of the background. It's a real case. It happened at the University of Illinois when I was there. This patient has abdominal surgery. She's very allergic to non-steroidal anti-inflammatories, but as it turns out, Alan, in a non-highly reliable way that allergy is typed as a free text in the dropdown menu, which our policy allowed at the time. And with the next slide, what happened was, since there was no, not a lot of the systems were in place to prevent this, even with the armband, the patient gets catorilac. They get extremely short of breath and they require urgent admission to the ICU. Fortunately, with very aggressive bronchodilator therapy, they get better. And with the next slide, you're gonna see we now have this opportunity to communicate to this patient and their spouse about this error, why they're in the ICU and be prepared to answer questions. So this is that, how do you prepare in a highly reliable way to address this? And with the next slide, we do this setup here. It's the patient's ICU room. You're gonna see we film this during COVID. So you're gonna see only one dot come in, have the conversation with the patient and their spouse. What I find really interesting, Marty, is when you pull this video up, people are surprised at the patient and the spouse. And I think in June, it's just particularly important to use this particular video. So if we go to the video, we can watch this conversation because we'll try to hit those elements. Great, thanks, Tim. Hi. Hello, Donna. Hi, my name is Chris. I'm the ICU doctor.  Yeah, hi. How are you feeling? You've had a rough night. Yeah, thanks for asking. I feel better now. I feel much better now. I was pretty scared there. But yeah, man, I'm a little groggy still, but breathing is much better. Yeah, I don't know what happened. That was very scary. Yeah, I can imagine. And I'm glad to hear that you're feeling a little better this morning, and I hope that that continues. And the reason we wanted to talk with you this morning is because we wanted to explain why you didn't in fact end up in the ICU. And the reason is that we give you a medication that we should not have given you. As I'm sure you're very well aware, you're allergic to NSAIDs. Right. And we gave you a torolac, which is an NSAID, and that's what produced your allergic reaction, and that's what ended up putting you in the ICU. We are still looking into exactly how that could have happened, but it did happen, and we take full responsibility for that happen. How could something like that happen? I mean, Jamie was wearing a wristband that said that she had the salargy. I mean, I've been allergic to... He told people forever, it was in my chart. I made sure everybody knew that. But you guys gave it to me anyway? Yeah, I want to stress this so, so much. This should not have happened. This is a failure on our part. And you're right, there's so many ways in which you're identifying the fact that you're allergic to us. This is our failure. And as I said, we're still looking into what happened, and over the next hours and days, we're gonna get a clearer picture, and as soon as we find out anything else, we're gonna share it with you. And we do know that the computer safeguards that we have in place to prevent this kind of thing happen, they failed in this occasion. That is not an excuse by any stretch of the imagination. This is, there's a bigger picture here, and this was a system-wide failure. We fail you as an organization. And I want to stress that this was our fault, and we are so, so sorry that it happened. Oh my God. This is so good. I can't believe this. Now this is, this is something like that should never happen. Of course not, and we had to, I mean, she had to be in the ICU overnight. I mean, also, that kind of thing's expensive. You expect us to pay for something like that when it was your fault? You know, I'm an ICU doc. I'm not on the financial end of things, so I can't make any cast iron promises, but I can tell you that we are really committed as an organization to make sure that patients such as yourselves are not held responsible financially for care that was a result of mistakes that we make. We take that really seriously, and we want to make sure that you know we're committed to that. That's good to hear. And we're gonna, I'm gonna put you in touch with people in that department to make sure that they reach out to you as quick as possible so that they can explain the situation in as much detail as you'd like, and you're right, this shouldn't happen. It really, really shouldn't happen, and... It was really scary. I knew something was really wrong. I don't know, I don't know how I can feel comfortable staying here, you know? Like, it's such a simple mistake. How do we know that this is not gonna happen again? How can we trust you guys after this? Yes, a great question was we have already put in place additional measures that we'd like to share with you, and we have to rebuild your trust. We understand that, in us, and one of the ways we'd like to do that is during your stay here, we wanna have one of our nursing staff show you and explain to you the medication that we're gonna give you prior to giving it to you so that there's no question as to what medication you're getting. And in addition to showing you the medications, I'm also gonna have your surgeon come in here, pharmacist come in here, other nursing staff come in here to answer any questions that you might have, and also talk to you about your treatment going forward. That would be helpful, I mean, I'll tell you what, I'm not gonna have anyone administer anything to me without me knowing exactly what it is and double and triple checking, because that's, I mean, I didn't even think to double check any of that. I didn't think that I had to, you know? Oh, of course not. You shouldn't have to, that's the truth. This is your failure. This is nothing to do with you double checking, triple checking anything. You shouldn't have to worry about that. So what do we do going forward? I mean, am I gonna have to, you know, it ripped open the sutures. Am I gonna have to have another surgery now? I'm so sorry that that happened, and thank you so much for telling me. I'm gonna let the surgeon know that the surgeon was already gonna be coming in to see you, but I'll make sure that they chat with you about that and what that means. Good. Once again, I'm kind of apologizing enough. I'm so sorry that this happened, and we're gonna do everything we can to figure out exactly what happened and tell you everything. Who can we be in contact with about this going forward? Like, is there someone who we can call, or I don't know, it just seems important that we keep the lines of communication open so that we have questions. Absolutely, that's vitally important, and as I said, we're gonna have the surgeon, the pharmacist, and the nursing staff come in and talk to you, but of course we will provide you with a number and a contact that you can reach out to when you have any questions, but also we'd like to reach out to you and to make sure that you're doing okay and that you have the information that you need so that, you know, you don't feel like you have to keep phoning us to get information. We're gonna be proactive in reaching out to you if that's okay. Thank you, I appreciate that. Once again, I'm so, so sorry. Thank you. I think we're gonna have to talk about what we wanna do. I know, yeah. I want you to feel safe, that's absolutely the most important thing, so. We do too. Okay, Tim, we wanted to show that video to give people a sense of what implementation of candor involves. So Alan reminded us that it's a lot of structures Alan and Heather did, but it's also just a lot of training and a lot of focus on communication. Yeah, absolutely. And the one point I wanted to make, Marty, and then we can have them comment is, in the real case that happened at the U of I, we weren't highly reliable in our response, Marty, and we actually published it, what really happened. And with the next slide, you'll see what really happened because we hadn't fully hardwired it. And in fact, this is proof that apology programs don't work because CRPs, you know, beta heart, candor, it's not an apology program, it's that comprehensive response. Cause in this case, what happened is the ICU doc did explain the error and apologize, but never submitted an event report. So the patient was billed for their ICU care. And then they were sent to collections when they didn't pay their bill. So they filed a joint commission complaint and CMS grieve it and they sued us and they sought care for the follow-up because of the sutures got, you know, torn up and they had to go to another hospital to get the care. And of course it cost us a lot of money and we didn't learn very much related to it. So I like using this case as a point for why you need that comprehensive approach like heart to really take advantage when you put these things into place, how to prevent heart, but then respond when it happens. Yeah. And Tim, the, correct me if I'm wrong here, but my sense is that you, part of the implementation process is you challenge your organization or find in the organization who the really good communicators are, recruit them as coaches and then train everyone and that, you know, everyone can learn to communicate better. Am I saying that? Okay, good. Thanks. No, absolutely. Okay. We're running behind on time now. So I'm gonna quickly turn, Carol, we haven't even heard from you yet and I apologize for that. So I'd like to bring you in. Eileen Karina in the chat box in the chat room has wondered, questioned when we bring patients and families into this process. So you've had a lot of experience working with Tim and others on the Kander program. What do you, what would you say to that? What role do patients and families bring to implementation of Kander? So I think the first thing is Marty is when Heather was setting up her program, I was brought in other patients and family members were brought in to help the ones create it. So first, if you're gonna create a program and you think it's gonna be successful and not have patients and families, you're wrong. We look at it different. We ask different questions. We think different. So I think the first thing is bring in patients and families. If you have a PFAC, bring your PFAC in to be part of the work. You can't create something that impacts the end user without having the end user be part of the process along the way. So I think that's the main part, Marty. Okay. And Tim, you do, Tim, Heather, you do really bring in patient and family voices as part of the GAP analysis, correct? When you do that, you find some way to do focus groups or bring that in and we bring them along. Actually, we actually help them understand Kander and the paradigm shift that we're trying to create. It's absolutely correct, yeah. And involving them in event analysis is actually key, right? Their perspective is amazing. It's not something as healthcare people, I'm a nurse. It's not something we can think about really because we're watching it or they're viewing it from a different lens. And so the learning that comes from that is incredible. And of course, it's super important, right? It's critical that we hear that. Yeah. Heather, you know, Jonathan Stewart, you know, who's part of the beta heart team brought in, Marty, some of the best in the world in engaging patients and families in event review. And it was part of the webinar that they put on recently, you know, where they have the different domains, Marty. It's a lot of the people you know, because I know you've done a ton of work and I know Alan has done a ton of work, you know, in the NHS as well. It was so cool to be part of that webinar that Jonathan helped coordinate and put on. Fantastic. The other thing I want to kind of hit onto and the importance of Carol's voice and so many others, unfortunately, but just kind of setting the stage with the purpose of doing this work is super important. So connecting the heart with the head and really getting to pull on the heartstrings of individuals who went into medicine, who don't intend to harm people, but yet found themselves in the situation and or, you know, unfortunately just connected to a situation such as that, that's where we really can move the dot because that is what we start with at every conference, at every learning. And that's really key to actually get the word out around that and hear that patient's voice. Okay, we're a little out of order here, but since we brought it up, I want to address this now. Engaging patients and families in event analysis, Heather, you brought that up. There are very few organizations, I think, in the country that still do that yet. Could you and Carol and Tim, any of you speak to the importance of that and the value that you get from that to the RCA process or to the event analysis process? So I'll go up in real quick first, Marty, is you'll never have a complete event review process if you don't capture the narrative of the patient and family. We're the ones there 24-7. It's a revolving door of the providers that come in and out of the room and they only see a snippet of the whole movie and we are the whole movie. And unless you capture what we have to say, you're always gonna be missing something. It may not be big, but we do see things. We see the breakdown in communication. We see the lack of double checks. We may not have the vernacular that you use, those terms, but when we describe it to you, it's huge learnings. So the biggest gift we can give is we're giving you opportunities to learn frontline from the patient and family perspective. So, Carol, you're talking about really, if you're the patient or the family member involved in that event, bringing you into that process. You've also mentioned the PFAC as a structure. I mean, Tim, let me ask you this question. What structures do you try to implement in organizations or help organizations implement to really bring that patient voice, patient family voice into the process? Well, so a couple of things, Marty. One is you can build it into your software. Your event review software, you should be very intentional to include having brought the patient and family perspective into that. And I know Heather is, and Carol will talk about this later, the metric side, you can actually measure that. But you can get this from patient and family advisory councils like we did at the U of I. You can put patient advocates on your serious event review teams. So, again, they're reality checking, Marty, what's out there? And as you know, you were at some of these at U of I. When they're there, they ask some of the best questions, even though, as Carol said, they don't have the vernacular.  Yeah, that hit her connection, Tim. I was amazed when I walked into UIC and saw the people that came to those events and the way in which the Molizo family, who you brought in really helped. I mean, I think you referred to them as the conscience of your community. That's right. It was very special to see. Okay, we are gonna get to metrics in a second, but I wanna back up a little bit, Alan. We've talked a little bit about high reliability, and I'd like to kind of bring that concept back with a question to you. I mean, this is what you focus on. You've spoken a little bit about how candor can help or candor type approach can help, you know, foster that. But will you speak to the issue of burnout? I mean, we're hearing so much about it, especially after the COVID crisis. And that's gotta be, you know, a challenge in creating a safe culture, psychologically and physically. No, sure. Monty, I'm happy to talk about it in terms of what we factually know and then to theorize a little bit about, you know, what the relationship is. If we look at our burnout data, and as I mentioned, you know, we have, at this point, you know, two and a half million respondents to our survey at any point in time, we've got about 400,000 in our benchmark. We've actually, I think at this point, got the largest benchmark database about physicians and nurses worldwide. So I can tell you that when you ask nurses and docs, but also respiratory therapists, pharmacists, et cetera, what the levels of burnout are in healthcare in general, they are staggeringly high. And there are units where eight or nine people out of 10 would say, you know, 80%, 90% say, yes, I feel burned out. There are other departments and hospitals where you're sitting at, you know, 30, 40, 20%. But in every organization we look at across the country, burnout is high. So it's worth defining the term burnout to then think about its implications. The Maslack inventory or the spectrum of burnout starts off with, do you feel frustrated? Then the next level is, are you getting emotionally exhausted? So the implications there are, I'm frustrated around the experience. Now I'm so frustrated, I'm getting exhausted by it. Then the next level is cynicism. I'm frustrated, I'm exhausted, but nothing's changing, so I'm cynical. Then after that, I begin to feel ineffective. And then finally, I begin to depersonalize. So when we look at healthcare, the levels of burnout, people will say, yes, I'm frustrated, exhausted. I feel ineffective. I am burnt out, depersonalizing is massively high. What are the implications in terms of the ability to achieve high reliability? And the answer is pretty straightforward. Burnout leeches from, the analogy is, I plant a seed called high reliability in the soil. Can I get it to grow? It depends on the fertilizer on the ground. Burnout is leaching your fertilizer out of the ground. The willingness of the workers to participate in making efforts safer diminishes as the levels of burnout go up. So you're just gonna be more error-prone. And ultimately, if you get the levels of depersonalization, you're not looking at patients as people. So it becomes even more of an issue in terms of how people apply there and do their work. So burnout is a massive factor in healthcare worldwide. We see it in New Zealand, Australia, Germany, France, England, Denmark, Canada, the US in varying degrees, but all intensely. It's the job of leadership to look at the underlying factors that lead to burnout and to ameliorate them. And it's the ability to avoid adverse events and then for Canada to act effectively on adverse events is linked to the levels of burnout in your organization. Hone, can you quickly just comment on this? Because this I think is the nugget. Does candor implementation help address the burnout issue? I mean, that focus on communication, on head-heart connection, on engaging patients and families in the process. How does that improve our impact? It's huge. Let's put it another way. What are the things that decrease burnout? And two of the biggest factors that decrease burnout, and one is, and I mentioned this before, when people walk into an organization and they look around the people they work with and they say, this group of people care about me, it's called community, burnout goes down. When people have a sense of voice, that they speak up and they have a sense that actions are taken to improve things, burnout goes down. And lastly, when they say my values and the values of the leadership in the organization are aligned. We see things similarly, burnout goes down. Candor and the way Heather described the heart program is aimed at improving that environment of delivering care that increases community, increases voice and increases value alignment. And then on that, you then build your candor program. So when you add those all together, you're absolutely working towards decreasing levels of burnout in frontline employees. Tim, Heather, I know that part of the motivation for advancing candor has been care for the caregiver. I think that was almost a surprise to many of you at how important a factor that was, how much care was needed for the caregiver. I do wanna, and so I just wanna acknowledge that, but I also wanna turn to Carol, because Carol, you've been doing some really interesting work about the emotional harm done to patients and families long-term. Do you wanna comment on just the importance of this kind of caring attitude to the healing of patients and families? Yeah, it's really important and I'm glad that there's care for the caregiver programs, but we don't have the same thing for patients and families. And we suffer greatly and now we're seeing intergenerational harm. So those of us who have either been harmed, lost loved ones or children, we are now starting to see that impact on our children specifically when there have not been candor-like programs, that we had to fight for all the answers that it took us years and sometimes we still don't know. That was lost time that we couldn't heal. And when you look at Maslow's hierarchy, if the parents or the loved ones can't heal, the children can't heal, they don't feel safe. And we now are seeing that. And so I encourage organizations to now start to what is the program you're gonna create to take care of harm families, just like your harm providers. Great. Marty, if I could follow what Carol said and what we learned from her was, the communication part in candor or heart, it's not over until the family says it's over and sometimes Marty, that's years and we need to be committed to that. And my sense is, and I'm gonna turn to you for comment on this, Heather, is that the implementation is probably never really over, that implementation must require some sort of continued support for the process. That's exactly right. It's like I said, disclosure is kind of that term itself is sort of this endpoint, but this requires ongoing commitment to walk beside those we've injured. And ensure that we don't really harm them more through failure to communicate or kind of disconnection or whatever that is. And of course, it's they who say when it's, when they're healed or when they're at least okay to walk away. Yeah, Marty, let me add, because Carol's comments are just so powerful because Carol, I totally agree with you. My world is predominantly how to stop the events from occurring. You're describing out to the event occurs, how do we take care of people? You know, there are interesting, there's a relationship in this long-term care of patients and the ability to galvanize an organization to further efforts towards reliability. So for example, in the VA system here in the US, you know, the biggest healthcare system we've got, the four major efforts they have underway, one of them is safety forums. So what's the logic behind a safety forum? In a safety forum, you are looking at events and analyzing them and understanding how they happened in order to keep all of your frontline providers thinking about the risks and trying to ensure that they won't occur again in the future. And the ongoing relationship with patients and people are bringing folks like you, Carol, in to talk to people and remind them that the preoccupation of failure, that the concept of mindfulness is so key is an intrinsic part of achieving high reliability. So it's both designing the system to be reliable and on the mindfulness part, bringing people back to the core work and why it's important. We've done some fantastic webinars on the importance of building that patient and family engagement structure for that continued input. And Candor is just one of the things that, you know, continued voice and experience of patients and families can really latch on to and grow and become, you know, part of a trustworthy culture. We are close to time and there's one more issue I wanna get to. So I'd love to talk to you all more about what we've already teed up. But there's gonna be questions about how we're measuring effectiveness of an implementation of a candlelight process or a CRP process. And I know there's important work going on. Carol, if you could break up the slide about the accountability collaborative. Carol, you're part of this collaborative and would you talk to the work about the work you're doing on metrics? Sure, so about two years ago, a group of people, Marty being one of them and four at the Collaborative for Accountability Improvement said, you know, we need to measure, we need to see are we being successful with communication resolution programs? So along with Tom Gallagher and others, metrics were created and there was patient families involved in these as well. And so the first iteration that came out, you know, there were some good metrics, good feedback. However, they were very organization-centric. So it was easy to capture the organizational side of it. There was some more qualitative that were patient-centered and organizations had a more difficult time. But then what we really realized is we now have a group of patients that have worked together to really create metrics of what we feel are important from the CRP. And it's really, again, it's that soft side. It's that qualitative side because even though you can get your metrics from an organization that says you're great, it's really how we feel it went in the end that really says was this program successful or not. So that's what we're working with now with Tom and look to, you know, test these. That's always the hard part is getting the feedback from the patients and families. But when you do, it's probably the best data that you get to the success of your program. Okay, so this is a project that Tom, when you mentioned is Tom Gallagher out of the University of Washington, one of the preeminent researchers in this area of communication and CRP. And just for those of who are tuning in today who are thinking about implementing Canada or already implementing, when will these metrics be available for them to use? What's your best estimate of when the project will be? I know it's being piloted now, but when will it be available? So I believe the first set of metrics are actually out there. I believe they're part of the whole pack program that's going on. The new set with patients and families and how we're gonna take those and put them in, I'm thinking still Marty probably a year until we get that and test it. Okay, great. That's a year is they go by faster and faster. So that's almost here. So Marty, I will say, and Heather, you probably could speak to this. They're already using a lot of their metrics that also include the patient and family engagement part already. I mean, they already have their organizations creating dashboards and other stuff. So kudos to you Heather for building that out and helping your organizations do that. Again, informed by the National Metrics Task Force and which I was a part as well. And I know that we still have some work to do. So as per Carol, we really don't have metrics to measure the patient's experience from all of this. We do collect information, as we roll out each domain, there are culture survey items and domains that actually tie to each one of our domains. One of them is burnout for care for the caregiver, for example. But we look at staff turnover and other process and structure metrics pertaining to the program. We certainly look at timeliness because timeliness is key. When we open up that line of communication, it has to be near to immediate. And so ultimately, we do look at that. And then we also look at outcome metrics as well, being a liability carrier. We of course look at claims and costs and things, but it really pales in comparison to what we really need to be looking at. And that is truly just, what are we doing to transform culture in an organization and get it to that next level? We're wrapping up here and it just feels like we're getting started. So, Donna and PSMF team, I think we may need to do more on Candor because we've given people a lot to think about and a lot to talk about today. I do wanna just thank my panel. I hope you saw the connection that we were drawing between, if you're on a higher liability organization journey, how, what a great fit Candor is. There was a little bit of a polling question that popped up there about, if you're on that journey, please consider building Candor or a CRP program like Candor into it, like BetaHeart. And I can't thank the panelists enough for sharing, where you are on the journey and all the great work that you're doing. It feels transformative. It feels like a paradigm shift. And with that, Donna, back to you to kind of wrap us up today. Well, thank you, Marty. And thank you to all of our panelists. This has been such a great discussion and we really appreciate it. You're right, Marty. I think we could spend an entire year talking about this topic. So, thank you very much again. I suggest to, again, a little bit of housekeeping. If you are a nurse, a physician, or a pharmacist, or a respiratory therapist looking for a CME credit, you'll receive an email from MedStar within the next five to seven days with an evaluation that you'll need to complete to be able to obtain that CE. This is what the email will look like. So, you know that it's coming from MedStar. If you are looking for ACHE credit or CPHQ credit, then we will be submitting your information to those organizations and you can log your activity in the appropriate portal for that professional organization. And for CPPS and BCPA, we'll be providing you with a certificate for attendance today. We do provide all of our webinars for free and we're very proud to be able to do that. And in order to continue to do that, we would appreciate your support. If you are interested in helping us keep our education free, then please visit our website at patientsafetymovement.org slash donate. And we will be sharing these slides along with the video of this webinar on our YouTube page. So, we'll be sure that you have access to all of this very soon. So, thank you all so very much for joining. We are right at 9.30. And thank you again, Marty, and to all of our panelists. Thank you. Thank you, Carol. Thank you, Heather. Thank you, Alan. Thank you, Tim. It's been wonderful to the audience. If you've got questions or want more information about Canada, let us know. Let us know what your questions were and we'll respond. Thanks so much. Thank you. Thank you, everybody. Have a wonderful day, everybody.


Hey everyone, welcome to Higan Iruthil. We have here an FAQ for the soft launch happening on February 23, 2023, so is it a coincidence? Anyway, this soft launch by the way is happening in Malaysia, Singapore and Canada. So for those who are expecting it to be in their country, that is going to be happening in global launch, which it's not announced here, but the speculation is might be dropping in in April, but again, take it with a grain of salt. I'm not sure if that is finalized or not, but not, you know, not causing a panic here for global launch, but for now soft launch is happening on February 23rd. Let's go over the FAQ here. We have a couple of questions here. Some of these questions actually you can reference through the official Facebook page. So all of the questions are there or you could actually just pause this video and also read through some of the FAQ questions indicated here, but I'll go through each and one of them. I'll probably have an explanation on the other thing. So starting off with number one, it's going to be available on only on Android platform. It's not going to be available yet on iOS. So soft launch only on Android. For iOS, you'll be, you know, you'll be enjoying this game during the upcoming official release, which I said earlier, but again, it's not final. So don't be, you know, don't don't make, don't reference me just in case that it doesn't push through by April. But again, Android only for February 3, February 23 soft launch. And the next one is number two is soft launch open in all countries in this trick. So again, it's only open in Singapore, Malaysia, and Canada. For the rest of the world or the rest of the release, it's only going to be available on the full release or the official release of the game, not on the soft launch. But again, I mentioned earlier or in the previous video that you might be able to get some of these soft launch countries in their own Google Play Store. But again, you have to download the Google Play Store. You can actually find a way to do that. So I won't go into detail on that. Next up, will my data in progress be saved when the game releases officially? So all progress, all data in progress in the soft launch will be saved. And you can log in the soft launch server as usual when the game officially releases. They are going to be putting up probably a separate server for the soft launch and the official launch. So please make sure that you you actually understand that because if you have friends in soft launch and you play in the launch, probably you won't see each other unless they would merge those servers. And where the content and event of the soft launch server will stay the same with the open beta server. So again, there will be separate servers for the soft launch and for the official launch. But I'm not sure if content will be simultaneous. Will they be waiting for the official launch for all the content to go out? Or will soft launch people have advanced content or probably newer characters ahead of them before official launch that I cannot confirm at this point. So number four, when will the soft launch begin begins on February 23 again on the 2023 at 11 GMT plus eight until the game releases officially. Okay, so number five is the number of seats limited in the soft launch, obviously not. So that's the server will be accommodating as many players as it can in the, you know, in the countries that are indicated for the soft launch. Number six, can I log in as a guest on the soft launch login as a guest is not available on soft launch. rerolls will be affected by this because you'll have to be creating different accounts for you to reroll. Don't worry, I'll take you through the reroll process once soft launch or before or right after soft launch is launched. So is there any benefit if I top up in the soft launch? So please just read here or probably just have a pause on this video and try to read all of the benefits if we do top up on the soft launch and definitely there will be rebate percentages for this one. So also this is the rest of the rest of the explanation for the top up. And next is going to be where can I download the game for the soft launch download will be available as a pre download on 11 GMT on February 21. So that is exactly 48 hours before the launch. The link is going to be here. And I think it's going to be available in the designated countries that we specified for the soft launch in their own Google Play stores. So if not, you can actually click on this link to pre download the game for your for the countries that are participating in this soft launch. Okay, so what are the devices device requirements for running he going to Ruth Hill here are the system requirements again, please pause on these and check them out if your device is compatible with the new game coming out again so that you may actually prepare and not complain if the game is lagging on your end or is not really compatible with your device. And what do I do when there's an installation also pause on this video just in case if you want to read the instructions here and also number 11 what should you do when your game crashes also pause for this video and the last one is number 12. So what do I do if you encounter blurred or low resolution images. Again, please do follow the instructions here so that you can correct these these problems or the small glitches in your game. Okay, so at 13. So how do you claim your pre registration rewards they will be sent to you and your in mail game within an hour after a character has been created. So that means that the global will receive theirs when goes live. So soft launch guys are going to enjoy the pre registration rewards early number 14 do I contact the service how they contact this customer service during the soft launch also please read through the instruction here and if you want to get the latest information on hegan iruthel you can actually check out these pages here twitter facebook instagram youtube discord and reddit so hope to see you guys in the soft launch I'll try to I'll try to download the game as well during probably by tomorrow if I can and try to have a good head start okay guys in another note we have already reached a million pre registrations for hegan iruthel as you can see here we have still the link if you still want to register for the pre register for the game please click on these the devs might give us additional rewards in just in case if we reach another pre registration milestone before the 23rd so please do read pre register now if you still if you still want to pre register and if you want to probably have a you know a chance at additional rewards for the pre registration and we have achieved this one because we are getting media she is actually she doesn't have she didn't have a preview guys of um she didn't have a preview um during the cbt that uh i participated so she's totally new character we do have to review her hopefully she is going to be a good character to have because again we will need a lot of help to start this game and not sure what type of character she is she is probably range she has a pistol and media is a justice seeker she looks like a a jester kind of but again never mind she does look cool hopefully she could add to our better characters that we receive from the game and that is it so hopefully guys you can download the game if you're participating if your region is participating in the soft launch uh download it tomorrow and i'll see you in the soft launch on february 23rd so thank you very much guys for staying this far take care stay safe this is the warden and i'm out of here


Now, interviews are nerve-wracking enough on their own, but not knowing the questions you might get asked can make it even worse. Now, I do have a good amount of experience doing interviews myself, as well as interviewing candidates, so I've been on both sides of the table. All right. Name. Dwight Shrews. Thank you, Mr. Schnute. We will let you know. And in this video, I'm going to go over some of the most common interview questions that you are definitely going to encounter. Now, I am going to poke a little bit of fun at these interview questions, but at the same time, I'm also going to tell you what I think is the best way to go about answering them. So this video will hopefully entertain you and also help you knock that job interview right out of the park. So right after you gently tap the like button, let's get started. Now, first of all, I just wanted to say I did research on other videos that go over, like, interview questions and answers, and a lot of them will give you kind of a canned response to interview questions. And I don't think you should ever use these cookie cutter canned response answers in an actual interview. And the reason for this is because millions of other people are watching the same videos. So if you try to memorize these canned responses, I can almost guarantee you that your interviewer will have heard it at least several times. Imagine if you heard the same exact answers to the same exact 10 questions from five different people. You probably wouldn't have a very good impression of the fifth person that gave you these canned responses. Plus, when you're nervous during an interview, it's almost never going to be a good idea for you to memorize answers word for word. Almost guaranteed, unless you have like a photographic memory, you're going to forget it. What's better to do and I'm going to go into this later on in the video is to think of a story that has to do with the answer to the question. And the reason for this is because the human brain actually thinks and many times memorizes things in the form of stories. So when you hear a story, you almost have no choice but to remember it. So not only will it be easier for you to remember the answer, but at the same time, it's also easier for your interviewer to remember you. All right. So first one on this list, describe your dream job. Ah, yes. This is like when you're going on a first date with a girl and she asks you to describe your dream girl and she promises that she won't get jealous. Classic trap question here. If you're honest with them and you're like, you know, I don't even really have a dream job or I do have a dream job, but it's definitely not this position. That's going to be a pretty bad answer. You're probably not going to get hired. So the correct answer to this one is something along the lines of, I really like this position that you're interviewing me for, but I would also enjoy moving up in the company later on and taking on more responsibility and more leadership. I don't think it's going to come across as very genuine if you lie to them and tell them that this position is your dream job. So I wouldn't recommend doing that, but I would recommend saying that, you know, you are really excited about this position and you're also excited about your ability to work your way up and the company take on more responsibility and more leadership. So this one is going to go in the trap tier. Describe yourself in three words. How about work for money or work to survive? Yes. A very important question that lets you generalize yourself so that they can put you into a very neat little box inside of their head. Now with this one, as much as you might want to tell them about your magic, the gathering card collection or your obsession with video games from the 1990s, you should probably keep this work related. So a really good way of answering this one is think of three words that you would want to describe your ideal coworker as, right? So someone that you have to work with and interact with on a day to day basis, think of three words that you would really want to describe them. Things like reliable, teamwork, hardworking. Yeah, I just put those two together. Hardworking, one word, right? This is a super easy one to answer. It doesn't take that long to think of these sorts of things. This one is going to go into easy tier. Next one, how do you deal with a difficult customer? I personally like to get down on my hands and knees and beg Karen's to forgive me for the audacity of trying to make a living. No, all joking aside though, this is a very common one. There's a lot of different variations of this one, slightly different ways of asking it. But I'm going to get to this more later on in the video. The best way by far to answer this question is to just tell a story about a time where you dealt with an angry customer. Or if you don't have any stories like that, think of a situation where somebody else dealt with an angry customer or just think of what you would do in the situation. And as much as you might want to, try not to tell them about that time where you got a Karen permanently banned from your business. Tell them about a time where a customer did have a legitimate concern and you were able to help that customer out, ease their worries, et cetera, et cetera, et cetera. And I'm going to go over exactly how you should structure these stories at the end of this video. So make sure you stay tuned for that. All right, so this one is going to go into the story tier. All right, so the second one is how would you deal with a situation where you have conflict with one of your coworkers? All right, so this is another one where you want to tell a story, very important.  So this one is also going to go into the story tier. Think of a story or a situation where you did have a conflict with a coworker or a classmate or something like that and how you resolved it. Next question, how would your past coworkers describe you? This is another question where you would want to use empathy, use the golden rule basically. Think of what you would want to see in a coworker. Think of the words, the adjectives, et cetera, that would describe that and then use those words. So this is very similar to the other question we talked about earlier. So this one is also going to go into easy tier. The next one is job specific problem solving questions. And this is one of the few that unfortunately, no matter how slick you are, you're not going to be able to fake this one. Unless you're Frank Abengale from Catch Me If You Can. So this is a question that is used to test your knowledge. And this is something that's not easy to prepare for. In certain industries, there's more of these questions than others. For instance, in the technology industry, you're going to get a ton of these questions. In my industry and pharmacy, I didn't get that many, but you really do have to be prepared for it. So for instance, Elon Musk will ask people incredibly difficult problems that basically only geniuses can solve because he wants to work with people who are like genius level smart. Now that's a pretty crazy example, but just make sure you know your stuff when it comes to whatever your trade, your career or your craft is. This one is going to go into hard tier. Next question, tell me about a time when you failed. Now for this one, they might just ask you the general question, tell me about a time when you failed or they might make it work specific. If they ask you the general question, my personal recommendation is to talk about something outside of work. So for instance, tell them about a time that you failed in college or in high school. Tell me about a time that you failed when you did some sort of competition and debate or sports. I know this doesn't logically make sense, but I just don't think that it's a good look to tell somebody about a time that you failed at work when you're interviewing for a job. But if they do ask you about a time that you failed at work specifically, then of course you have to think of that. So this is almost like a borderline trap question if they ask you about a time that you failed at work. So you have to be very careful about how you answer this one. Now with this one, don't tell them about the time where you accidentally burned your previous employer's business to the ground. Instead, tell them about a time where maybe you were a little bit late on a deadline. Maybe you hired someone who didn't do the best job or maybe there was some sort of miscommunication with one of your fellow employees and a project didn't get done the right way. The most important thing here is that you take full responsibility for it and then you tell them how you learned from it and how you improved in the future. But again, if you can keep this one more personal and outside of work, I would recommend that. So for that reason, this one goes in the personal tier. Tell me about the toughest decision you've ever had to make. Whew, that's a heavy one. Now, realistically speaking, the toughest decision you've ever had to make was probably a personal decision. But with this one, I actually recommend doing the opposite. I recommend telling them about the toughest decision that you ever had to make when it comes to your career. If you were a manager in the past, for instance, tell them about a time where you had to lay off an employee. So yeah, in my opinion, keep this one work-related. I've seen in interviews how people get really kind of like emotional and they get a little bit too personal and it just creates a little bit of a weird vibe. Now, if you have finesse, of course you could pull that off, but there's been some interviewing situations where it kind of just seems like the person is trying to get you to feel bad for them the whole time. And as much as I empathize with people's struggles, a job interview is not the time to do that. So this one is going to go into the work tier. Next one on the list is a very common one. Might even be the first question you get and that is, tell me about yourself. Now, many content creators will tell you to only talk about yourself in terms of what you do at work and don't talk about your personal life at all. And I disagree with that. I think it should be about 80% of who you are when you're at work and then 20% just a little bit about your personal life.  This is your opportunity to spice things up and show them a little bit about your personality. So I recommend starting this off by talking about yourself a little bit, the first 20%. And then the last 80% of the answer, you should be talking about yourself in terms of work. So give them a little bit of a brief history about yourself and try to mention things that you think would stand out in their head. So for instance, when I was a kid, I worked at an animal refuge that had lions, tigers and mountain lions. And I was actually inside the cage with them. So I probably tell them how I had a very interesting childhood where I moved around a lot as a kid. And that was one of the first jobs that I had. Now, if you don't think you've done anything interesting, yes, you can leave this part out and just talk about work. But in my opinion, this is such a great opportunity for you to showcase a little bit of your personality.  And then the next 80%, you want to tell them about your job history. So basically tell them about your work history a little bit and things that you've done at other jobs that will help them as a company. Try to tell it as a story if you can and then finish the answer with, that's why I'm here because I'm ready to take the next step. All right, so just because of the fact that you do tell them a little bit about your personal life, I'm going to put this one in the personal tier. All right, next question. What are your biggest weaknesses? So this is another really tough trap question to answer. It's a trap. You're basically walking a tightrope with this one because realistically, everybody has weaknesses and nobody is perfect. But if you're too honest about this question, I think you're putting yourself at a huge disadvantage because the truth is most people are not going to be completely honest when they answer this one.   My only weakness is my humility. What? Bro, what are you talking about, man? So this is one of the few where I kind of think it's probably best for you to do a somewhat canned answer. Things like being a perfectionist, focusing too much on the details, not having experience in leadership, but the willingness to take on leadership positions in the future, having trouble asking for help, having a little bit of trouble with confidence, working too much, caring too much about your job. As cheesy as these are, you kind of do want to stick with a little bit of a canned response here just because of the fact that you're kind of walking a tightrope. So this one goes into trap tier. The next one is what are your strengths? Now, this one is a little bit of a trap, but it's not nearly as bad. Now, a lot of people are afraid of coming across as they're bragging or something along those lines, but the truth is this is a job interview, right? So you need to tell them about yourself and what you're good at. And then on top of that, they are literally asking you. It's not like you just brought it up out of the blue. So do not be afraid to sell yourself a little bit here. Now, obviously you want to pick things that are work related and would make you look like a good candidate for that position. So don't tell them that your biggest strength is doing speed runs on video games. That's awesome, but keep it to yourself. Now, if you do want a good canned response to this question, a really good one is saying something along the lines of, you know, I might not be the smartest, I might not be the fastest, but what I can tell you is that I'm somebody who never gives up. I always get back up and try again whenever I fail. That's kind of like an underdog response. It's like a rocky type story. Everybody loves the underdog and everybody loves people who just get back up again and again whenever life knocks them down. So this one isn't nearly as much of a trap, but I'm still going to go ahead and put it into trap tier. Hey guys, I'm on vacation right now and I'm in the process of editing the video and I realized that it's way too long. So I'm actually going to switch it into part one and part two. I'll have part two come out a day after part one and it will be posted right here. So thanks for your understanding and I will see you next time.