Written by: Center for Care Innovations

CCI’s Health Pilots podcast presents our next Resilient Beginnings feature, shining a light on the care team at Children’s Health Center (CHC) at Zuckerberg San Francisco General Hospital. CHC’s Kathryn Hallinan Aguilar, Maite Garcia, and Dannielle McBride take us inside the clinic’s distinctive environment where a varying range of patient experiences, needs, and challenges converge. They discuss with us the intricate coordination required in operating within a complex hospital system. Tune in to discover how their collective expertise and collaborative drive work toward bringing forth inclusive, holistic care for all – striving for comprehensive and equitable access to healthcare.

Below is a transcript of the episode, edited for readability.

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Episode Teaser // Kathryn Hallinan Aguilar (guest):

Be comfortable with the idea of the reality that there’s going to be lots of ruptures and opportunities for repair, and that that actually is incredibly healing as well, to be willing to keep trying and failing, knowing that we can then put some time into repair and trying again.

Health Pilots podcast intro:

Welcome to the Health Pilots podcast presented by the Center for Care Innovations. This podcast is about strengthening the health and well-being of historically underinvested communities. Every episode offers new ideas and practical advice that you can apply today!

Episode 53 intro // Resilient Beginnings Network (RBN):

What happens when health care shifts its focus from “What’s wrong with you?” to “What happened to you?” And how does it impact pediatric care delivery? To answer this and to share with us deeper insights into the work, Health Pilots is featuring care teams from the Resilient Beginnings Network — a Center for Care Innovations program dedicated to advancing pediatric care delivery models that are trauma- and resilience-informed so that 100,000 young children and their caregivers have the support they need to be well and thrive. Facilitating this conversation with the team we have today is Dr. Dayna Long, primary care pediatrician and clinical director for the Resilient Beginnings Network, or “RBN” for short.

Hear the team’s journey through this program – the valuable lessons they’ve learned individually and as a care team – and the unique, transformative impact of the Resilient Beginnings model on patient care. Find out what it means to provide care in which all parties recognize and respond to the impact of traumatic stress and resiliency factors on children, caregivers, and service providers.

With that said, I’ll pass it on to Dr. Dayna Long for our episode today!

Dayna Long (host, RBN):

Hi, I’m Dr. Dayna Long, medical director of the Resilient Beginnings Network (RBN) with the Center for Care Innovations. Today, we’re talking with the team from the Children’s Health Center (CHC) at Zuckerberg San Francisco General Hospital, and they have been doing great work in pediatric care delivery around trauma informed and resilience informed care. Our hope is that by sharing the story of the Children’s Health Center, that other safety net organizations can apply the lessons that they learn to their own context.

I’m here with Kathryn Hallinan Aguilar, Maite Garcia, and Dannielle McBride, who are all members of this 15 community health center learning collaborative that we have from Resilient Beginnings Network.

We are going to start with Kathryn.

Kathryn Hallinan Aguilar (guest, CHC Zuckerberg SF General Hospital):

I’m Kathryn Hallinan Aguilar. I’m a licensed marriage and family therapist, and I’ve been working within the Children’s Health Center as a part of the behavioral health team, specifically with a program called Healthy Steps. So really being able to bring this kind of focus on dyadic relationships and what young children and their caregivers are coming into medical spaces with and what are their needs and how to support them. That’s where I’ve been able to bring some insight and thought.

And then I’ve done a little bit of work around consultation and mental health consultation in particular. So then being able to think through how to support the clinic as it makes these changes to support each other as staff.

Dayna Long:

Thank you, Kathryn. Maite, how about you?

Maite Garcia (guest, CHC Zuckerberg SF General Hospital):

Nice to meet everyone. My name is Maite and I am the Family Navigation Lead on the Resilient Beginnings Network. I’m the case coordinator at the Bridges Clinic and the Bridges Clinic is a subspecialty clinic where we work with newcomer families at the Children’s Health Center. My role there specifically is training the family navigators to work with our families. I also do the social needs assessments for our families, training our family navigators how to do those social needs assessments.

Dayna Long:

And Dannielle?

Dannielle McBride (guest, CHC Zuckerberg SF General Hospital):

Hi, my name is Dannielle McBride and I am a pediatrician working at 6M Children’s Health Center. I guess my role is to see the children, but in regards to the Resilient Beginnings Network, I’ve been working on the more patient facing initiatives around building resilience in clinic. A lot of that is around Patient Voice Project that I have been doing along with Kathryn to get a sense of what families need to feel supported, feel cared for, those kinds of things. That’s been my role.

Dayna Long:

Thank you for the introductions. Tell us more about the Children’s Health Center. You all mentioned some really great projects that you’re doing.

Kathryn Hallinan Aguilar:

I feel like when it comes to the Children’s Health Center, there’s probably a million projects that are going on all the time that a lot of us don’t even know about. I think what we know is it’s a team of providers and staff that want to support in any and every way possible the families that we serve. And so there are all these different grant-based programs and some that are embedded within the system, and I think something that feels unique and sometimes challenging within the Children’s Health Center I find is that we’re a part of DPH, the Department of Public Health as well as UCSF and trying to navigate these different systems all under Zuckerberg General Hospital. And so how to be able to bring so many projects and programs together to do this work in a unified way. I think that’s what comes to mind for me. Curious Maite or Dannielle, what else you’d add?

Dannielle McBride:

I think for me, I would add that I have found our clinic to be unique in that it just runs the gamut in terms of what people have experienced in life, what challenges folks have, what traumas people bring with them in clinic. And that’s what I have enjoyed the most about the clinic, but it also is a challenge, for sure, in terms of how to provide the best care for everyone.

We know that historically and currently some groups get a certain level of care that other groups don’t, and we’re trying to figure out how to navigate that space and make the care that is delivered at our clinic different, in that everyone is getting what they need to live whole and healthy lives. I think that that’s one of the things that’s unique about our clinic and that’s what’s been so fun about working on this project, is everyone brings their expertise to these different areas around that same idea and that same goal. It’s a fun clinic but has its challenges and we’re working together to make a difference.

Dayna Long:

Given what you just said, Dannielle, when you think about systems of care delivery that are trauma-informed, walk us through what it looks like on a day-to-Day in terms of how you are approaching patients as a pediatrician and what their experience is when they come in contact with the Children’s Health Center.

Dannielle McBride:

I would say the way that I have approached it has been starting with a lot of listening, and that is what prompted us to take the approach that we did with our specific piece of the project. But even before the project, it was really important to me in my individual one-on-one appointments to just really take the role of listening, because I found that families will tell you what they need if you’re willing to listen and hear what they’re saying. So often we come in with our agenda but don’t allow for our families to actually express what they’re feeling, what they’re needing, just where they’re at. This provided a great opportunity to do that.

Dayna Long:

It’s about your approach to patients. The comments that you say about listening remind me of a quote from one of my mentors, Dr. Melanie Tervalon, who her and Dr. Jann Murray-Garcia with the founders of the Cultural Humility Movement. What they said is that you have to listen as if your whole body is a ear to listen fully. Everything that you’re saying just really echoed that for me. You guys have been at this now for a while. What have you accomplished as part of the Resilient Beginnings Network? What did you do in year one and where are you guys now?

Maite Garcia:

I think I can speak on behalf of the family navigation piece. I think that year one, there were multiple programs doing a lot of things and they were all doing them separately, but some of them, there was so much overlap amongst all of the programs and there was a lot of duplication of work. There were a lot of families that were in a particular program, so let’s say the health advocates, so they also provide these services to families, but it’s to the general Children’s Health Center. But then some of our families would get a referral to Bridges, so these newcomer families, and then we would also start another social needs assessment.

And so there was a lot of duplication of work and we were coming across the issues of, “well, who is this person?” It seems like they’ve already been helped by a specific person and so let’s do something else. And everyone’s trying to do a lot of things all at once, which is great because that just shows the fire that everyone has at the Children’s Health Center. But because of this, we found ourselves kind of running in a loop and running in a circle all the time. I would say that was year one compared to now, it’s much more collaborative. And I think now all of the programs meeting – if it’s a regular meeting amongst all of the programs to discuss what our workflows are, how we can actually collaborate more together. If it’s a family that is in one program, we at least have knowledge of where they are being connected to and what things are being done so that, a) they can get connected much more efficiently, but then also close the loop and not have families to re-explain themselves or re-explain their stories.

Kathryn Hallinan Aguilar:

Absolutely. I think the other piece… I joined the project a little bit into the first year already, and so I was able to just hear about what were all the areas of focus that the team members were taking on, and I got to join in a few of those projects, which was really nice. In particular thinking about the patient voice work that Dannielle and I have been able to focus more on, the beginning was really just starting to look at what information did we already have, as well as trying to research what are ways that people gather experiences from patients and especially in medical systems, and how has it worked and how does it not work. What are ways that it feels less connected to the very real emotional experience that a family has?

We were fortunate that there had been a project through a different grant that had ended before Resilient Beginnings started that had done a listening project where they met with a number of families and did these interviews, one-on-one, to share deeply about experiences within the clinic setting. I think from that, what we found where there were things that families already shared that we could start on. So there were a couple of small projects that we realized, hey, families don’t know how to navigate a referral for the school district, and the providers aren’t sure how to direct them, so let’s make a guide for that. So we jumped on some smaller projects right away, but then also had this takeaway of, “How do we bring this type of interview-based patient voice to this larger project we wanted to do?” Rather than it being just a survey or rather than it being something where they can push some buttons on a tablet and have that just give us data that we found the individual connection seemed to bring out so much more.

I think that whole process then took a while to figure out, okay, this is what we want to do. How do we actually make it happen and realistically fit it in between the work that we’re doing every day in the clinic already?

Dayna Long:

You mentioned, Kathryn, that you came into this work once it already started. Before you started this work, what did trauma and resilience informed care mean to you and what does it mean to you now that we’re at the end of the RBN journey?

Kathryn Hallinan Aguilar:

Well, I think for me, I came into the work at the Children’s Health Center already with this foundation or framework of seeing the importance of trauma-informed spaces. And that came from my previous work experience where I had been a part of a residential treatment for women and children, one of the first ones in San Francisco, and that was a core foundation of how are we going to do this type of dual diagnosis residential treatment for a caregiver and their child? We need to be thinking about trauma.

I think I came in with one idea of what it meant, but also this thought that I’m not sure how accessible it is in medical spaces. In these larger systems and institutions, it felt so far away, rather than this nonprofit in a home that I was working in. I think through this project and through this work we’ve been able to do together through Resilient Beginnings, it made it all of a sudden feel so much more accessible, this reality of there’s a way to do this that can actually result in change or in transitions and transformation. Not this idea that now everything’s amazing and perfect, but that there are enough people within this system and this space that want something different and we can find ways to collaboratively figure this out together. Rather than the typical ways we do it, which might be attend this webinar once a year and check the box.

I think this made it all feel real and with each of the projects that I was able to support and watching our team members do their work as well, noticing that it was having an impact every day, I could see it and feel it because I’m also working in the clinic every day and noticing people shifting how they were responding in a moment that was difficult or pausing afterwards and trying to reflect on what they needed to do differently or what they needed for themselves that I do feel very much was a part of the work we got to do through Resilient Beginnings Network.

Dayna Long:

I feel like that’s really profound, what you just said, is pausing to feel what did they need to do for themselves? I feel like that’s a really intriguing piece, because so often we don’t think about staff wellness at all. We just plow ahead and don’t realize what we as providers and staff are often bringing to the interactions. What does that look like, to actually pause and to think what do I need to do for myself?

Kathryn Hallinan Aguilar:

I mean, I think we started really small. This was some work I did with Maggie Gilbreth, Dr. Maggie Gilbreth, who’s a part of our team as well and we joined our different teams. We would join the front desk / admin team staff meeting, or we would join the nursing medical assistant staff meeting. We just practiced what it would be to do an intentional grounding activity for 30 seconds or for a minute. We started with this approach of: we’re going to test out a breathing technique. We’re going to test out a ‘humor memory,’ we’re going to test out, and having it be this really tangible, practical thing. And I think that felt a little funky at first, but then realizing people found what helped them.

What it looked like in the moment and what it looks like now is, I see different people walking by who might be like, “Oh my God, Kathryn, that humor memory is what just helped me right now. I just paused and thought for 30 seconds about that time that I couldn’t stop laughing, and it helped me reset to go back in the room.” It was this way in which we tried to test out different grounding techniques to find the fit for each person so that they could start to find ways to embed it in their day.

And the other thing I would say we did is we tried to intentionally practice doing it throughout the day. Rather than it being do a meditation before you start your day or close out your day with it, but how do you make sure you’re pausing in between and doing something intentional to reset, so you’re responding rather than reacting to everything that’s coming up.

Dayna Long:

What’s within the realm of possibility for what those pauses can look like? You just mentioned a couple, like the humor memory. What other types of techniques did you teach people?

Kathryn Hallinan Aguilar:

We tried to touch on all different kinds of sensory pieces. Some things might be physical, maybe it was finding a way where you’re able to do wall pushups, something where you have tension and you’re able to release some of that. Others might be having a seat and really feeling yourself grounded to the chair, to the floor, your feet on the ground. Some of it was around listening, being able to pause and just notice, “What do you hear right now? What reaction do you have to what you hear?” And then various breathing techniques. Trying to be able to do breathing where you might hold it in for longer and exhale for longer and see if you’re noticing a different reaction in your body.

All focusing with this idea for folks on what we’re trying to do is pause enough to notice what’s happening inside for you, and help you to feel like you’re reset so you can function the way you’re wanting to rather than functioning off of some panic or stress or need to get through a moment, which we know often then might elicit some negative response in somebody else or might build up more of a negative reaction from ourselves than we’re wanting.

Dayna Long:

Dannielle, what did it mean to you as a primary care pediatrician to be trauma and resilience informed before you were part of RBN and what does it mean for you now?

Dannielle McBride:

I think before, as I said previously, it meant listening, it meant those pauses, it meant setting aside my agenda to make sure that I’m prioritizing who should be the priority, which is the families and what they need. I think after this project, it feels deeper than that. It feels more… I think before I focused on my one-on-one interactions and now I have a much better sense of what the families experience as a whole, even before they hit the door, even before they come to our clinic, just what those feelings and those emotions. One of the questions we ask is just, “What are your thoughts or feelings around being a black parent?”

For our first round of patient voice, we focused on our black identified families and just even being able to understand what they’re bringing with them, in their own words, I think is, I don’t know. I felt like it even caused a shift in me, where I feel like I understand a bit about what that could look like. It was just a complete shift. I think understanding all the different interactions that happen before they even come to the clinic and how that completely informs what your visit is like, what that connection, what that relationship is like.

I think after RBN, my mind feels expanded a lot more in terms of what it means to care for our families and just how intentional we have to be when we are attempting to support them. We have to have all these things in mind. It’s not a one size fits all, and we have to think about and build that relationship where there can be some vulnerability there, where we hear what’s needed and see where we can fill in those gaps. I think that’s been the biggest shift for me, is still listening, but having just a broader sense of what it means to care for folks.

Dayna Long:

What is the Black Family Listening Tour?

Dannielle McBride:

As Kathryn mentioned, when we first started RBN, they had just finished a listening project, so we had some information just to start off with. There wasn’t any funding or any plans to do anything with that information. And it was kind of like they’ve told us all these things that they need, why don’t we just start there, start to try to address some of these things?

But I think as we were working on that, we noticed that there were a lot of things happening in clinic, a lot of pressure points, that seemed to align with race and ethnicity. And we wanted to do something that allowed us to incorporate a little bit of anti-racism work. I had a little bit of experience doing race-based caucusing in medical education. I was a facilitator for the black identified group of residents and we used to have these protected spaces to do this, and I found them to be really unique and really vulnerable and powerful spaces. And so we had the idea of bringing this to our families.

We started off with our black identified families and thought, why don’t we do these interviews in a way that models that race-based caucusing, where you have a racially concordant interviewer, where you’re talking about the experience of racism, what that is like, and what families experiences have been and how they want to see things change, what things they want to see addressed, what do they feel like they need to feel cared for?

So that’s what we did. We did interviews with families. They allowed us to transcribe and code and come up with themes and ideas of how they want to see their experiences change or just what they experienced in general. That was that project. We presented to leadership and we have plans moving forward to try and change some things. That was that project, and that’s what blew my mind a little bit in terms of all the things that we need to look at and need to be open to shifting.

Dayna Long:

How did leadership respond to the approach that you were suggesting?

Dannielle McBride:

Kathryn?

Kathryn Hallinan Aguilar:

Happy to jump in. I think Dannielle and I tried to put a lot of thought into how are we going to present this to our leadership space, so that it can really be taken in. I think knowing that it is a challenge for people to talk about race, it is a challenge for people to talk about their role within racism and even the ways in which we, as a clinic, are perpetuating that and we as individuals may be doing that on a daily basis. We really tried to focus as much time and energy as we could into how are we going to really get this heard? And so that’s what we did.

We created a presentation where we were able… We were fortunate the families were open to having their voices shared, and so we had recordings of certain quotes and we had captured those into different pockets or groupings of experience. I would say just in my experience joining the leadership space for other meetings, the timing, they would give about an hour and you can present and then we wrap up and let them do the rest of their meeting. One thing that I was surprised by, pleasantly, was we were reaching our hour and Dannielle and I were like, “There’s so much more to say here.” And they said, “Please keep going.” And they gave us the entire time because they really wanted to just be present.

I think we were really fortunate in that our leadership team is at a place where they really want to hear it, and now it’s about helping them think through, and this is the work that I know Dannielle is going to keep holding, is how do we help them know what to do with that and not get lost in just creating a checklist of things that are going to fix it and make it better? But how to really intentionally connect with what they heard, what that meant, and then have some intentional change. But there’s movement. There’s been lots of emails. Dannielle, I know, I’m sure you have lots to share around what will happen next or what potential there is, right?

Dannielle McBride:

Yeah, I completely agree, Kathryn. And just to add to that, it’s so funny because going into that part, it felt like the hard part. It was really emotional for us to do those interviews, to read about those experiences. I don’t think I was prepared for how I would be so affected doing that work, but it’s so funny because now that we’ve presented and are working on steps forward, I’m like, oh gosh, now the real work. That was real work, but this feels like real, real work. This is now we have to use our imagination.

One of the things that came up was, one of the questions alluded to use your imagination. “What would it look like to be in a clinic that basically where racism didn’t exist and you felt cared for and validated”-and a couple other things? You realize, I realized as we started to ask this question that no one knows what that looks like, because the lived experience has been racism. It didn’t surprise me, but it really made me take a step back and realize that in carrying this work forward, it’s going to have to look different than anything else we’ve done. It’s going to have to feel different than anything else we’ve done. It’s going to have to really require just being able to think outside the box and involving our families in that process.

It’s really interesting, because, yes, the presentation happened. They gave us a space to do it, which is amazing, but now comes the part of really pushing the envelope a little bit and really trying some things, failing, taking two steps forward, one step back, and really just engaging in what can be really emotionally challenging and hard for folks. I’m looking forward to that, but also taking some deep breaths as we embark on that next step.

Dayna Long:

I just want you to know, Dannielle, that as you go through this work, you have a faculty advocate in me and I want to help you on this journey for as long as I can. I could talk to you about this for a very long time. I also know that the Black Listening Tour is exceptional. You also have many exceptional projects, like your Family Navigation Project and the Bridges program.

I do want to pivot towards thinking about family navigation in the Bridges Clinic. And my particular question for you, Maite, is to answer, what did trauma and resilience informed care look like to you before RBN, Resilient Beginnings Network, and now, as it relates to the Bridges Clinic?

Maite Garcia:

I think before, considering that we as family navigators are usually the first point in contact for many of our families, we are required to listen. We’re here with our families, that’s the first thing that we are to do so that our families can get connected and then see their medical provider. But it was a checklist, essentially that’s what it was. It was a social needs assessment where we literally would check the box and just write down all the details. And in many of the cases, it’s just speaking to our families and just writing down what they’re saying, taking some notes, what our action plan is going to be, and it was very focused on what’s our plan of action and what are we doing and okay, let’s get them connected here and not really actually holding any of the experiences that our families were telling us.

I think through this process of being part of Resilient Beginnings Network is understanding to really listen. I think both Kathryn and Dannielle have really explained and really stressed the importance of listening with your whole self. And when you’re speaking to families, it’s not just a checklist that you need to fill out, but it’s how do we hold these experiences that our families are holding and what do we do with them? And what do we do with them to build trust with our families? And making sure that what is it that their needs are at this moment, if it’s to get them connected or to be a listening ear or to make their needs known and letting them know that we’ll be with them through the process as well.

I think at the beginning too is, this checklist is for the family that we’re doing. It’s for the family, but now it’s in collaboration with the family, this is the plan that we’ve thought about and we’ve discussed different options that we have after talking about all of their experiences that they hold and now what can we do with this? It’s not just an individual effort as a family navigator, but now it’s much more of a team.

I think as well too, our team of family navigators at Bridges was very much everybody does their own thing. They do their own checklist in their own way, but just make sure that they get the things done and they’re checking the boxes. And now, us as family navigators are discussing what are the experiences that you are holding? How can we support each other to work with each other to support our families better? It’s beautiful to see the process as well of everyone’s doing their own thing and now we’re all in it together and how can we continue to support each other, take pauses, reassess, making sure that we are with our families every step of the way?

Dayna Long:

This approach that you’re speaking of in terms of you used just to have a checklist and it sounds like it’s now a lot more family engaged, what does that look like for you as a navigator or how you train navigators to actually do that on the ground?

Maite Garcia:

There’s a bunch of trainings, there are. But I don’t want to say it’s just a one type of training and that’s it, but it’s meeting at multiple times with our family navigators and then myself as a family navigator. Am I taking the time out of my day to make sure I’m present for this family as well? So before doing the social needs assessment is looking at what information I already have about the family, and now let me take some time for myself to make sure that I’m going to be fully present when I speak to this family and what are some things that I might have to think about when talking to this family?

And as I’m talking to the family, letting it flow like a regular conversation. Instead of saying, okay, I got this information, now let’s move on to this need and what about this need? It’s having some additional questions and before it might have been just, it’s like, do we need an actual script? But now it’s actually flowing of, can you tell me a little bit more about what’s happening here or what’s happening there? Would you like to talk about it a little bit more? Is this an experience that just you hold, anyone else in the family? Because as a family navigator, we’re mainly speaking to parents and caregivers.

Although it’s a pediatric clinic, most of these needs that we’re talking about is with parents or caregivers, and we try to keep the whole family in mind. Everyone that’s living in the same household, we try to make sure that we’re including everyone. It’s not just the patient, but it’s parents and caregivers and other siblings that are in that household, and there are also even siblings that might not be in the household. So how are parents and caregivers working through that as well? So how can we take those pauses, is what I would tell myself as I’m actually speaking to the family, to make sure that all of those things…

And sometimes there would be too much in a phone call that it’s okay, maybe this isn’t something that we can finish all at the moment. Is there a space or a time that you have that we can see each other in clinic? So it’s taking that extra time to schedule a one-on-one with families. Okay, so what are some more things that we can talk about or go through or so we can just get a little bit more information about you and where you stand and where we can best support you. It’s just a lot of trial and error as well. And it’s not the same for every family. Every family has their unique experiences and how can we accommodate the family and how can we work with them to do that?

I think also another thing that I’ll say, there’s different levels of handholding, that I would say, as a family navigator. And some of our families, maybe it just might be a light touch, just a light touch is comfortable for the family, and there are others that we might need to do multiple check-in points maybe multiple times of the week. I mentioned, it maybe a sit-in. Or maybe at the time is also giving the family space to process all of the things that we’ve discussed and letting them know, “When would be a good time to check in again to discuss these things?” Really putting the family at the forefront and making those accommodations for the family.

Dayna Long:

Resilient Beginnings Network is a collaboration. We believe in partnering and collaborating and not reinventing the wheel and having this attitude that “I need to figure this out for myself.” Is there any advice that you have for listeners who want to have a similar approach as you?

Kathryn Hallinan Aguilar:

I guess something I would put out there is, just how important it was to have teammates, to have people within the clinic space within our Resilient Beginnings team that wanted similar things. Knowing that, okay, I’m not the only one trying to go into this. So I guess for other spaces to think through and look for the people in your setting that maybe you are aligned with in some way or that you can see opportunities for this connection around an issue, a need, a worry, a concern, or a desire. Because I think so much of that was helpful for me, to know that I could lean on and reach out to and work through and talk about all of this with Dannielle, with Maite, with Dominique, with Maggie, that there are just ways in which we were holding each other to keep moving forward even when it felt really hard.

Dayna Long:

That’s relationship building, this whole notion that relationships are healing and they also can accelerate the work that we all want to do. What are the next steps for the Children’s Health Center?

Maite Garcia:

Sorry, can I add one more thing to that previous question?

Dayna Long:

Please do.

Maite Garcia:

Similar approach. Something I actually would advise as well is, reminding yourself that every person’s experience is their own expertise. I think sometimes we forget this because we come in with our own agenda and as well, this is specifically to family navigators as well, is we try to say, oh, they need all these certificates. They need all this training to be able to serve their families, when there’s so much success already in our community members being our own family navigators, that they’re the closest to the ones with our families. So recognizing that their own experience is their own expertise as well, which is amazing and really powerful in the work that they do.

The other thing I’ll also add is with this idea about using workflows is, of course I would advocate not creating your own workflow, but even though there are some models that already have existing workflows, I think there’s going to be a lot of tweaking and editing and how do you sit down together? So I would say even getting all of those stakeholders involved in a meeting to be able to discuss what works for you, what doesn’t work, what are the connections that you currently have, and what are some referrals that we can already use and grow upon?

Kathryn Hallinan Aguilar:

As you’re saying that, Maite, it also reminded me of this, I guess, for other spaces to be comfortable with the idea of the reality that there’s going to be lots of ruptures and opportunities for repair, and that that actually is incredibly healing as well, to be willing to keep trying and failing, knowing that we can then put some time into repair and trying again.

Dayna Long:

I actually think that’s great for the advice that you have too, is understanding the rupture and the repair. It’s a necessary part of healing. Last words from any of you?

Dannielle McBride:

I will just say that this has been such a great opportunity. It has really allowed, I would say, all of us to take a step back and think more deeply about how we’re caring for our families, how we’re supporting our families. It’s been really special to be able to do it as even our nuclear team, but then as a larger team of all these other clinics, and just to have a sense that there are other folks and other people engaged in this work and that we’re not here on an island. There are folks who are really pushing the envelope when it comes to building up our families. I think that that has been one of the things I will definitely take away from these last three years of working.

Maite Garcia:

I’ll add that I think being comfortable that things might not be moving incredibly as quickly as we would like. Some things are going to be very slow to move and it’s just going to require some patience to be able to wait. Okay, when is it that we can actually think of doing something more or implementing this and seeing that. I think at the first phase Resilient Beginnings Network, I was very anxious of, okay, when are we going to start? When are we going to start? And so being patient with starting to start changing some things and now, as I look back I’m like, oh my gosh, there’s so much change that we’ve already done and we’ve already been able to do so much with the way the Children’s Health Center now works and is going to be implementing more family navigators and across all hospital medical records and can actually use the databases and that’s fantastic. Where at first I was just very anxious of when is something going to happen? Just being patient with that, it’s beautiful to see the transformation.

Kathryn Hallinan Aguilar:

I guess I would add my appreciation for the project and the opportunity itself. I think it’s so easy to get lost in the every day of clinic and the overwhelm of what I face when I’m meeting with families and when I’m working with my colleagues. This Resilient Beginnings Network gave me an opportunity to still nourish myself in growing and in trying to find ways of healing and in trying to find ways of connecting outside of the day-to-day. Being able to show up every day, keep doing what I needed to do, sometimes that was harder, but knowing that there was this other work I was able to do to really try and change how that felt every day. I think that just, I will absolutely miss that piece. But I know as Maite has said, there’s so much change that has happened and there’s so much that I can see different already in our clinic.

Dayna Long:

Thank you all so much. That was amazing. You guys are just such special people.

Health Pilots podcast outro:

Thank you for embarking on this episode of Health Pilots hosted by the Center for Care Innovations, with podcast production services by Wayfare Recording Company. Special thanks to Dr. Dayna Long, the Resilient Beginnings Team at CCI, Trauma Transformed, and the featured pediatric care team that has joined us today.

Check out this episode’s show notes for relevant links, resources, and opportunities! And, if you like what you heard, please spread the word – we’re available on all major platforms and be sure to subscribe where you listen to podcasts.

For more information about the Center for Care Innovations or for upcoming programming, events, and funding opportunities, please visit our website – careinnovations.org – and connect with us on our socials: LinkedIn, Facebook, and Twitter. This is Wes Gabrillo at the Center for Care Innovations, and we appreciate you tuning in. Catch you on the next episode of Health Pilots!

                          

                           

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