Podcasts about Quality management

Do you have an idea for a podcast episode?In this episode of the Talking Pools podcast, hosts Steve and Rudy discuss various aspects of pool maintenance, including the challenges of maintaining pools on cruise ships, the importance of water quality management, and effective strategies for preventing and treating algae. They also delve into the role of phosphates in pool chemistry, the necessity of regular inspections, and the complexities of health department regulations. The conversation wraps up with insights on pricing and value in pool services, emphasizing the need for transparency and expertise in the industry.takeawaysCruise ships often raise chlorine levels to manage pool safety.Regular water flushing is essential for pool maintenance.Brushing is crucial for preventing algae growth.Phosphates can contribute to algae problems but can be managed.Health department regulations vary significantly by state.Regular inspections can prevent costly pool issues.Communication with clients about pool conditions is vital.Pricing in pool services can vary widely based on expertise.Understanding water chemistry is key to effective pool management.Preventative measures are more effective than reactive treatments.Sound Bites"The solution to pollution is dilution.""Brushing is the most important part of this.""It's not a problem until it's a problem."Chapters00:00Introduction and Guest Appearance01:45Cruise Ship Pool Maintenance Challenges07:34Algae Management and Prevention Strategies12:46Understanding Phosphates and Water Quality19:51Testing and Diagnosing Pool Issues25:03Best Practices for Pool Maintenance30:10Innovative Solutions in Pool Care31:29Phosphate Management in Pool Care32:49Understanding Customer Expectations and Pricing34:14news-ting-6832.mp3 Support the showThank you so much for listening! You can find us on social media: Facebook Instagram Tik Tok Email us: talkingpools@gmail.com

In this episode, Doug Hall, founder of Eureka Ranch and Brain Brew Distillery and a recognized innovation expert, discusses his book, "Proactive Problem Solving." He shares practical strategies for identifying and resolving challenges using systems thinking. Inspired by Dr. W. Edwards Deming, Hall emphasizes engaged leadership and empowering those closest to the work. The conversation focuses on moving beyond simply fixing problems to proactively preventing them.

In this episode, Carmen Bellebna will share with us the journey of deepeye Medical to implement the EU AI act requirements in parallel with the EU MDR certification. We will review first what is the AI ACT for those that are still not aware and also all the challenges that deepeye went through to be able to get the EU MDR certification.  Who is Carmen Bellebna?  Carmen Bellebna is a Regulatory Affairs and Quality Management expert at deepeye Medical, a medtech company pioneering AI-driven solutions for ophthalmology. With a strong background in implementing EU regulatory frameworks, Carmen has been closely following the evolution of the Artificial Intelligence Act (AI Act) and its intersection with the Medical Device Regulation (MDR). She has played a key role in integrating AI-specific compliance strategies into deepeye's QMS, ensuring alignment with both MDR and upcoming AI requirements. Carmen recently delivered a well-received presentation at the Outsourcing in Clinical Trials (OCT) conference in Munich, where she shared hands-on insights and practical tips for operationalizing AIA obligations within a regulated medtech environment.     Who is Monir El Azzouzi?  Monir El Azzouzi is the founder and CEO of Easy Medical Device a Consulting firm that is supporting Medical Device manufacturers for any Quality and Regulatory affairs activities all over the world. Monir can help you to create your Quality Management System, Technical Documentation or he can also take care of your Clinical Evaluation, Clinical Investigation through his team or partners. Easy Medical Device can also become your Authorized Representative and Independent Importer Service provider for EU, UK and Switzerland.  Monir has around 16 years of experience within the Medical Device industry working for small businesses and also big corporate companies. He has now supported around 100 clients to remain compliant on the market. His passion to the Medical Device filed pushed him to create educative contents like, blog, podcast, YouTube videos, LinkedIn Lives where he invites guests who are sharing educative information to his audience. Visit easymedicaldevice.com to know more.  Link Carmen Bellebna LinkedIn:  https://www.linkedin.com/in/men-be-a1828a81/   Social Media to follow Monir El Azzouzi Linkedin: https://linkedin.com/in/melazzouzi Twitter: https://twitter.com/elazzouzim Pinterest: https://www.pinterest.com/easymedicaldevice Instagram: https://www.instagram.com/easymedicaldevice Authorized Representative and Importer services:https://easymedicaldevice.com/authorised-representative-and-importer/ 

In this episode, we sit down with Shaun Hastings ( a seasoned quality assurance and compliance expert with two decades in pharma and clinical trials) to unpack the most pressing data protection issues in healthcare today.From cross-border consent complexities to AI risk, Shaun offers a behind-the-scenes look at the hidden privacy gaps most professionals overlook. Whether you're advising healthcare clients or shaping internal governance, this episode is packed with insights to future-proof your practice.Discover:Why pseudonymisation isn't enoughThe real cost of ignoring incident responseAnd how to simplify staff training that actually sticksListen now. Shaun Hastings is a powerhouse in quality assurance and compliance who has spent the past twenty years transforming data practices at pharmaceutical companies and research organisations. With a master's degree in Quality Management from Cranfield University, Shaun has developed comprehensive SOPs and led quality teams through complex compliance challenges.Connect with Jamal: https://www.linkedin.com/in/kmjahmed/Connect with Shaun: https://www.linkedin.com/in/shaunhastings/

In this episode, host Gillian Bowen explores the cutting-edge advancements transforming the audit profession. Joined by Steven Watson FCA, Managing Director at National Audits Group and Masood Mehmood FCCA, CA, CA ANZ Senior Policy Advocate - Reporting and Assurance, the discussion looks at how Gen AI, automation, and other innovative tools are changing the audit process, enhancing efficiency, and ensuring higher quality outcomes. The discussion also addresses the opportunities and challenges for audit firms, especially smaller-sized practices, and highlights the new CA ANZ resource, Audit and technology playbook: A practitioner’s guide. Find out how to stay competitive in a tech-driven environment and gain valuable insights from our experts. Resources referred to in this episode: Audit and technology playbook: A practitioner’s guide Acuity article on the guide CA ANZ Cyber Security Playbook CA ANZ’s Certificate in AI Fluency CA ANZ’s micro courses Exploring the IESBA Code - A Focus on Technology guide IESBA’s Technology-related Revisions to the Code IAASB ISA 220 (Revised), Quality Management for an Audit of Financial Statements IAASB ISA 315 (Revised), Identifying and Assessing Risks of Material Misstatements International Standard on Quality Management (ISQM) 1 See omnystudio.com/listener for privacy information.

We're celebrating a major milestone with the return of our very first guests: Kristen Mackey, Director of Arizona Combined, and Natasha Jerde, Director of Minnesota Blind. As Vocational Rehabilitation leaders navigate rising demands, shifting funding, and major structural change, Kristen and Natasha join us again to reflect on the post-pandemic landscape—and how it's testing directors like never before. From managing centralized services to sustaining staffing under fiscal strain, they share the real-world challenges that keep them up at night—and the strategies they're using to adapt. With transparency, persistence, and a mission-first mindset, these leaders dive into: ·       Navigating state and federal priorities ·       Responding to workforce volatility ·       Staying connected to data and purpose Their insights are a must-listen for anyone leading in today's VR environment. Tune in and be inspired to lead with clarity and resilience.   Listen Here   Full Transcript:   Natasha: Our program income is significantly dropping. The inflation, the cost of services. We've had four and a half and 5.5% salary increases with no additional state appropriations. So all of these things together keep me up every single night.   Kristen: We want job placements, we want employment, we want independence. If somebody's saying increase your job placements, fine, we can do that. It's how do we then take what they're giving us and make it not be a distraction, and we can mold to the thing that they want, but still do it at the base level.   {Music} Intro Voice: Manager Minute brought to you by the VRTAC for Quality Management, Conversations powered by VR, one manager at a time, one minute at a time. Here is your host Carol Pankow.   Carol: Well, welcome to the manager minute. Joining me in the studio today is Kristen Mackey, director of Arizona Combined, and Natasha Jurdi, director of Minnesota Blinds. So how are things going in Minnesota, Natasha?   Natasha: I think the Minnesota word for today is going to be interesting. It's interesting. How about I leave it at that and I'll talk a little bit more as we dive into the questions.   Carol: Awesome. That is interesting. I want to know about that. How about you Kristen? How's it going in Arizona?   Kristen: You know what? I think I might steal Natasha's word. There's so much happening. We're trying to keep managing and keep abreast of all of the changes that come out on the news and everywhere, trying to keep centered and just keep doing what we do to get the work done. It's been a lot of fun.   Carol: Well, I couldn't think of two better people to bring on because this is super exciting. This is actually our 50th episode of The Manager Minute, and I couldn't think of a better way to celebrate the milestone than by bringing back my two incredible guests from episode number one in May four years ago. It's so crazy. And back then I just laughed. We were diving into the world of post-pandemic VR. What's it gonna look like? How are we going to navigate all these changes? You guys were working on things like electronic signatures and how you equipped your staff, you know, to work remotely and all of that. So a lot has changed since those early days, and I'm excited to catch up with you both to see how far that you've all come. So just reflecting back to my time as a director, I remember many a sleepless night and Natasha can attest to that. I remember coming to a meeting like, I don't sleep at night and I keep a pad of paper by my bed. And it was so funny. I heard a director tell me they did the same thing. This was a month or so ago. They were like, you know, I keep this pad of paper by my bed because, you know, we were worried about so many things. There was WIOA implementation back then, and we had a less than stellar monitoring report and a financial picture that was super tough and it just wasn't very pretty. And so I kept that notepad because in the middle of the night was always my best thinking I'd wake up, I'm like, oh, I gotta write this down. And so I can remember in the morning. So I know now, four years later, from talking to you all last on the podcast, the pendulum has certainly swung in a new direction, and I'm really eager to see how things have evolved for the both of you. You know, like what's changed, what's stayed the same, and what lessons have you learned? So let's dive in. So, Natasha, will you kick us off and just give our listeners a little snapshot about yourself and the agency that you lead?   Natasha: Sure. So I have worked at State services for the blind since I was a baby intern 2008. I have been a deaf blind counselor, a supervisor, the director of our policy and program administration, and I became the director in August 2019. Our agency, we have about 140 staff across the state. We have a Voc Rehab program, an older blind program, our Randolph-sheppard program. But we also have a communication center where we do braille audio transcription and have a radio reading service. So we have a little bit of everything at State Services for the blind. We've grown a bit since 2019. Yeah, there's a lot of fun.   Carol: It is a lot of fun. Blind agencies are always near and dear to my heart. And since I came from Minnesota blind, Natasha knows that I just love that whole variety and all of the work. It's so fun. Kristen, how about you give our listeners a little snapshot about yourself and the agency that you lead?   Kristen: Sure. Similar to Natasha, I started as a VR counselor in the field transition. That was my first job in first entrance into VR. I moved into policy manager policy and then became the director of the Arizona Combined Unit in 2016. Arizona is combined and we are also under a safety net agency. All of the VR, IL OIB, BEP is in a division. That division is in a department. So our DSA is really rather large and we are kind of shuffled 3 or 4 deep down. So we have enterprise services, shared services, which makes things a little bit more difficult to manage than it was when I started the job, when we didn't have some of those other items. So it's been a learning lesson and trying to figure out how do we get done what we need to get done with all these people involved now.   Carol: Yeah, your structure makes me nuts. I'm just saying, full disclosure, but having gone on site with you and your team several times, I'm like, what? You have to always explain. We had DIRs and we have this other thing and all these different levels. I'm like, oh my Lord, I just don't even know how you do it. So I know there's been a lot of big changes since we spoke last, so I'm going to kick it to you first. Natasha, what are some of the biggest changes you've seen in your program since we last spoke?   Natasha: I was actually talking to one of my outreach coordinators, Lisa Larges, and she's like, I think you brought some bad juju because the timing when I started and then everything that happened since I started has just been wild. So since we last met, I've experienced a global pandemic, a civil rights movement that essentially started literally down the street and around the corner from our headquarters. A roller coaster ride of funding at both the federal and state level. We went from having too much to now we don't have enough. We have a new federal administration with very different priorities than we have seen before. We have settled into this new hybrid work, which isn't new anymore. It's kind of our new normal. It's just been, I think you name it, it has changed or it's different or it feels different or it looks different. I think the biggest question right now that we're all faced with is, in light of all of these changes and challenges and opportunities, how do we maintain the integrity of the program, continue to provide high quality services that get people into competitive careers and retain the staff that we have worked so hard to get. While these past few years that's been a focus of a lot of our agencies is how do we recruit? And now with everything happening, is all of that recruitment efforts going to go to waste?   Carol: You know what's kind of funny when you talk about that? Because I look back to when I started at SSB, you know, and so in 2013 I become director. You go at the very end of the year, I was the interim and then made permanent in 14. And you just go, okay, I thought I brought bad juju with me to because WIOA went into play and then we had all this wacky stuff going on. We owed all this money for the case management system. So now, you know, just hearing you, it's like, well, maybe it's just the cycle of the program. Like there is no spot in time where everything is ever just copacetic and all smooth sailing. I think it just continues on.   Kristen: I think that I really feel like that's so good to remember because I think you can in this position, you can take a lot of things like, oh my gosh, am I not doing this right? What skills don't I have? How am I not doing this, that or the other. And it just is a constant. Like it just changes constant. And you have to constantly readjust your focus and your priorities and your strategy. And so it's helpful to remember that our environment is constantly changing at state and federal level. And we just have to be able to manage and navigate and not beat ourselves up over it.   Carol: Oh, that's a super good point. Natasha's going to laugh at this, but I'm actually going to hold up so our listeners won't see it. But I still have my Strengths Finder. So we used to always do strengths Finder at SSB. I still have my top five strengths. And staff used to ask me one of them is adaptability. So my fifth strength was adaptability because people would be like, how can you just roll with the flow? Like you need to just tell like Central Office, we're not going to do that thing that they want for the legislative session. And I'd be like, okay, we're going to pick our battles. That is not the battle we're going to pick right now. We're going to answer the question they need, because the sooner you do that, you get that off your back and then you get back to your business and do your things. And so for me, it's easier because in me is adaptability. I've always been able to kind of go with the flow, whether administration changes or, you know, any of that, where that is more difficult for other people when you want things to be very set and it's hard for you to pivot and make that move. So, Kristen, what are some of the biggest changes you've seen in your program in the last four years?   Kristen: Wow. Well, as I indicated, the state was kind of in that move and shift to centralized services, you know, some of those shared service models. So, you know, it started with our training department and, you know, but we got to keep our policy and we got to keep our contracts and procurement. And the next thing you know, like air moves out and then, oh, we're going to move out all of your facilities management. And so slowly, piece by piece, the staff that you had working with. You have been now pulled to a different reporting structure and a different requirements to do their job. And so when, you know, we used to have a staff of like 500 people that were fully dedicated on board, directly connected with me, I had direct relationships with them. I was able to really work with them. And over the last five years, I've seen that direct connection and relationship with people fade out because those folks are no longer in those positions. They've graduated or moved to other things. They didn't stay within the agency. So, you know, within our VR program, IOB program, BEP, those program staff super dedicated and want to really fulfill the mission of the work in serving individuals with disabilities. And then we have all of our shared service team dedicated to their job to don't necessarily have the same focus on the mission and the outcome of serving individuals with disabilities. It's been very difficult to try to figure out how to play nice with them, because they got to do stuff for you, right? I need you to manage my budgets. I need you to manage my contract. But I also, you know, don't quite like the way you're doing it or you're not doing it fast enough or you're not following my vision for how that would work. So it's just been a real challenge to see how to grow and manage the different structures that are in play now.   Carol: I think you hit the nail on the head on that with that centralization, because it's happening across the country. I mean, we see it everywhere. Every director like just struggling as your people move out from under you, whether it's the IT, the HR, the whoever you had. And now they're centralized, which Congress allows. It was written in the rehab Act, like you can structure that way. But they lose that connection to the mission and what you're trying to do. So when you're doing that work sort of in isolation of what's the end game and how you impact, you know, the staff person having their computer so they can do the work with the customer. You don't see that urgency in it. So it's like, yeah, so we get to you in two weeks, you know, really need your computer or whatever. It's just hard. It makes the job so much harder. So I know not only those changes have happened, the financial landscape is shifting drastically for the VR program. How has this impacted your ability to serve individuals? And Kristen, I'll send it your way first.   Kristen: We've been fortunate in that Arizona with the formula grant. You know, we still receive a little increases every year. So the not getting the cost of living this last year was not as impactful as it had been to some other agencies. So I do, you know, knock on wood for that a bit. Now if that continues we're going to have another, you know, constantly evolving story there. We have had to take a look at for our cases. How do we spend more money faster. And that's been again the challenge of working with shared service opportunities is, well, they don't have capacity to put these contracts in place that I need in order to be able to spend the money that we have, right? We have been successful in keeping it in the VR bucket, but now we need to spend it on our consumers and our clients. But I need a contract to do that and don't have the resources or the capacity from that team to be able to put that out the door. So it's super challenging to know that you're sitting on money that you could spend and do a lot of good things with, but there's then that external factor of not having the capacity to put all of that together to get that money spent.   Carol: So you're in actually a pretty lucky position. You know, other people listening to this podcast are going, What? Kristen Mackey, you've got all this, you've got all this money. Because almost all the calls I get on a daily basis with my list of people all going on the order of selection, I keep a little sticky note, you know, and everybody calling and just frantic. They are literally like tapped out. There is no money, but yet you're trying to spend your money and you don't have the resources to really help you get some of the plans in place.   Kristen: It is challenging, but I feel fortunate that I'm challenged on that end of the spectrum versus the end, where there's not enough money or capacity or staff resources. One of the other pieces, too, is, you know, in this current landscape, budget wise, can't bring on as many people as we would like to, you know. Can't do all of the support services that we or support staff that we would like to. So downsizing your footprint, right? All of that, those are our major expenditures. And we're asked to shrink that. It creates a really kind of a nightmare for projection and and budgets all of that.   Carol: Oh, 100%. How about you, Natasha? How's the finances looking at SSB?   Natasha: It's getting tight. It's getting tight. We were on the other side of that a few years ago. We had more money than we could spend, and we used that as an opportunity to do things that we've always wanted to do or needed to do, and we never had the funding to do it, but we always did things that we could course correct quickly on them or aren't forever. So we didn't make a lot of permanent decisions with that money because the writing was on the wall. We knew that once the pandemic shifted, we were going to see an influx in applications. Inflation was already on the wall that prices were increasing. So we made some, I think, pretty strategic and smart decisions with the money we had and how we spent it. However, it's still tight because we are getting an increase in applications. The cost of services is increasing. We ended our order of selection September 2021. I have no desire to go back there for me. I don't even want to speak it out loud. I know it's an option. I know I may need to use it one day. I can't say never, but I don't think that is the best direction for us because people need our services just as much as before, if not more. And for individuals who are blind or low vision or deaf blind, there really aren't any comparable options available, at least in Minnesota. And we're here for a very specific reason. And so I have always said it's my responsibility to ensure that we can continue doing what we are here for. That may mean that services are going to take a little bit longer to get started. We are increasing our supervisory oversight. We have a ton of financial reports, which I'll talk about in another question that have helped us get ahead of sudden spikes that we're seeing so we can do those course corrections. This also may mean that we're not backfilling or we're freezing some of those positions for a little bit that aren't essential. I'm using the term we're going to freeze, flick or fill, and every position that's our litmus test will freeze it, meaning we don't need it right now. It's not essential for service delivery. We'll revisit this. Flick means you know what? This position really isn't serving its purpose anymore. Let's figure out a different way of doing the work or fill. And we've prioritized counselors and VR techs and anyone doing direct service provision. But it's also all of this is going to force us and continues to force us to find new ways of doing things, which I don't think is a bad thing. One of the goals I've put in place this year is that all of the extra noise. You know, that can happen when you're working in a state government agency. Things that pretty much distract you from what you're supposed to be doing. My goal is we don't do those things if it doesn't stem back to our mission and actually help people get jobs or live independently, we're not going to do it. And I told that to the commissioner's office. You can ask me all day long to do all of this extra stuff, but it's not serving a purpose for us. I'm sorry. I'm not going to do it. And they've been okay with it so far.   Carol: That's awesome. Until you get a legislative request that they need you to answer in ten minutes and analyze.   Natasha: Yeah, I can't say no to those. Yeah, all these extra work groups and task forces and let's do this and that. We got other things we gotta do.   Carol: So what's the biggest thing, Natasha, that's keeping you up at night right now? Because I know there's always something, something is niggling somewhere. What would you say is the biggest thing keeping you up at night?   Natasha: Well, I have a few, but the biggest one is that. So we're not a combined agency. We have a separate general agency and that separate general agency is an incredibly tight budgetary situation. I would go so far as to say they're in a budgetary crisis, and because match maintenance of effort and carry forward determinations are at the state level, not agency, it is very possible that their constraints will impact our funding. And specifically I am very worried are Carryforward is in jeopardy. And we had a scare where we had a very high chance of losing all of our carryforward this last end of the federal fiscal year. Because of those budgetary constraints, the general agency is doing workforce reductions and doing layoffs, and they have the same type of staff classifications that we do. And we are a union state, which means bumping, which means my staff are in jeopardy. And so I'm up every night between 2 and 3 a.m. thinking of ways that we can help in any way possible. Our program income is significantly dropping. I think I've heard other states experience something similar. The inflation, the cost of services. We've had four and a half and 5.5% salary increases with no additional state appropriations. So all of these things together keep me up every single night trying to figure out how do we sustain.   Carol: Now they're going to keep me up at night, too, because of course, I worry about you all. And of course, I really worry about SSB. So I always hold that near and dear to my heart. But oh man, that is a lot. But I know you instituted some things, though, between you and the general agency, just to make sure you guys were communicating better about those financial reports and such, didn't you? Like, what did you do?   Natasha: We have an amazing relationship. We review our federal reports together. I sat closely with the VA's fiscal team, walking through what I know about the fiscal processes, the federal regulations. That's something that Carol taught me very well. I understand it quite well. So we worked hand in hand. We've been doing that since October.   Carol: That's good. Good stuff. How about you, Kristen? What's keeping you up at night?   Kristen: We had a recent monitoring that monitoring. We get through it, Right? And, you know, you haven't always have an inkling of things that need to be fixed and things that we should address, right? And sometimes those get shuffled because priority is whatever. So we had the monitoring very much highlighted certain areas that we need to address and take care of. And one of those was our fiscal management and continue as managed outside of my direct staff and even two and three layers above me. So it's one of those concerns of like, I wonder what's going to happen next. I never quite know what the fiscal situation is going to be. Emails flying around, you know, I'll get an email at the end of the day and it's I need more information. What is this about? How did you come to this conclusion? Who was involved in making this decision? It's kind of just a plethora of items that, you know, any given night, and mine is usually between 3 and 4. Like, oh, wake up and go like, oh, shoot, that sticky note fell off the roster somewhere. I need to go and send that email or this project. We started it, but now it's like kind of hanging, languishing. I need to poke somebody about getting that back on the roll again. I don't know that it's one specific thing, but it's just kind of just the size of the job is not a 40 hour a week job. It is a all encompassing. I dream about work. I it wakes me up at night, you know.   Carol: Well, my newest trick with not having my notepad beside my bed, but I actually been waking up more just because I've had so many more phone calls. Things have been really crazy lately with our fiscal team and people just reaching out. And so maybe end of the day or, you know, people's time change, you could get a call from Guam. You know, it's a way different time. So people are calling all the time. So now at night when I wake up, I text myself, you know, a note like, just so I remember, like remember to get back to so and so tomorrow. So now I just am picking up my phone. I don't have the pad there anymore, but I had two messages from last night for today that I didn't want to forget.   Kristen: I sent texts because I don't put my work phone by my side, but I have my personal. So my work cell phone is embedded in my personal and I just send text to myself.   Carol: Yeah, my work and my personal are all together, so it makes it a little challenging. So I know we're going through an administration change on the federal level right now. And a lot of state administration, you know, that changes every four years to with governors, sometimes you keep a governor twice in a row, but a lot of times not. And it will bring these shifts in priorities and just all of this change. How do you guys navigate and adapt to those changes, whether it's on the state level or federal level, when you're approaching your work? And I'm going to kick that to you, Natasha, first.   Natasha: I think the biggest thing, at least for us, has been a lot of communication and transparency, not only with our staff, but our customers, our community partners and stakeholders in the face of unknowns. People look to steadiness and information even if you don't have a lot to share. The absence of information often speaks very loudly, and people will fill in the blanks, sometimes not in a way you want them to. So we are communicating frequently, even if we don't have information. People look to me, am I panicked or am I calm? And know if I am panicked, it will not be good. People feed off of that and so I am always calm. I am always just. I can't guarantee or promise anything, but I can say we're in this together and I remind everyone why we're here. We have a mission. As Carol knows, the mission is on the wall. We look at it frequently and nothing has changed. No matter what happens federally or at the state level, that mission has not changed. We have proved that during a global pandemic. VR agencies are adaptable, creative for us in Minnesota, SSB was one of the first agencies, if not the first, allowed to go back into people's homes and provide services. That's because we know how to do things quickly and strategically to respond to whatever comes our way. We don't wait for people to tell us what to do or how to do it. We take charge and we lead the way. And I feel that is how VR is across the country. We tend to be leaders in faces of crisis and urgency. We tend to step up when others don't.   Carol: Yeah, good advice. That's all good advice. Kristen, how about you? Because you've had major shifts. I mean, you've already alluded to this, this whole like take away your people. And that's been all shifts in the structure within the state government and such. You know we've got the federal different priorities. So how do you navigate and adapt to those changes in your work and for yourself, even, like how are you taking care of yourself through all this.   Kristen: Being able to adapt the work that we do? Natasha says that we have a mission. We have a very clear outcome that we have whatever side, whoever's telling you what they want to do or how they want to do it. You need to be able to mold what that strategy looks like so you can speak to it. And I always talk about it. It's a spin. I don't like the terminology of spinning, you know, for the sake of trying to hoodwink anybody or not be transparent. But at the end of the day, we want job placements, we want employment, we want independence. So if somebody's saying increase your job placements, fine, that we can do that. It's how do we then take what they're giving us and make it not be a distraction and we can mold, you know, whatever we're measuring to the thing that they want, but still do what we are doing at the base level. And so I do feel like that's really part of our job as leaders is to and Natasha spoke to this earlier is take that noise and then see how we can like get it to stop with us and push it back in a way that still supports the work we're doing, whatever comes to us in terms of work group where you need to measure this, or we want some kind of change in X, Y, or Z. Okay. I can give you this back that will meet your needs. And it doesn't change or distract from what I'm doing in our department or in our programs. I think it's just being flexible in your thinking, being able to not have to have a certain way of approaching things, because you got to understand what that landscape is. You got to speak the words that they're speaking in order to get them to listen to you and kind of play with you so that we can all get to the same end goal.   Carol: One thing I've seen from you, Kristen, just working with you these past years in my TA capacity is I'm like, I love your persistence because you've had to navigate this really tough, internal, weird structure. It just is weird. And you are super persistent in messaging. Okay. Like you send a message to this person, oh, I'm not the person. Okay, then who is the person? Okay, I'm going to go to this person and you will not let it go till you find till the end the little trail of crumbs you get to and you're like, all right, I'm finally getting to the person because I have to get this thing answered. Some people just give up. They're like, oh, I don't know. And then staff ask and you're like, well, I don't know. We don't know who's doing what. Oh not you, you. You don't let that happen.   Kristen: That is one piece of advice I give to people when they come on. This is a state government, federal government, there are all sorts of red tape, barriers, hoops. Everything will get in your way if you let it. You're going to have to be persistent. Don't get jaded with it. Don't give up. Just know that you're going to have to be persistent with getting to the thing that you want to get done.   Carol: So switching a little bit. There's a lot of different structures in hiring VR agency leaders. I mean, you can be a political appointee. You can be more of a career professional where maybe you have some protections, maybe it's not a full blown union, but you got something. And we've had 14 new directors in the last less than ten months. Again, 14 new directors in VR. You know, people don't always realize like, how does that and each of you represents a different bucket here. How does that distinction, whether you're a political appointee or you have a little more protection influence your agency. Kind of how you approach the operations and your decision making. And I'll ask you first, Natasha.   Natasha: I am a career professional. I'm the highest level you can go before you start hitting the politically appointed positions. So that means I get the privilege of bringing some stability to the agency. Granted, that doesn't mean I can't get fired or laid off, but I am not politically appointed. So when the administration changes, I don't change with it. So that means staff can expect some consistency, and they don't have to wonder who's going to be coming in now to shake things up with their own ideas and views. They know what my priorities and goals are. They know how I work and they know what to expect. And so I have the luxury of time to create a culture that will sustain anything that comes our way. I have the time to develop that succession plan, offer professional development and mentorship opportunities. But when I was thinking of this, I can see the value of Having fresh new faces, coming in with different perspectives and experiences, and that they may have a better idea for how we do things. You know, we talk about people who have been in the position for 30, 40 years. Is there some value to having that new life coming into an agency? So I recognize that being a career professional could also be a limitation of mine, which means that I really need to surround myself with people who think differently from me, and I can't get stagnant.   Carol: Yeah, that's a really good point. Although there are very few 30 year or 40 year career leaders in the VR program anymore, I think we got Diane Delmas out in Vermont and Greg Trapp, those are the two I always think of. Otherwise, boy, people have been coming and going pretty fast, but that is good advice because you can get a little stuck. Now, Kristen, you're on the other end of the spectrum because you are a political appointee.   Kristen: I am not a political appointee, but I am an at will employee.   Carol: Oh, you're an at will though.   Kristen: Yeah,.   Carol: So it's very similar. So you're an at will person, does that impact you at all, like in decision making or as you go about doing your job?   Kristen: Well, certainly. You think, you know, is this decision going to make me the scapegoat for something that goes south, right? So, you know, it does impact my thinking. I don't let it impact whether it's right or wrong. To do that is just my base. You know, you just have to have that gut kind of commitment to. This is what I said. It's the truth. I don't have any qualms about how I do the work or the transparency that I have in the work that I do. So keeping it all above board, hope that that serves you in the end. Natasha, you had a very positive outlook on new people coming in. In my tenure, I've experienced a lot of changes in different people at different levels coming in and not having any idea about the rehabilitation programs that we run. And so it is a kind of a continuing education of individuals who are coming and going to have them see the value of the programs and the way that they need to operate.   Carol: Yeah, I appreciate that. So let's look a little bit at kind of leveraging both of you like this leveraging your data. And we're kind of skipping around a little bit here. But how do you guys like to leverage data to inform your financial and programmatic decisions? Now remember we've got a lot of new directors. We have listeners out there that are they don't know we I get this question all the time. You know, we talk about data informed decision making. People are like, yeah, we talk about it, but what does that mean? And how do you really do it in practicality? So Kristen, what would you say do you have like an example or how do you like to best leverage data when you're looking at making decisions, whether programmatically or financially?   Kristen: Just because I have a little bit more programmatic data that I have access to and ability to manipulate, we really look at that in terms of, you know, when we're setting our annual strategic goals, what is our five year goal? Take a look at what have the last three years look like. You know what the percentage of increase or decrease is? How are we adjusting those things? Use the data to understand where are the gaps, what's not working, and something we expected the needle to move and it didn't. What's not working in that process. And so you know, what lever do we pull to say this is going to be quote unquote a countermeasure for that thing, and then measure that data over the next three, six months. And if there's a change, then we can kind of understand then did that work or didn't it work? I think far too often in our workforce we say, well, this is a problem, but we don't really have any data around it. Should we gather a ton of data for the program to being able to use that data to help inform what decisions or what changes to processes should we be making and how should we make those. And then we can track it to see did it make a difference or what difference did it make? And is it something we should replicate? Is it something we should pull back. So I really like to use our data from our program, you know, participant program data to inform our strategy on what we're going to be doing in the next 1 to 5 years.   Carol: I know before you have presented at CSAVR and showed like you had some really cool ways you were able to look at data and you did a lot of it by your region so you could start narrowing in, because you can have this tendency to go, oh, you look at the data broadly and then you're like, oh, we must have this problem everywhere. Well, you realized you had regions, you know, in your state you're like, well, why am I like spanking everybody? What we write, we need to focus over here.   Kristen: Yeah, we have those metrics. And it's a metric per counselor, per rehab tech, per purchasing specialist. That unit of counselors rolls up to the supervisor. The supervisor rolls up to the program manager. So I can drill down from a state level perspective to a region perspective. Is it a supervisor office problem? Is it a person problem? And that has really helped us understand. Also, where do we need to direct the energies and efforts in terms of making changes.   Carol: Yeah, I really like that. That was really good stuff. How about you, Natasha? What are you doing with leveraging data? Because I know that's in your wheelhouse, too.   Natasha: We actually hired within, like, the last year or so, a data analyst who is skilled in data visualization and being able to take a bunch of raw numbers and tell a story. And we have been working with her to develop not only the programmatic data, which we now have a ton of that we can look at, but also our fiscal forecasting and what's happening on a budgetary level. It is because of those reports which I am getting weekly, monthly and quarterly reports, depending on the nature that we were able to suddenly see this huge, unexpected spike in case services authorizations. Within just a month of it happening, we were able to drill in. What exactly is going on? What are the bucket items that are the red flags we were able to look at by staff member by region, and we found that our interpreters have gone up over 300%, which then led us down to, okay, what's going on with that? What's the story behind the data? We also are every week meeting as a fiscal team. So the three fiscal staff that I have and myself, we meet every single week. I am intimately involved in our federal reporting. I look at every single report that they put together before we submit our 17. We walk through it. I know where we're at with match. I know where we're at with maintenance of effort. I know exactly where our 15% set aside is, and I can tell you that every single month how we're doing and what issues we're going to be facing. And that's because we have the data. If a director never looks at data and doesn't know what's happening in their programs, they're not going to be able to spot issues. You have to know whether you're doing good or you're not doing good. You need to be able to catch those things.   Carol: Yeah. And unfortunately, you have many colleagues across the country. And I will come in and they're being told by like the DSA fiscal staff, hey, don't worry about it. We got it. And so there have been directors of programs of 150 plus million dollars, have never seen a budget report. Zero idea. So literally anything they want to do. Hey, can we send a staff to training? They're asking this group of fiscal people sitting over here because they don't even know what's in the budget. It is the most insane thing I've ever seen. So you really hit the nail on the head. Like, you have to have access and it is required in the law, in the act, in setting up the agency org structure, you have the sole responsibility over the allocation and expenditure of your funds. And how can you have that sole responsibility and not have any data that goes with it? So I preach. Natasha: I will say, data is if you have a legislative ask and you are requesting more funding, the stories are important, but they also want to see the data behind it.   Carol: 100%. And it can't be data that's changing by the day. Oops, we forgot this because I've seen people get burned on that as well. And then the legislators are going, okay, well, this data now is suspect, and I think they need a legislative audit report and review because what are they doing over there?   Kristen: From a data reporting perspective, like having historical data to the same reports they pull, they cannot keep changing the reports that you're changing the methodology of that. That was a lesson learned for us is we had to understand what data we were pulling, how were we calculating the numbers we were calculating. And now we have data since 2018, and we can tell when we've made any changes. And so then we can see what are our trends. What does that look like. How can we use that to help us predict in the future. So that was a lesson learned for me. We came in and it wasn't much in terms of data. We built some reports and then it was like, oh, but now we need to kind of be able to track, oh, well, this thing happened. And that's why maybe that spiked or dipped or we did this thing and here's the change we saw. So we were able to speak to that year over year as well.   Carol: Well super cool. So what advice would you guys have for other leaders out there? All the lessons you all have learned. We can try to read the tea leaves, like where is VR heading in the next few years? But what do you all think? Like what do you think where's VR going? And what advice would you have for other leaders? And Kristen, I'll go to you.   Kristen: I just think remain committed to the mission and the purpose of the programs that we have. we're here to serve individuals with disabilities. We'd keep that at the forefront. And, you know, I heard Natasha say to you, the mission is on the wall, right? We all have our missions. We all have our visions. Just don't let that get buried in all of the craziness that is happening and continue to be persistent. Carol mentioned the persistence. I think that is key. You don't let it drag you down. Don't let it burn you out. Just be persistent and know that all of the work that you're doing is for a good reason, good outcomes.   Carol: Good stuff. Natasha, I'm going to give you the last word.   Natasha: Don't get comfortable with how things are going right now. Speaking to what Kristen said earlier? Things will change, and probably for reasons completely outside of your control. And also remember that easy decisions aren't always the best decisions, and the best decisions aren't always the popular ones.   Carol: Well said. Very true. Well, I appreciate you both. Oh my gosh, I'm so excited to see what you all have done. You're two of my favorite directors. Don't tell the, don't tell the other directors that are listening.   Natasha: Yeah, cut that out, Jeff. Don't have that in there.   Carol: Thanks for joining me today. Sure appreciate it.   Kristen: Thank you.   Natasha: Bye.   {Music} Outro Voice: Conversations powered by VR, one manager at a time, one minute at a time, brought to you by the VR TAC for Quality Management. Catch all of our podcast episodes by subscribing on Apple Podcasts, Google Podcasts or wherever you listen to podcasts. Thanks for listening!

Send us a textDr. Mirza Rahman, MD, MPH serves as the President of the American College of Preventive Medicine ( ACPM - https://www.acpm.org/about-acpm/governance/executive-officers/mirza-rahman/ ), a professional community, founded in 1954 as a professional community for board-certified physicians to network, share their expertise and advocate for the advancement of prevention. Today, ACPM represents over 2,000 physicians, medical students, non-physicians, and other partners. All believe in the importance of preventive medicine in our society. Dr. Rahman also serves as the Senior Vice President, Patient Safety & Pharmacovigilance at Cybin ( https://cybin.com/our-team/ ), a pharmaceutical company seeking to bring novel, second-generation psychedelics to market. He also and is a Co-Founder and President of the Guyanese Diaspora Charity ( https://www.guyanesediasporacharity.org/ ), a 501(c)(3) non-profit organization focused on helping to improve the lives of Guyanese. In addition, Dr. Rahman is an Adjunct Associate Professor of Epidemiology at Columbia University ( https://www.publichealth.columbia.edu/profile/mirza-i-rahman-md ) and as an Adjunct Associate Professor at the University of Guyana.Most recently, Dr. Rahman was the Vice President & Chief Safety Officer at Organon, a global healthcare company. There, he was responsible for leading and setting the broad strategic direction for pharmacovigilance for this multinational company.Prior to that, Dr. Rahman was the Senior Vice President, Chief Global Pharmacovigilance Officer & European Research & Development Lead at Otsuka Pharmaceuticals, a global Japanese based pharmaceutical company. In 2013, he created the ACPM - Otsuka Pharmacovigilance Physician Program in Global Medical Safety. Dr. Rahman joined Otsuka from Merck Research Laboratories, where he was an Executive Director in the Clinical Risk Management/Global Safety department. Before this, he worked at Johnson & Johnson in a variety of positions, serving as a Worldwide Vice President, Health Economics & Reimbursement at Ortho-Clinical Diagnostics in his last role there.During his 25+ years in the pharmaceutical industry, while Dr. Rahman has worked primarily in Pharmacovigilance, he has also worked in Medical Affairs, Medical Information, Health Economics and Outcomes Research, Quality Management, Clinical Development, Manufacturing, and Regulatory Affairs.Dr. Rahman completed his Public Health & General Preventive Medicine Residency along with his Family Medicine Residency at Stony Brook University. He completed the Advanced Management Program at the Columbia Business School and earned his Master of Public Health degree from the Columbia University School of Public Health. Dr. Rahman earned his Doctor of Medicine degree from the Stony Brook University School of Medicine, and his Bachelor of Science degree from the Sophie Davis School of Biomedical Education at the City College of the City University of New York. #MirzaRahman #AmericanCollegeOfPreventiveMedicine #PatientSafety #Pharmacovigilance #GuyaneseDiasporaCharity #Epidemiology #ColumbiaUniversity #UniversityOfGuyana #MedicalAffairs #HealthEconomics #OutcomesResearch #QualityManagement #ClinicalDevelopment #RegulatoryAffairs #PublicHealth #BrainHealth #DiabetesPrevention #ReducingHypertension #LifestyleMedicine #PopulationHealth #ViolencePrevention #Psychedelics #ProgressPotentialAndPossibilities #IraPastor #Podcast #Podcaster #Podcasting #ViralPodcast #STEM #Innovation #Science #Technology #ResearchSupport the show

ISO consultancy isn't a field many aspire to enter, mostly because many don't know it exists until you're tasked with either managing an existing ISO Management System or implementing a brand new one.  We're continuing with our latest mini-series where we introduce members of our team, to explore how they fell into the world of ISO and discuss the common challenges they face while helping clients achieve ISO certification.   In this episode we introduce Sarah Ball, a Senior Isologist® at Blackmores, to learn about her journey towards becoming an ISO Consultant and what drives her to help clients on their ISO journey.   You'll learn ·      What is Sarah's role at Blackmores? ·      What does Sarah enjoy outside of consultancy? ·      What path did Sarah take to become an ISO Consultant? ·      What is the biggest challenge she's faced when implementing ISO Standards? ·      What is Sarah's biggest achievement?   Resources ·      Isologyhub ·      Productivity Ninja   In this episode, we talk about: [00:30] Episode Summary – We introduce Sarah Ball, a Senior Isologist® here at Blackmores, to discuss her journey towards becoming an ISO consultant who specialises in ISO 9001, ISO 45001, ISO 14001 and ISO 27001. [03:45] What is Sarah's role at Blackmores? Sarah is a Senior Isologist® with Blackmores, supporting companies with maintaining systems, undertaking internal audits, and supporting with implementing new systems to gain certification utilising our Isology methodology. Sarah also coordinates the development of content of our online learning platform, the isologyhub. [04:50] What does Sarah enjoy doing outside of consultancy?: Sarah has a keen interest in history, having studied it at school, she like to travel to various locations of historical interest. She also spends a lot of time researching her own family tree, learning as much as she can about the far reaching members of the past. Sarah also likes to go jogging outside, as the gym environment didn't inspire much enjoyment, she instead prefers to be in nature while exercising. She has also participated in long distance running for charity, completing the 10k Race for Life. She's taking on the more daunting muddy 5K version this year, which includes a number of obstacles, so we're wishing her luck! One of the new hobbies she's like to take up this year include mountain climbing, with Mount Snowdon on her to-do list. [06:35] What was Sarah's path towards becoming an ISO Consultant?: Sarah initially started in Customer Services, working as a customer service advisor in a company and then got promoted to manager of a team. At that point, her role became more about understanding why they were getting certain complaints and what could be done to prevent them happening rather than just resolving them. She ended up spending more time with suppliers and other departments to help prevent some of the recurring issues, and along the line it lead onto being asked to implement an ISO 9001 Quality Management System. Which was a tall request considering the fact that at the time, Sarah knew nothing about ISO 9001 outside of it's designation and area of focus. As a result, she spent a lot of time researching it, and had the help of an external consultant to Implement the Management System. This was necessary, as knowing how to apply it to a business was something that she needed support with. 2 years later, the company asked Sarah to implement an ISO 45001 Health & Safety management system and an ISO 14001 environmental management system. These two she implemented herself after getting a feel for it during the initial quality management system implementation. For the next 10 years, Sarah worked in other companies, assisting with their integrated management systems. Along the way, she also picked up on ISO 27001 Information Security, before landing in Blackmores in 2020. [09:10] A path people fall onto – Most people don't actively plan to get into ISO consultancy, it's usually a result of being tasked with managing or implementing a management system while working in another role.  [10:10] What is Sarah's favourite aspect of being a Consultant? – Sarah enjoys the variety, not just in the work and tasks but in the companies and industries that she gets to work with. Each have their own way of working, unique approaches and knowledge nuggets in the form of ways of working that can be cherry picked and applied elsewhere. She also likes to see how a management system develops and evolves overtime and how it can become part of a company's success, driving continual improvement. Sarah enjoys working with people that can see the real benefits of ISO management systems, rather than just focusing on the certificate on the wall. [13:40] Making a Management System your own – Sarah is a big proponent of making a Management system your own, giving it an identity so that it can be fully integrated into the way a business works. Businesses do it all the time, usually by naming large projects that everyone can reference by a common shorthand. A Management System can work in the same way, making it a part of the day-to-day running of the business. She's also a fan of not worrying about the terminology in Standards. Many of the terms used are meant to be general, this was due to the way international audiences referred to certain aspects of management, it wouldn't always translate correctly. So many Standards have some admittedly awkward terminology that can be applied to any business, and you by no means have to use their wording, as long as you can explain what relates to what in an audit then you're free to name things as appropriate to you.   [16:55] What Standards does Sarah specilaise in and why? Starting with: ·      ISO 9001 Quality: This is the main standard that Sarah starting working with, and is one that touches on a lot of areas within other Standards. It's a great base to build off of, and is the starting point for many venturing into the world of ISO. ·      ISO 14001 Environmental: Sarah got experience with this Standard at her first company, it's also commonly implemented alongside ISO 9001.   ·      ISO 45001 Health & Safety: Another one of the first Standards Sarah implemented, it's also a common one to see in integrated management systems.   ·      ISO 27001 Information Security: Sarah got to grips with this Standard through years of working with other companies. Sarah's favourite Standard is ISO 9001, not only because it was her first experience with implementing ISO Standards, but because it create a blueprint for success. ISO Standards are setting the minimum requirement, not the maximum, they are designed get you started so you can make continual improvements. It also acts as a foundation to build onto, you can pick aspects of other Standards to integrate into your existing system. You don't necessarily have to certify to those additional Standards, but nothing is stopping you from strengthening your Management System with the best bits from other ISO's. [21:00] Sarah's favourite clause in ISO 9001: Sarah personally favors Clause 10 – non-conformity and corrective action. The reason behind that choice is due to that clauses' importance in driving continual improvement. It's about taking something negative being turned into a positive, which is what Quality Management is at it's core. [22:05] What is the biggest challenge Sarah had faced during a project and how did he overcome it?: Molding the Standard to the business. As a consultant, the biggest challenge is understanding how to make the requirements of a Standard fit the business, and not the other way round. It's all about trying to align the ISO Standard requirements to their values and mission, and then getting people on board with understanding the true benefits of management system implementation. At Blackmores, we ensure that each management system is unique to each business. We don't operate with a copy paste model. This is another reason why Sarah encourages naming your management system, by branding it you encourage engagement. Sarah highlights the fact that we run a lot of workshops in the initial part of a project, conducting a Gap Analysis, SWOT and PESTLE ect, this helps our consultants to really get a feel for how a business ticks. From that, we can help steer the delivery of the Management System to the wider business, by building it into their existing tools, such as an intranet. [25:45] Leading by example: We revamped our own ISO 9001 Management System a few years ago, with both Rachel Churchman and Sarah Ball leading the refresh. We gave it a name, H20 (How 2 Operate) and integrated it with our Microsoft Teams channels as we'd all swapped to mostly remote work following the COVID pandemic in 2020. As Sarah points out, there are many different ways to display and deliver your management system, including: ·      Microsoft Teams ·      Intranet ·      Google / Google Drive ·      SharePoint ·      CRM's such as Monday.com The key is building it into the day-to-day tools everyone uses. Make the Management System part of your processes, so adhering and maintaining it becomes part of everyone's way of working. [28:55] What is Sarah's proudest achievement? Obtaining her degree through the Open University while still working full time. It took Sarah 8 years of hard work to obtain her honours degree in History, which was one not required by her work or career development. It was simply something she wanted to do to prove to herself that she could achieve it. Many other members of Blackmores can attest to Sarah's level of determination, and organisation, as she shares many tips and techniques learned from her years of study and work. This includes: The Productivity Ninja – Learned from Graham Allcott's book, which seeks to help reduce procrastination, and tackle tasks with efficiency. The Second Brain – A tool to help keep track of ideas / tasks that aren't an immediate priority. These tools are now used by a number of the team, and we have no doubt Sarah will be schooling us on more techniques in future. If you'd like any assistance with implementing ISO standards, get in touch with us, we'd be happy to help! We'd love to hear your views and comments about the ISO Show, here's how: ●     Share the ISO Show on Twitter or Linkedin ●     Leave an honest review on iTunes or Soundcloud. Your ratings and reviews really help and we read each one. Subscribe to keep up-to-date with our latest episodes: Stitcher | Spotify | YouTube |iTunes | Soundcloud | Mailing List

Nebraska VR is on a mission to elevate careers and empower businesses through its innovative Disability Innovation Fund Career Pathways Advancement Project (CPAP 2.0). In this episode, Carol Pankow sits down with Cathy Callaway, Nebraska VR's Assistant Director, to discuss how the program helps individuals with disabilities advance in high-demand fields like STEM and skilled trades. With over 130 business partners signed on, the initiative is breaking barriers, fostering workforce development, and proving that growth doesn't stop at job placement—it's about career progression. Tune in to hear how Nebraska VR is redefining success through strategic partnerships and a dual-customer approach!   Listen Here   Full Transcript:   Carol: Listeners, we would like to dedicate this podcast to Mary Eunice Neary. As the different CPAP 2.0 director. Mary played a vital role in this work, but was unable to join us for the recording. In her absence, Cathy Callaway, the interim director, stepped in for the discussion. Sadly, Mary has since passed away, but her impact on Nebraska VR will always be remembered.   {Music} Cathy: We look to find those clients that were closed previously in VR and work with them to advance them in their careers, and then in conjunction, we work with businesses to create a business model that we can help businesses work to advance people in their business so that it assists them in their workforce as well. The number of business partners we had a goal in the grant of signing 100, and we're at 130 plus with still a year and a half on the grant to go.   Intro Voice: Manager Minute brought to you by the VRTAC for Quality Management, Conversations powered by VR, one manager at a time, one minute at a time. Here is your host Carol Pankow.   Carol: Well, welcome to the manager minute. Joining me in the studio today is Cathy Callaway, Nebraska VR assistant director and interim director of the DIF CPAP 2.0 project. So, Cathy, how are things going in Nebraska?   Cathy: Cold right now? Other than that? Very well, though. Very well with the grant.   Carol: Excellent. No, it is cold here today, too, in Minnesota. I tell you, we go from 54 degrees down to minus eight. It has been a lot. So for our listeners, three years ago, Nebraska VR received a Disability Innovation Fund grant for the Career Advancement Project, and the Rehab Services Administration funded this initiative and is focused on helping people with disabilities who are eligible for VR services, including those who are previously served and have returned to the program, advance in their careers, and the goal is to help individuals move into high demand, high quality fields like science, technology, engineering and math. Those Stem kind of professions, including computer science, and the initiative also supports entry into career pathways and key industries through programs like pre-apprenticeship, registered apprenticeships and industry recognized apprenticeship programs. And the efforts really designed to help people achieve better jobs with competitive wages, become more financially independent and reduce their reliance on public benefits or state and local support, and promotes independence and full inclusion in their communities. Oh my gosh, that's a bunch. So I know Nebraska has been at this for a bit, so let's dig in and find out what's going on. So Cathy, help our listeners out. Let's start by getting to know you a bit. What's your role and how did you get into VR?   Cathy: That's a long story actually. As you mentioned, I'm currently in the assistant director role. I started when the 1992, amendments to the Rehabilitation Act were implemented. In those amendments, the State Rehabilitation Council was created, and I was hired clear back then to work with the State Rehab Council. And then I just kept working with VR. I actually have a business degree, and I kind of started working in the financial area and really was working in the fiscal area when the push to integrate data and program was kind of a thing. And so I started working on integration of fiscal and program and data and all of that. So I worked very closely in both of those areas and kind of just got to know the program side and the fiscal side and the data side, and moved from then the fiscal arena into the program director for quality assurance for a few years. And after that, just two years ago became the assistant director. So kind of had a little bit of a role in everything.   Carol: Well, excellent. You're a person that takes after me in my heart with having the fiscal program combined. I might have to tap you for some other things about that, because we often talk in our work about combining fiscal with program and data, and there aren't a lot of places that have people who've done all of that. So good to know. Thanks for that fun fact.   Cathy: You're welcome.   Carol: So I hear you had a pretty unique situation in Nebraska that made you the perfect fit to apply for this grant. Can you share a little bit about what that was?   Cathy: Sure. We applied for the grant in 2016 to 2021, and it was our what we call Career Pathways Advancement Project CPAP 1.0, and it focused specifically on promoting, upskilling and backfilling incumbent workers with disabilities. So that project ended in 2021. And at that time then another DIF project was made available. So we applied and expanded that. We are still looking to upskill and advance workers, but we also then included another component that was related to working with businesses directly. So this grant was kind of a add on to the CPAP 1.0. We actually call this one CPAP 2.0. Yeah it's the similar but it expands into working with the businesses as well.   Carol: Well and just for folks, so they know what is CPAP. Can you just tell them...   Cathy: Yes, it's career pathways advancement project.   Carol: Perfect.   Cathy: Advancing clients in those career pathways that you mentioned in those STEM areas.   Carol: Excellent, thank you. I just know VR is notorious for our acronyms. And then some new people are in there like, I don't know what you're talking about. So give us the big picture. What are you really hoping to accomplish with this project?   Cathy: We're hoping to develop a business model under this grant that can be sustainable. And once the grant ends with VR and we look to find those clients that were closed previously in VR and work with them to advance them in their careers. And then in addition to that advancement, whether that's in a new career pathway or in the jobs they're already in, we hope to increase their wages, benefits, maybe their hours, and to help improve their economic self-sufficiency. And then in conjunction, we work with businesses, as I mentioned, to create a business model that we can help businesses work to advance people in their business so that it assists them in their workforce as well.   Carol: I love that you're really living into WIOA, you know, the whole dual customer approach.   Cathy: Yep.   Carol: Now, I know early on when you were introducing this idea to clients, people were thinking you guys were scammers. What was going on with that?   Cathy: They were we started out thinking, well, we'll just call back these clients that we closed and talk to them about advancing. And because of the world today, many of them. Yeah. Thought we were scammers and there's no way somebody's going to pay for my training or me to go back to college and advance. So we really had to kind of refine our outreach efforts. We actually moved to sending them a letter with the name of the counselor that they previously worked with and some more about. Remember when you worked with VR and we assisted you. And so we send out those letters first and provide some information about the grant. And then we follow up about a week after the letter goes out with a phone call from someone. So that's really made a difference. They kind of are like, oh yeah, I worked with VR before, I know who you are. And I remember that counselor. So that's made a difference for us in terms of outreach.   Carol: Well, good. And hopefully your phone isn't showing up as, um, scam possible scam call.   Cathy: Exactly.   Carol: So what have been some of your biggest challenges you faced while getting this project off the ground?   Cathy: Yeah, I would say probably some of the things we wrote into the grant, maybe we would do a little bit different. We had written into the grant that we would like to sign businesses up, I guess, to make referrals to us. And we've had some resistance in terms of the signing of it isn't obligating them to anything, but they kind of some businesses are reluctant to sign anything. And so we've had some resistance that way. Although we've been able to sign over 130 business plans with businesses to offer referrals to the program. So we would probably do that a little bit different. That's been a challenge, I think training. We hired new staff for the grant and then that, of course, learning the VR process and all that goes with it really took a significant amount of time. So we got behind in serving clients and then retaining, of course, with a grant, your staff realize that it's a grant and it will end. And so some staff that worked on the grant have now taken permanent positions with VR. And so we're kind of a work in progress with the keeping the staffing. And then just as I said, building the trust with clients as we reach out to them. And we've adjusted, as I mentioned earlier, but kind of making sure that adjusting our marketing outreach so they realize we're not a scam.   Carol: Well, I know often these projects, you know, you're projecting ahead and you're thinking, okay, I want to do these great things and you create all this in your mind. But typically all of the DIF grants end up evolving in some way a bit from the original plan. And you alluded to this a bit, but I know you guys have had to pivot. And so what have been those ways in which you've pivoted, maybe from what your original intent was in the grant?   Cathy: Yeah, we've pivoted a little bit. The grant, we thought we would get a lot of clients that wanted short term training, and a lot of them want to get advanced degrees or get a degree. And those have been taken much longer time than we thought. So there's been just some different thinking about clients that want the more long term degrees or advancing in degrees. We've had to change our marketing materials. We kind of had just generic flyers, and now we've moved to developing specific marketing materials for the businesses that we're going into, which has really helped with their employees. Instead of just seeing this generic flyer, they can say, oh, the company I'm working for, there's opportunities in these areas and I can advance. And it's been very specific to the business, which I think has created some buy in with the employees. I would say we hired a Career Pathways recruiter specifically to work with individuals with more significant disabilities, specifically developmental disabilities, just because that's a whole different group to work with. And so we've kind of hired an expert in that area, which has helped. And then I would say changing because Nebraska is such a rural state, we had identified originally career pathway recruiters to work with specific areas of the state, and we've had to kind of pivot and say, okay, you can work with anybody across the state given Zoom and Adobe Sign and all those things, because it's allowed us then to serve more clients statewide, rather than limiting it to just areas where we have the career pathways recruiters.   Carol: Yeah, that really has been amazing, especially for states that have more rural sections. You do like we do in Minnesota as well, you know, and the whole ability to serve people remotely is amazing or virtually, you know, you can get at them. I think that's great. I know in your marketing efforts have been super impressive. And like, how are you making that happen? Do you have an in-house person, or are you contracting to make those marketing efforts happen? How are you making that work?   Cathy: We do have an in-house marketing team and they're amazing. They're super flexible. They're willing to work with us, so they work to provide whatever materials we need, as I mentioned, able to work in partnership with businesses to specifically customize those marketing materials for the business. And then the other marketing piece we've really done that's kind of new is what we call lunch and learns. And we go into businesses and we kind of do a presentation over like the lunch hour, or sometimes early in the morning at the beginning of a shift. And we really target the HR managers and the team leaders and the people that can get the word out to their employees about our services and about the grant. So those lunch and learns have been pretty well attended, and we're able to really get the word out to a lot of people in the businesses for them to then refer their employees back to us.   Carol: Yeah, that's excellent. So looking back so far, what accomplishments are you most proud of?   Cathy: I think the number of business partners that we've been able to reach out to and connect with and sign those individualized business plans, we had a goal in the grant of signing 100, and we're at 130 plus with still a year and a half on the grant to go. So just getting that word out. You know, the nice thing about doing that, getting in those businesses is we're not only mentioning the grant, but we're also able to mention Nebraska VR. And if you, you know, can get people just the word out about Nebraska VR, even beyond the grant has really been a benefit. We've had several clients that I say we are really proud to say have gotten advanced degrees. It's not just certifications, but they've been able to go on and get advanced degrees through this program, and then just being able to help contact those clients that we previously served and were able to get a job, and just letting them know you can do more, you can advance and we can help you with that. So I think just all of the clients that we've been able to reach out to and really help them become more economically self-sufficient.   Carol: That's excellent. I know that's a big foundational piece within VR. So it's fun to see it actually happen. So for those folks out there that are thinking about applying for a grant in the future, and hard to say what the future holds, what advice would you give them? Because I know often people are like, oh, I don't know. Or, you know, is it too much of a pain in the butt, you know, to try to do all of this stuff? What kind of advice do you have for them?   Cathy: I would just say, take the plunge and do it. It's given us an opportunity to really think outside the lines, a little bit of what we could do in Nebraska VR, but it's also gives us the opportunity to make those mistakes and adjust and pivot and evolve. So the hope would be, you know, by the time this grant is over, we have created that model that is going to be sustainable under VR, and we have just learned so much more about our dual customer approach, working with the businesses as well as with the clients. So I would suggest if anybody is looking at doing that, to just do it and give yourself the chance to develop things outside of what you think is currently possible.   Carol: I like that. That's great advice. You know, with the dual customer and this focus on business. Are there particular sectors you're seeing that are responding, you know, to this program. Are there certain sectors. You know every state has a different kind of flow to it. So I wondered if there were specifics there in Nebraska.   Cathy: Yeah, we've had a pretty big response in the healthcare industry. We actually just signed a business here. Vetter. And I think they have over 30 locations across the state, so we're going to be working with them. We've had a lot of success with the CDL, the transportation and distribution and logistics area. Those have probably been our two biggest focuses or the ones where we've had the most interest. And then probably we've had some in the manufacturing area as well. But specifically we have a lot of businesses with the CDLs that is popular.   Carol: Interesting. That's very cool. I know Minnesota was doing something and they also were doing it in the transportation area. I guess I hadn't realized how big that is and the need right now.   Cathy: It is, yes.   Carol: So where can our listeners go to learn more about your project? Do you have a project website?   Cathy: We do. It's VR.Nebraska.gov/pathways. And there's contact information on there regarding the Career Pathways Advancement Project. There's some success story videos out there and just a lot of information about our project and our grant.   Carol: Excellent. And then are people able to if they go on the website, are they able to like get at if they had any other questions or something they could get one of you?   Cathy: Yep, there's contact information on there as well for anyone to reach out with. Any questions.   Carol: Yeah, it's been really fun. As of late, I've been hearing from a lot of folks across the country and they said, we sure like hearing these stories because they're trying to plant the seeds and get ideas. And are there things that they could even try in their state right now...   Cathy: Absolutely.   Carol: Different way. Yeah. That's great. So any last parting thoughts for our listeners?   Cathy: No, I just appreciate the opportunity to share information about our project and encourage anyone interested to go to our website and ask any questions, if they have any.   Carol: Well, thanks for coming on today. I really appreciate it. We don't hear much from Nebraska, so I'm like, I have to get at you guys and see what's going on. I look forward to talking to you again when you get kind of in that last year and see where you're standing with all the data and what's happening. So thanks much, Kathy. Appreciate it.   Cathy: Thanks, Carol. Good to see you.   {Music} Outro Voice: Conversations powered by VR, one manager at a time, one minute at a time, brought to you by the VR TAC for Quality Management. Catch all of our podcast episodes by subscribing on Apple Podcasts, Google Podcasts or wherever you listen to podcasts. Thanks for listening!  

In this episode, Martina attends the 22nd Annual International Hotel forum to discuss sustainability in the travel and tourism industry, talking to experts about key sustainable technologies, and the challenges to implementing sustainable practices.Find us on LinkedIn: ⁠https://www.linkedin.com/company/globaldatastrategicintelligence/⁠To understand how to use our Themes product please contact us: ⁠customersuccess.strategic@globaldata.com⁠ +44 (0) 207 406 6764Host: Martina RaveniGuests:Renée Nicole Wagner, Corporate Director ESG & Quality Management, Orascom Hotels ManagementSergio Guerreiro, Senior Director, Turismo de Portugal & Member of Statistics Committee, UNWTONicholas Wyatt, Head of R&A Travel and Tourism, GlobalData

We share a lot of success stories here on the ISO Show, along with hints, tips and updates to Standards, including insights from our consultants who work with Standards day in and day out.  In our latest mini-series, we're taking a step back to introduce members of our team, to explore how they fell into the world of ISO and discuss the common challenges they face while helping clients achieve ISO certification.   In this episode we introduce Darren Morrow, a Senior Consultant at Blackmores, to learn about his journey towards becoming an ISO Consultant and what drives him to help clients on their ISO journey.   You'll learn ·      What is Darren's role at Blackmores? ·      What does Darren enjoy outside of consultancy? ·      What path did Darren take to become an ISO Consultant? ·      What is the biggest challenge he's faced when implementing ISO Standards? ·      What is Darren's biggest achievement?   Resources ·      Isologyhub ·      Engagement Amplifier Gameplan   In this episode, we talk about: [00:30] Episode Summary – We introduce Darren Morrow, a Senior Consultant here at Blackmores, to discuss his journey towards becoming an ISO consultant who specialises in ISO 9001, ISO 45001, ISO 14001 and ISO 50001.   [03:45] What is Darren's role at Blackmores? Darren is a Senior Consultant with Blackmores, supporting companies with maintaining systems, undertaking internal audits, and supporting with implementing new systems to gain certification. A key part of his role is translating ISO Standards into plain English, and guides clients on how to apply them in practice. [04:55] What does Darren enjoy doing outside of consultancy?: Darren moved to Norfolk back in 2021 ans has since found the relaxed way of life there to be a great fit. It also offers a lot of good walking opportunities for his 2 Leonberger's (giant breed dogs), who mostly enjoy the local parks and beach walks. Darren is also an avid reader, clocking in a whopping 343 weeks' worth of reading on his kindle. His favourite genres include:- ·      Crime, thriller, adventure types - Clive Cussler, Michael Connelly, David Baldacci, CJ Box, Dan Brown, James Carol ·      Horror - James Herbert, Stephen King ·      Supernatural, urban fantasy, fantasy - Ben Aaronvitch, Jim Butcher, Raymond E Feist, C S Lewis & Tolkien ·      Historical - CJ Sansom, SJ Parris ·      And Terry Pratchett for a weird dose of reality. He's also a movie buff, with a collection of over 1,000 films ranging from the 1930's all the way to modern era. Recently he took on the challenge of watching all the Marvel films in chronological order, which took a few weeks! [10:35] What was Darren's path towards becoming an ISO Consultant?: Before Blackmores, Darren was the Quality Manager for a company that worked within the Highways Maintenance sector, working there for 8 years. For the first 18 months he was primarily the Quality Manager for a specific contract on the Olympic Park, as that contract came to an end, he moved into the main company Quality Manager role supporting multiple highway term maintenance contracts along with various smaller projects that the business won. Prior to that, he was a SHEQ Advisor within the Rail industry, working for a signaling company. Darren worked there for about 5 years, within head office support roles for quality and health and safety, moving to working on supporting the project teams and project delivery for signaling schemes. Overall, looking back, he's worked with standards within a quality, health & safety, environmental for around 25 years now.  [13:20] What is Darren's favourite aspect of being a Consultant? – Darren likes the variety. As an ISO Consultant, he gets to work with lots of different people, companies and industries, so he gets to learn a lot about how they work and how Standards apply to different industries. He also enjoys the fact that after working with clients for a number of years, he becomes just another member of the team.   [15:15] What Standards does Darren specilaise in and why? Starting with: ·      ISO 9001 Quality: This is the main standard that Darren starting working with back in 1999 ·      ISO 45001 Occupational Health and Safety: While working within rail, Darren was given the opportunity to do some training and proceeded to complete NEBOSH courses - general and construction, this proved invaluable in future roles. ·      ISO 14001 Environmental: Darren ended up working with this Standard as part of on-going development. His role as a Quality Manager expanded, and at the time, all external audits with our certification body were coordinated through him. So, for on-going development he completed the NEBOSH environmental managed certificate. ·      ISO 50001 Energy Management: This is one of Darren's favourites. He's taken on this standard since working with Blackmores and seemed like a natural progression with the work he was already doing. He likes how this standard helps companies think more about their impacts on the environment in terms of energy consumption. In terms of companies climate change impacts, Darren likes how ISO 50001 can support deep dives into data that is available or not clearly available in many cases to support improvement and reduction in energy consumption. This also can pave the way for those companies that take it more seriously, and progress to newer standards like ISO14064-1 for quantification and reporting of greenhouse gases, but also part 3 for the verification and validation of greenhouse gases. This is where our sister company, Carbonology Ltd, really excel. Darren does his bit with ISO 50001 clients to educate and prepare them for taking more proactive steps towards meaningful energy and carbon reporting. For example, if they grow sufficiently or fall within the parameters of mandatory schemes such as ESOS or SECR reporting, or they just want to do their bit and demonstrate their commitment to minimising their impact on the environment and overall energy consumption. [23:10] What is the biggest challenge Darren had faced during a project and how did he overcome it?: He doesn't have a single one that stands out, but common issues are usually either down to availability or commitment of the individuals within the company he's supporting. For example, the company may decide that they require certification to a standard or multiple standards. There will be commitment from some within the business, and there are those that may not see the importance or feel it's not important to them and what they do.  Darren's job is to support the company in achieving its main goal in gaining certification. His work with the company involved explaining what is to be done and why. He's found that most of any resistance is because individuals do not know the why and how it impacts them, etc. The other aspect is to make it clear that he is not there to tell them what to do, or that they're doing it wrong. He works with people to either document the process (where required), help them find improvement in the process and continue to search for improvement. [27:00] What is Darren's proudest achievement? Darren states that there's no one definitive achievement to highlight, rather he would say supporting clients who are new to the standards. Working with them and providing knowledge so that they know the 'why' and understand the standards and their processes, and finally seeing the end result with being recommended for certification. The ones that he's particularly happy with are those that go for multiple standards, that result in recommendation for certification with little or no significant findings from the certification body, it shows that the company has been fully engaged and embedded the overall process into how they work. If you'd like any assistance with implementing ISO standards, get in touch with us, we'd be happy to help! We'd love to hear your views and comments about the ISO Show, here's how: ●     Share the ISO Show on Twitter or Linkedin ●     Leave an honest review on iTunes or Soundcloud. Your ratings and reviews really help and we read each one. Subscribe to keep up-to-date with our latest episodes: Stitcher | Spotify | YouTube |iTunes | Soundcloud | Mailing List

In this episode of The Safety Guru, we welcome Dr. Nektarios Karanikas, Associate Professor in the Health, Safety, and Environment discipline at Queensland University of Technology. He shares enlightening insights from his recently published research on "Redefining Health, Risk, and Safety" and explores their interconnectedness. Dr. Karanikas emphasizes the importance of leaders recognizing that safety is a duty, actively engaging with safety professionals, and listening to foster a culture of safety within organizations. Don't miss this opportunity to gain valuable perspectives from Dr. Karanikas—listen now! About the Guest: Dr. Nektarios Karanikas is an Associate Professor in the Health, Safety, and Environment discipline at Queensland University of Technology (AU). He holds an MSc in Human Factors and Safety Assessment from Cranfield University (UK) and a PhD in Safety and Quality Management from Middlesex University (UK). Nektarios has 19 years of experience in the Hellenic Air Force, specializing in safety, quality management, and accident investigations, and served as a lecturer in safety and human factors. He has published two edited books and numerous peer-reviewed articles and has presented at over 100 events. Nektarios is also an active volunteer in various scientific and professional activities. For more information: https://www.linkedin.com/in/nektarioskaranikas/ Learn more about your ad choices. Visit megaphone.fm/adchoices

How does "quality" apply in all areas of an organization? In this final episode of the Misunderstanding Quality series, Bill Bellows and host Andrew Stotz discuss lessons from the first twelve episodes, and the big ah-ha moments that happen when we stop limiting our thinking. TRANSCRIPT 0:00:02.6 Andrew Stotz: My name is Andrew Stotz and I'll be your host as we dive deeper into the teachings of Dr. W. Edwards Deming. Today I'm continuing my discussion with Bill Bellows, who has spent 31 years helping people apply Dr. Deming's ideas to become aware of how their thinking is holding them back from their biggest opportunities. Today is episode 13 and the title is Quality Management: Don't be limited. Bill, take it away. 0:00:30.5 Bill Bellows: Hey, Andrew. So this is episode. What number did you say it was? 0:00:36.2 Andrew Stotz: 13. Lucky 13. 0:00:38.1 Bill Bellows: Lucky 13. So then for those who are concerned about the use of the number 13, this is episode 14. 0:00:51.0 Andrew Stotz: I thought you're gonna say episode 12A. 0:00:54.7 Bill Bellows: And for those who don't mind the number 13, this is episode 13. And as we talked earlier, if Dr. Deming was to title the episode it would be... It would not be "don't." It would be "do not", do not be limited. So at the start I wanted to go back to review the path we're on. We've been on episode one back in end of May, Quality, Back to the Start. All part of the Misunderstanding Quality series for The Deming Institute. Episode two, we got into the Eight Dimensions of Quality with David Garvin. One of those dimensions was acceptability. 0:01:49.8 Bill Bellows: Another was reliability. Another was I say dependability performance. Okay. And I think it's important in a series about misunderstanding quality to look at the work of David Garvin. Just realize I think it's fascinating to... You move out of the world of the American Society Quality and control charts and whatnot. And that's why I think Garvin's work paints a nice... Gives a nice perspective to not be limited.  And then we got into in the third episode Acceptability and Desirability. Episode four, Pay Attention to Choices and the choice of differentiating acceptability which is I'll take anything which meets requirements, and desirability. 0:02:42.3 Bill Bellows: I want that little doggy in the window. Not any doggy in the window. And then we followed that with episode five, the Red Bead Experiment which for many is their first exposure to Dr. Deming's work. I know when I worked for the Deming Institute for a few years the Red Bead Experiment website was one of one of the most popular pages. I believe another one was the 14 Points for Management. And, personally, I've presented the Red Bead Experiment think just once, just once. And I'm going to be doing it at the 2025 at, let me back up, the Bryce Canyon Deming... The Bryce Canyon...Bryce Canyon Forum. I can't remember the name. It's a partnership between Southern Utah University and The Deming Institute, and we're doing it at Southern Utah University. And on one of those days, I'll be doing the Red Bead Experiment, which takes a lot of time and then studying to present it a few years ago I was getting all the videos that I could find of it, many of them on The Deming Institute web page and none of them have the entire data collection. 0:04:18.5 Bill Bellows: They kind of fast forward through six people putting the... drawing the beads each four times and when you're up on stage trying to do that, I had four people that's, you gotta do a lot of work to make it that exciting. But the reason I present it, I say I present it for a number of reasons. One is to do the classic "The red beads are not caused by the workers are taken separately. They're caused by the system which includes the workers. It's an understanding of variation and introduction to control charts" and all of that is as exposed by Dr. Deming is classic. 0:05:00.7 Bill Bellows: But, I'd like to take it one step further, which is to go back into that desirability thinking and look at the concept that we've talked about of going through the doorway and going past the achievement of zero defects, zero red beads, and realize that there's further opportunities for improvement when you start to look at variation in the white beads. And, that then takes into account how the beads are used. And that gets us into the realm of looking at quality as a system.   Looking at quality with a systems view as opposed... That's good, that's good, that's good. With or without an appreciation on how the bead is used. So anyway, that was episode five. We explored that. Next we got into the differentiation of Category Thinking and Continuum Thinking. 0:05:55.5 Bill Bellows: And for those who haven't listened to it, maybe not in a while, the differentiation is category thinking. Putting things in categories such as red beads and white beads are the... It could be any categories, categories of fruit, categories of religion, categories of political systems. We have categories and then within a category we have variation. We have different. We have apples and oranges and then we have a given type of orange. And then there's variation in the juiciness, ripeness. That's called continuum thinking, which goes back to, if we go back to the red beads and the white beads is notion that the white beads are not uniformly white, not uniform in diameter or weight. 0:06:44.5 Bill Bellows: And, what are the implications there? Well, if we think in terms of categories, red beads and white beads, if all the beads are white have we stopped improving? And Dr. Deming and I believe it was Point 5 of the 14 Points stressed the need for continual improvement. And yes, you can continuously improve and reduce cost, you can continuously reduce cycle time, but can you continuously improve quality? Well, not if you're stuck in a category of good, then the role of that is to just to remind people that there's opportunities to go further when you begin to look at variation in white, which is the essence of looking at how what you're looking at is part of a system, which Dr. Deming was well, well aware of. 0:07:33.7 Bill Bellows: Next we got into the Paradigms of Variation and a big part there was differentiating acceptability. Well, going beyond acceptability was differentiating accuracy from precision. Precision is getting the same result shrinking the variation, otherwise known as getting achieving great piece-to-piece consistency. Metrics that begin with the letter C and sub P could be Cp, Cpk, are the two most popular. Those are measures of precision that we're getting small standard deviations that they are very, very close to each other. But in the paradigms of variation that was what I referred to as Paradigm B thinking we're looking for uniformity. Paradigm A thinking being acceptance, we'll take anything that meets requirements... Or academically called paradigm A. Paradigm C is what Dr. Taguchi was talking about with the desirability, where we're saying I want this value, I want uniformity around this specific value. 0:08:43.9 Bill Bellows: Here what we're looking at is uniformity around the target, around an ideal, otherwise known as piece-to-target variability. And, the idea there is that the closer we are to that ideal, the easier it is for others downstream to integrate what we're passing forward. Whether that's putting something into a hole or does this person we want to hire best integrate into our system. So, integration is not just a mechanical thing. In episode eight we then got into Beyond Looking Good which then shatters the Paradigm A acceptability thinking, going more deeply into the opportunities for continual improvement of quality. 0:09:29.1 Bill Bellows: If you shift to continuum thinking. Next, Worse than a thief coming from Dr. Taguchi. And that's the issue of achieving uniform. Part of what we looked at is the downside of looking at things in isolation and not looking at the greater system. Then episode 10 we look at Are you in favor of improvement of quality? 0:09:53.6 Andrew Stotz: I'm in favor. 0:09:55.7 Bill Bellows: To which he would always say, but of course. That was a reference back to chapter one of The New Economics. And he said everyone's got an answer. Improving quality computers and gadgets. And what we spoke about is Quality 4.0, which is gadgets of the 21st century, tools and techniques. And again, what we said is, there's nothing wrong with tools and techniques. Tools and techniques are about efficiency, doing things well, but they lack what Russ Ackoff would say in asking, are we doing the right things well. And then episode 11 delved into what I've...amongst the things I've learned from Dr. Taguchi, To improve quality, don't measure quality. 0:10:42.5 Bill Bellows: If we have a problem with, we want to reduce scrap, we want to reduce rework, we want to eliminate the problems that the customer has experienced or that someone downstream is experiencing. And what Dr. Taguchi emphasized was start asking, what is the function of the thing we're trying to do? And the idea is that if you improve the function, then you're likely to improve the quality as measured by what the customer is looking for. If you focus on what the... If you focus your efforts on reducing what the customer is complaining about, you're likely to get something else the customer is complaining about. And for more on that, go to episode 11. 0:11:19.0 Bill Bellows: And then episode 12, Do specification limits limit improvement? Which again goes back to what I experienced on a regular basis is in my university courses with people I interact with and consulting is a very heavy emphasis on meeting requirements and moving on. And not a lot of thought of going beyond that or even that there's anything more to do, that's alive and well. And that's reinforced by Six Sigma Quality is filled with that mindset. If you pay attention closely to Lean Manufacturing, you'll see that mindset again, alive and well. So, what I wanted to get to tonight in episode 13, Quality. 0:12:04.3 Andrew Stotz: That was quite a review, by the way. 0:12:06.7 Bill Bellows: Yeah, Quality Management: don't be limited, as and I'm teaching for the sixth time a class in quality management at Cal State Northridge. The title used to be Seminar in Quality Management. The title this year is Engineering Quality Management and Analytics. One of the assignments I give them, essays, the quizzes, attending the lectures. 0:12:34.9 Bill Bellows: Learning Capacity Matrix that I learned about from David Langford. But what I was sharing with you earlier, Andrew, is one of the first things I thought about and designed in this course, back in 2019 was I could just imagine students going through the course. And, what I'm going to hear is, what I've heard before is professor, these are very, very interesting ideas, but I'm not sure how I would apply them where I work. Because where I work is different. It's different. And to avoid that question, I came up with an assignment I called the Application Proposal. And there's four parts to it. But part one is: imagine upon completion of this course. And I let them know about this in the first lecture and I say, imagine upon completion of the course, your boss, someone you work with, challenges you to find three things you can do within three to six months of the of the completion of the course. 0:13:34.6 Bill Bellows: And it must include something you learned in this course. I don't say what thing, I don't say two things, I don't say three things. I leave it to them. But all it comes down to is I'd like you to contemplate and within three to six months of the completion of the course, what could you do? And I call that the near-term application. Well, subtask one is come up with three. They have to meet your job, your role, not your boss's role, not another department's role. They have to fit your role because only you know then the method by which you would go about that. And, so for that near-term, I ask them to let me know what is the present state of that near term, the before, the current condition and what is the after. What is the future state of that near-term? So I assign that before the course begins, I give them until week five to submit and give me those three things. The reason I asked for three is if one, if the first one they give me, if they only asked for one and one didn't quite fit, then I say, well, okay, Andrew, go back and give me another one that same time. 0:14:49.7 Bill Bellows: So I said, give me three. And most often all three are fantastic. In which case I say they're all great. Which one would you like to do? But again, it has to fit their role because in Sub-Task 2, the next thing I want them to do is not so much tell me about the present state, tell me more about the future state. And again, the future state is how much can you accomplish within that three-to-six month period? And that's subtask two. Then they come back to me and tell me the plan. What is the plan by which you go from the near-term present state to the near-term future state, tell me about the plan. Tell me what some of the obstacles might be and how you plan to deal with the obstacles. And then I say now what I want you to do is imagine that is wildly successful, jump ahead a year and a half to two years and tell me what you would do next. How would you build upon this? And in that mid-term time frame, what is the present? What is the future of the mid-term? And then go a few years out and tell me how you're going to further expand on what you've learned. 0:16:03.4 Bill Bellows: I call that the far-term. And for the far-term, what's the present, what's the future? So when they submit that to me, then I come back with - it could be questions about some of the terminology.  It could be a suggestion that they look at something with the use of Production Viewed as a System. Or, I ask them to think about operational definitions or perhaps suggest a control chart and, or a book. So, part of the reason I wanted to bring that up is few of the title, few of the topics we are looking at are specifically quality related. They're all about improving how the organization operates. Which goes back to what Dr. Deming stressed is the importance of continual improvement. 0:16:50.9 Andrew Stotz: Can you explain that just for a second? Because that was interesting about quality versus improving the organization. What did you mean by that? 0:17:00.4 Bill Bellows: Well, I, they didn't come to me with this process I have, has lots, has a very high defect rate and I thought that's where I need to focus. Or this process has a lot of scrap and rework. That's where I want to focus. What I was excited by is that they were looking at how to take a bunch of things they already do and better integrate them. Just fundamentally what I found them thinking about is how can I spend time to organize these activities as a system and as a result spend a whole lot less time on this and move on to the next thing. And, what I found fascinating about that is if we keep our thinking to quality and quality's about good parts and bad parts, good things and bad things, and having less bad things and more good things, that could be a really narrow view of what Dr. Deming was proposing. Now another aspect of the assignment was not only do I want them to give me three ideas, we down-select to one. It could be they're writing a new piece of software. One of the applications has to do with a really fascinating use of artificial intelligence. 0:18:27.0 Bill Bellows: And what's that got to do with quality? Well, what's interesting is it has a lot to do with improving the functionality of a product or a service, having it be more reliable, more consistent, easier to integrate. But, the other thing I want to point out is not only do I ask them to come up with three things and then assuming all three things fit well with their job, their responsibilities, their experience.  What I'm also interested in is what from the course are you going to use in this application? And, two things came up that fit again and again.  One is the value proposition of a feedback loop. 0:19:12.9 Bill Bellows: And they would ask me, what do you mean by feedback? I said, well, you're going to come along and you're going to tie these things together based on a theory that's going to work better. Yes. Well, how will you know it's doing that? How will you know how well this is performing? And, I said when I see this is what people refer to as Plan-Do, but there's no Study. It's just... And, I saw that Rocketdyne, then people would come along and say, oh, I know what to do, I'm just gonna go off and change the requirements and do this. 0:19:44.6 Bill Bellows: But, there was no feedback loop. In fact, it was even hard to say that I saw it implemented. It just saw the planning and the doing. But, no study, no acting. 0:19:57.3 Andrew Stotz: Is that the Do-Do style? 0:20:01.3 Bill Bellows: Yes. But what was really exciting to share with them is I said in a non-Deming company, which we have referred to as a Red Pen Company or, or a Me Organization or a Last Straw. And I don't think we covered those terms all that much in this episode, in this series, we definitely covered it in our first series. But what I found is in a Deming or in a non -Deming company, there's not a lot of feedback. And even if I deliver to you something which barely meets requirements and we spoke about this, that in the world of acceptability, a D- letter grade is acceptable. Why is it acceptable? Because it's not enough. It's good parts and bad parts. And so even if I deliver to you, Andrew, something which barely met requirements, and you said to me, Bill, this barely meets requirements. And I say, Andrew, did you say barely meets requirements? And you say, yes. So, Andrew, it did meet requirements and you say, yes. So I say, "Why are you calling me Andrew?" 0:21:12.1 Andrew Stotz: By the way that just made me think about the difference between a pass fail course structure and a gradient course structure. 0:21:20.7 Bill Bellows: Exactly. 0:21:21.5 Andrew Stotz: Yeah. Okay. 0:21:22.5 Bill Bellows: Yeah. So even if you give me that feedback. I reject it. I'm just going to say, Andrew, move on. But I said, in a Deming organization, feedback is everything. The students were giving me feedback on the quizzes and some things that caused me to go off and modify some things I'm doing. And I told them, if I don't have that feedback, I cannot improve the course. So, I met with each of them last week for an hour, and the feedback I was getting is instrumental in improving the course for the remainder of the semester as well as for next year. And, so that's what I found is what really differentiates a Deming approach to improving a process or a service or a product is feedback, which goes then to watching how it's used. It is, I think I mentioned to you Gipsie Ranney, who was the first president of The Deming Institute, a Professor of Statistics at University of Tennessee, when she met Dr. Deming and later became a senior consultant, maybe advisor to General Motors Powertrain. And once she told me, she said to Dr. Deming "You know, Dr. Deming, what do people get out of your seminars?" And. he said, "I know what I told them. 0:22:42.0 Bill Bellows: I don't know what they heard." And, the challenge is without knowing what they heard, because we would also say, and I'm pretty sure we brought this up in one of our this series or the prior series, Deming would say the questions are more important than the answers because the questions provide them with feedback as to what is going on. So anyway, part of what I wanted to bring out today in this quality management, don't be limited, is whether or not you're focusing on quality per se, minimizing scrap, minimizing work. If you're trying to improve a process, again, you're not improving it necessarily because there's more I want to have less scrap. But if your improvement is, I want it to take less time, I want it to be easier to do. I want it to be cheaper to do. Well, while you're at it, think about a feedback loop.  And the role of the feedback is to give you a sense of is it achieving what you're hoping it would achieve? It would allow you over time to maybe find out it's getting better.  Maybe there's a special cause you want to take advantage of or a special cause you want to avoid.  But, without that feedback, how do you know how it's working and then beyond that? 0:23:55.7 Andrew Stotz: And where is the origin of the information coming from for the feedback loop? Is it a feedback loop within your area or is it feedback loop from the next process or what do you. 0:24:08.3 Bill Bellows: All of that. That's what I told her. I said one is, I said, when you're developing the process. I told them, I said, when you're. If in Sub-Ttask 1, your idea is to flowchart a process, come up with a template, a prototype. Part of the feedback is showing that to people. And part of the feedback is, does it make sense to them?  Do they have suggestions for improvement? Do they... Is there an issue with operational definitions?  There would be better clarity based on the words you're using.  You may say in there clean this thing, or early in the semester, one of the assignments I gave the students was to explain some aspect of the course within their organization. And then I thought, well, then now it will explain to who. And I thought, well, unless I say if I felt that without giving clarity to who they're explaining it to, they're going to get lost in the assignment. Am I explaining it to a co-worker? Am I explaining it to someone in management? Am I explaining it to the CEO? And, finally I just thought, well, that's kind of crazy. 0:25:18.3 Bill Bellows: I just said, well, as if you're explaining it to a classmate. But, my concern was if I didn't provide clarity on who they're explaining it to, then they're going to be all over the place in terms of what I'm looking for versus what they're trying to do. And that being feedback and that also being what I told them is part of collecting, part of feedback is looking for how can I improve the operation, how can I improve? Or, what are the opportunities for paying closer attention to operational definitions, which means the words or the processes that we're asking people to follow. 0:25:58.3 Bill Bellows: But, I found in in joining Rocketdyne, I was in the TQM Office and then I began to see what engineering does. Oh, I had a sense of that when I worked in Connecticut, paid more attention to what manufacturing does. Well, then when I moved into a project management office. Well, project management is just like quality management. It's breaking things into parts, managing the parts in isolation. And, so when I talk about quality management, don't be limited. There's a lot Dr. Deming's offering that could be applied to project management, which is again, looking at how the efforts integrate, not looking at the actions taken separately. 0:26:45.4 Andrew Stotz: And, so how would you wrap up what you want to take away. What you want people to take away from this discussion? You went over a very great review of what we talked about, which was kind of the first half of this discussion. And what did you want people to get from that review? 0:27:05.2 Bill Bellows: The big thing, the big aha has been: this is so much more than quality. And, I've always felt that way, that when people look at Dr. Deming's work and talk about Dr. Deming is improving quality, and then when I work for The Deming Institute, the inquiries I would get it was part of my job to respond to people. And they want to know I work for a non-profit, do Dr. Deming's ideas apply. And, so for our target audience of people wanting to bring Dr. Deming's ideas to their respective organizations, even though the focus here is quality, we call this series Misunderstanding Quality. At this point, I'd like you to think more broadly that this is far more than how to improve quality.  This is improving management of resources, management of our time, management of our energy.  So this is a universal phenomenon. Not again, you can look at it as good parts and bad parts, and that's looking at things in isolation. That's what project managers do. That's what program managers do. That's what organizations do relentlessly. And this is what Ackoff would call the characteristic way of management. Break it into parts and manage the parts as well as possible. 0:28:21.5 Bill Bellows: So, I just wanted to bring that back as a reminder of this quality, quality, quality focuses. There's a lot more to this than improving quality when it comes to applying these ideas. 0:28:34.7 Andrew Stotz: And, I would just reiterate that from my first interactions with Dr. Deming when I was 24, and then I moved to Thailand and I did finance business and all that. So I wasn't, applying statistical tools in my business at the time. That just wasn't where I was at. But the message that I got from him about understanding variation and understanding to not be misled by variation, to see things as part of a system. Also to understand that if we really wanted to improve something, we had to go back to the beginning and think about how have we designed this? 0:29:20.3 Andrew Stotz: How do we reduce the final variability of it? And, so, it was those core principles that really turned me on. Where I could imagine, if I was an engineer or a statistician, that I would have latched on maybe more to the tools, but from where I was at, I was really excited about the message. And, I also really resonated with that message that stop blaming the worker. And, I saw that at Pepsi, that the worker just had very little control. I mean, we're told to take control, but the fact is that if we're not given the resources, we can only get to a certain level. 0:29:58.3 Andrew Stotz: Plus, also the thinking of senior management, you are shaped by their thinking. And, I always tell the story of the accumulation tables in between processes at a Pepsi production facility. And that basically allows two operators of these two different machines to, when one goes down, let's say the latest, the farthest along in the production process, let's say the bottling goes down, the bottle cleaning process behind it can keep cranking and build up that accumulation table until it's absolutely full. And, that gives time for the maintenance guys to go fix the bottling problem that you have and not stop the guy behind. And, that was a very natural thing from management perspective and from my perspective. But, when I came to Thailand, I did learn a lot more about the Japanese and the way they were doing thing at Toyota. 0:30:51.4 Andrew Stotz: I went out and looked at some factories here and I started realizing they don't do that. They have their string on the production line, that they stop the whole thing. But the point is the thing, if a worker can't go beyond that, you know what the senior management believe about it. So, that was another thing that I would say it goes way beyond just some tools and other things. So, I'll wrap it up there. And Bill, on behalf of everyone at The Deming Institute, I want to thank you again for this discussion and for listeners. Remember to go to deming.org to continue your journey. And if you want to keep in touch with Bill, just find him on LinkedIn. This is your host, Andrew Stotz, and I'll leave you with one of my favorite quotes from Dr. Deming and that is people are entitled to joy in work. 

** Named “Best Podcast” 3 Consecutive Years! 2022-2024 Apex Award of Publication Excellence. In this episode, Executive Editor Theresa Houck chats with Anthony Murphy, Vice President of Product Management at Plex, by Rockwell Automation, about: How manufacturing is evolving. Plex Connected Worker solutions with step-by-step guidance while automating low-value tasks. How workers use it. How it helps with the skilled worker shortage. And as always, get your family-friendly, silly Joke of the Day. Resources from this episode: Watch their discussion on YouTube at https://youtu.be/8Pm670QAO9E. Plex Connected Worker solutions. Learn about Plex, by Rockwell Automation. Free eBook, “Quality Management for Dummies,” by Anthony Murphy, VP of Product Management and Brian Martensen, Product Manager, Plex, by Rockwell Automation Subscribe to our 4 digital magazines at http://rok.auto/thejournal-subscribe.   Automation Chat is brought to you by The Journal From Rockwell Automation and Our PartnerNetwork magazine. Find us on YouTube. Find us on LinkedIn. Find us on Facebook. Find us on X (Twitter). Please hit the Share icon and share this episode with colleagues who would find this information helpful.

Join host Carol Pankow as she dives into the complexities of Order of Selection (OOS) in vocational rehabilitation with two expert guests: Theresa Kolezar, Director of Indiana Combined, and Chris Pope, Director of the State Monitoring and Program Improvement Division at RSA. In this episode, they break down: ·      Why agencies implement OOS due to financial and staffing constraints ·      Key regulatory requirements and compliance considerations ·      Strategies for managing and eventually lifting OOS ·      Indiana VR's data-driven approach to decision-making and communication ·      RSA's insights on fiscal forecasting and policy compliance If you're in the VR field, you won't want to miss this insightful conversation on planning, stakeholder engagement, and using data to overcome challenges.   Listen Here   Full Transcript:   {Music} Chris: As you know, we have 78 VR agencies and only eight of them have a closed priority category, and only one of those eight have all priority categories closed.   Carol: So by going back and saying hey you gotta look at this other side of the house and really analyze what's happening. It will give you the full picture, than what is playing into what's happening over here on the fiscal side of the house.   Theresa: For the majority of folks. They were maybe even having somewhat of a positive impact because we were able to get them processed, get them in sooner. And you know, there's obvious benefits that go along with lower case load sizes.   Intro Voice: Manager Minute brought to you by the VRTAC for Quality Management, Conversations powered by VR, one manager at a time, one minute at a time. Here is your host Carol Pankow.   Carol: Well, welcome to the manager minute. Joining me in the studio today is Theresa Kolezar, director of Indiana Combined. And Chris Pope, director of the State Monitoring and Program Improvement division at the Rehabilitation Services Administration. So, Theresa, how are things going with you in Indiana?   Theresa: Oh, we're doing well. Thanks. So happy to be here.   Carol: Thanks for being here. And, Chris, how are things going for you in D.C.?   Chris: Things are cold in D.C. at the moment, Carol, but we're hanging in there.   Carol: Yeah, not as cold as Minnesota.   Chris: I knew you were going to say that.   Carol: Yeah. I'm like, wow, we're 14 below people. Well, there has been a lot happening with the VR program over the past decade, and we certainly have had our ebbs and flows with funding and staffing. And as of late, the fiscal pendulum has been swinging, VR programs have been experiencing a tightening of the belt, so to speak, and discussions about the order of selection have been ramping up. And so for our listeners, order of selection is a process required under the VR regulations. When a VR agency does not have enough resources, whether it's funding staff or both, to serve all eligible individuals, and it's designed to prioritize services for those with the most significant needs. But over the years, order of selection really has sparked a lot of tension. And for some it's seen as just another layer of government red tape adding to the stigma around bureaucracy. Others argue that it undermines the very spirit of the rehab act by limiting access to services instead of promoting inclusion. Critics point out that it can widen service gaps. It leaves individuals with moderate disabilities without support, even though they still face serious barriers to employment.   And for our counselors, order of selection can bring its own challenges, including the emotional burden of explaining to clients why they can't receive immediate services. And for clients, being placed on a waitlist can feel disheartening and frustrating. And at the same time, agencies are grappling with a harsh reality. There's limited resources. Tough decisions have to be made. So how do we balance fairness, inclusion and the constraints of funding? And that is the question at the heart of today's conversation on order of Selection. So, Theresa, I've been a fan of yours for a long time. I think you bring a really thoughtful approach to almost every difficult situation in VR, and you been around a while, so I definitely want to pick your brain about your thoughts and approach on the topic. And Chris, I'm really count on you to bring the facts from an RSA perspective on what needs to happen with the Order of Selection. So let's dig in. So, Theresa, can you just tell us to start out with a little bit about yourself and your journey into VR?   Theresa: Sure. I probably have the least interesting journey, but maybe the most classic. I went from straight from undergrad to graduate school to get my masters in rehabilitation, got my CRC that same summer, and I entered the rehab field initially with a nonprofit, CRP, before coming to Indiana VR in 2004. So I've been with the VR program for a little over 20 years. Made my journey starting from a VR counselor and now director with, as you can imagine, a lot of other roles along the way. And I think I'm a fairly tenured VR director with almost nine years under my belt in this role.   Carol: Yeah, definitely you would be. Because I remember being told when I left, I had six years, you know, and people were telling me usually the lifespan of a VR director is about five years because the job is tough. So you're definitely one of our longer term folks. So, Chris, how about you? How did you venture into the VR world?   Chris: Thanks, Carol. Well, similar to Theresa, my graduate degree in rehab counseling, I became a CRC and began my career as a VR counselor with the State of New York in the general agency at the time, for about four years. And I've been with RSA now for a lucky 13. Just had my 13th anniversary. And in that time have served in a variety of roles. So, yeah, really happy to be here and now leading the division that's responsible for all of our formula grant.   Carol: Yeah, it's super cool. It's been fun to watch your career, Chris, as  you have grown. I remember one of the very first conferences you presented at, and I believe you were still, you know, more kind of on the staff level. And I thought, who's this guy? You were up there, you just had such a great presence about you. And I'm like, he's going somewhere. And you have, it's come true.   Chris: Thanks, Carol.   Carol: So let's talk about the realities of Order of Selection. It's not something that can be implemented at the snap of a finger. And so I want to start with you. What are those factors via our leaders need to take into account.   Theresa: Yeah. You know it's hard I feel like I sort of came to terms with it because it's it didn't feel so much like something we had to choose or decide upon, but more something we had to do. if your circumstances are such that you don't have the resources to serve everyone. So in Indiana, we enter the order in 2017, and I believe that was the first time in our history, as far as I know, it came after years of trying other things, you know, implementing strategies to improve our capacity, stretch our resources. And just a few examples. Implementing efficiencies, changing to our staffing structure, changing our minimum VRC qualifications to a bachelor's degree, and a whole lot more. And those strategies were definitely focused for us at that time around staffing resources. But there were also some fiscal unknowns or concerns because right around that time, the 15 earmark requirement was also, you know, kind of hitting us. And we were trying to figure out how to shift those resources. So the strategies we did pre they were definitely helpful. They were effective, but we still were left with a deficit. You know, we still had high caseload sizes. It was taking way too long for new referrals to get an intake appointment. Our VRC turnover rate was much higher than is optimal. Ultimately led us to identify that we were not able to provide the full range of ER services to everyone who was eligible, and therefore we needed to enter the Order of Selection.   So we started planning for that probably around nine months prior to. The implementation and when I was making my talking points, there's a lot that you have to do, right, to prepare for Order of selection. So discussion with our internal leadership, our VR council, our stakeholders, our staff conversation with RSA, drafting that state plan amendment, getting that out for public comment. We took a couple extra steps and met with our other workforce partners because we thought, hey, they may get more referrals here. We may want to tell them why and what's going on over here and what this means. And then we of course, you have to develop written procedures, adapt your case management system. And then we also wanted to be really careful with our messaging to applicants. So we drafted some materials that we wanted our intake counselors to share and get that consistent message out there and, of course, training our counselors. So I think the nine month runway was probably a fast track Approach, thinking about all those steps. You want to do it right? You want to be planful. But at the same time, once you identify that this is a need, you usually need it to happen pretty quickly.   Carol: Absolutely. I know for me, when I was a new director in Minnesota, I actually faced this. And Minnesota Blind had not been on an order for many, many, many, many, many, many years. And being a little naive, you know, coming into VR going, we have this situation, you know, I'm thinking this all can happen super fast. It does not. But I found for me, really getting grounded in understanding our data was so important because I see these things all going on. But you had to put all the pieces together, get your fiscal side of the house and what's going on and how you're making expenditures and investments in different things and what's happening with that. But what also is happening programmatically, the people that are coming in and the characteristics of your caseload and all those different things, you had to put it all together to really get the complete picture. And for me, I know I had to do that rather quickly. So it becomes super important to have people around you. If you are not that person you know, that can pull all that data and present it in a way so you can really see the picture of what is happening and kind of unfolding in the state.   I think it just so foundationally because I know I have this little list at my desk of people that have called me looking at needing to go on order selection or thinking they're going to need to. And we have over a dozen states that have outreached in the last two months. And part of my advice to them has been back, you know, you have to get grounded to and what was your data telling you? Because you can't just base this all in sort of an assumption or something. You've got to be grounded. So I always think that that's a really important piece to start with. Now, Chris, I know from a regulatory perspective there are items that are absolutely critical for VR to have in place when you were considering Order Selection. Can you help us with that? Because I want to make sure people aren't making a mistake, you know, as they're kind of thinking through the process.   Chris: Definitely. There are several regulatory requirements, and before we address those, I thought I could provide just a little bit of context at the moment of where we're at with Order selection across the country. As you know, we have 78 VR agencies and only eight of them have a closed priority category, and only one of those eight have all priority categories closed. So this is significant progress over the past several years, I'd say since the passage of WIOA in 2014, in the past, as many as a fourth of our VR agencies had at least one closed priority category. And I can say that when RSA meets with congressional committees and other stakeholders, they often ask us for a status check on Order of Selection, and I can tell you that they respond really positively when we share that very few VR agencies are unable to serve all eligible individuals. Further, since RSA and our federal partners approved, the latest state plan would be the 2024 to 2027 state plans, RSA has approved one VR agency's new order of selection, and at the moment, we have 2 to 3 VR agencies that have submitted paperwork and are pending implementation.   Carol: You might have a few more. Chris now coming because I have I have my list of people calling. I mean really we do have 12 now on the list, so I expect maybe some more outreach.   Chris: Yep. So in terms of all of those regulatory requirements, like you said, VR agencies need to have a few things in place as they consider implementation. These include a comprehensive fiscal forecast, cost containment policies if necessary, and assessment of staff resources. And as Theresa talked about, consultation with the State Rehabilitation Council, so that fiscal forecast needs to address six data points. Average case costs, the projected number of new IPEs, the current number of IPEs, the projected number of applicants and the cost of any assessment services that might be needed to determine them eligible for the program. Projected increase or decrease in the cost of providing VR services to these groups of people, and projected income, or in any other budget resources that may become available. The fiscal forecast produces that data, Carol, that you were talking about, that demonstrates whether or not the VR agency can do the following four things. Whether the agency can continue to provide services to all individuals currently receiving services under their plans. Provide assessment services to all those individuals expected to apply to the program over the next fiscal year. Provide services to all individuals who are expected to be determined eligible in the next fiscal year. And finally, that fiscal forecast needs to include data that demonstrates that the VR program will continue to meet all of the various program requirements, like that 15% reserve requirement that Theresa discussed. So in terms of creating an Order of Selection policy, there are about five things that the VR agency needs to include in that actual policy.   First is it's priority categories, including the regulatory definition of what significant disability means, how the VR agency will determine which individuals have the most significant disabilities. And that definition must build on that regulatory definition of significant disability. The policy needs to address whether the agency has elected to serve individuals outside of the order of selection, who may require specific services or equipment to maintain their job or to keep employment, was one of those new requirements. The policy must indicate how the VR program will provide information and referral services to individuals who may be placed on a waiting list. And finally, the policy needs to describe how the agency will carry out the order, how it will be implemented so, in effect, how the waitlist will be managed and how the VR agency will decide when to open all of those other priority categories. I was happy that Theresa also mentioned that VR agencies need to ensure that their case management system can fulfill the administration of the order. And we like to see in the policy some discussion of what tracking mechanisms VR agencies will use to account for such things as cost, staff time and caseload sizes. So in other words, sort of that real time data analysis that That informs whether the order continues to be necessary or whether it can be lifted.   Carol: Awesome. I'm sure people are probably, as they're listening, taking copious notes. So folks need to know that there also is always a transcript that goes along with the podcast. So if your wrist just broke, you will be able to just take a look at the notes and get all those things. That is super helpful. Chris, I wanted to ask as a follow up, so that people that have outreached so far, those states that have outreached are you seeing? Is it a fiscally related issue? Is it a staffing? You know how sometimes the states are really struggling with having appropriate staffing? I know it's only been a few, but do you know kind of what that looks like if it's based on more of the fiscal end of things, or is it they don't have capacity because they don't have any staff?   Chris: It's been a combination of all of those things, Carol. So we're seeing agencies with limited fiscal resources, whether that be state appropriated funds, their inability to kind of fully leverage the federal award. It may be retention and recruitment of VR counselors. It could also be sort of capacity of providers, whether those are community rehab providers or contractors who provide VR services. And oftentimes it's other things that kind of just contribute to those as well. And what we're hoping to see in those justifications that VR agencies submit is a real data informed discussion of those factors, like real time data in terms of both fiscal data and performance data. So the money and the people.   Carol: Yeah, I can't underscore that enough, because I know the folks that have reached out to us a lot of times they tend to talk about, you know, their hair is on fire about this thing. And then I'm always bringing  back. So if they're all focused just on the fiscal. But I said, what's happening in your program, what's going on? And that has been very interesting as people are talking about. And then they call us back. They go, you know, the characteristics of the individuals coming in the case characteristics, kind of pre-COVID to now is different. And so we're finding clientele coming in has many more needs, and so the cost of the case are so much greater. And they hadn't realized it until they went back in. They just knew something was going on with the people, but they didn't understand what. So by going back and saying, hey, you got to look at this other side of the house and really analyze what's happening. It will give you the full picture. And then what is playing into what's happening over here on the fiscal side of the house. So I think for, you know, we've all said it, the data is super important. I just want to underscore that. So Theresa, tell us a little bit about your journey with Order Selection in Indiana and your current picture what's happening?   Theresa: I echo the data conversation, that's critical, and you really have to justify the need for the order. So we did all of that really before we even probably got to that, that nine month runway that I spoke of. But from there, our next step was to get our internal leadership approval. And there were hesitancies, which is understandable. We really had to work to articulate and help them understand the challenges that we were facing. Again, justifying using that data that we were not able to provide the full range of services to everyone, while also meeting the range of other expectations, you know, timeliness, getting people in the door in a reasonable period of time. And we really had to work to articulate the negative impact of having these ongoing high caseload sizes and the cycle that we were in with staff turnover. It just felt like we were getting deeper and deeper into right into a hole and further and further away from optimal capacity. So ultimately, we presented the Order of Selection as one something that is federally required for our agencies, you know, not able to provide that full range of services. And then two, a lever of sorts that would enable us to maybe pause or slow some of that growth in participants, giving us the space to get out of that cycle to rebuild our foundation, which for us primarily at that time, was fixing our long standing staffing capacity challenges. But for those experiencing fiscal deficits, of course, that focus would look very different. Once we got leadership support, we moved as quickly as humanly possible. And now on the other side of it. I'm thrilled to share that we have now opened all of our priority categories. We released the last 200 or so from our waitlist just this past October, so we were in and out of the order in about a seven year period in Indiana.   Carol: I love that. I like that you said you want to project, you know, the ways to get kind of out of the order to open the categories and do that. I know for states that have contacted us, that's one of the pieces of advice I've been giving. I'm like, okay, you're thinking about the right now, but you also have to think about the future because that is everyone's biggest worry. You're going to do this thing and it's never going to go away. People are going to be in a waitlist forever. You're never putting strategies in place to come out on the other side of that. And I know for me in Minnesota, that was very much part of what I had to do. And given the circumstances we had at that time, I had this plan and I said, if you all can hang with me, I believe by about 2018 or so, end of 17-18, we're going to be on the other side of this, which actually ended up playing out and coming true. And so you've got to not only like react to your current situation, but you want to be thinking thoughtfully about what are those things that you can put in play so that you aren't just going to stay there? This is the lever we're pulling and we're going to be here forever. So I really like that you said that. I know, Theresa, when you and I talked earlier, Order selection can often be treated like a bad word in the VR world, and it is loaded with a lot of stigma and frustration. But at its core, you know, when you and I were chatting and, you know, you just boil it down, it really is a mechanism. It's a tool required by law to prioritize services when resources are limited. And so if we can't do everything for everyone, it's a system that outlines how to make those tough decisions. What are your thoughts about Order of Selection and how we can maybe shift the conversation to reduce the stigma and see it for what it is? It can be this necessary lever to balance fairness amongst those limited resources.   Theresa: Yeah, that's probably one of the trickiest parts in communication. Communication, right. Communication. Communicating with stakeholders about Order Selection will probably always be challenging. It's a challenging thing, but I think there's a couple of things that were really helpful. And one is sharing a game plan to address the underlying resource challenges. Is a helpful approach, right. Making sure that there's game plan. This isn't the end result, right? This is going to enable us to make this shift and again kind of get out of the cycle. We also found it helpful to share the federal requirements. So just very factually, if you can't serve all you have to prioritize certain populations first. And the Order of Selection is the prescribed process for complying with that. And I think it's a good process for doing that. It's effective at making sure the prioritization happens. Additionally, we also share data throughout our process on the percent of eligible individuals who were impacted. And what that showed is that the majority of individuals were actually not impacted. You know, relatively speaking, a pretty small percent of folks ultimately went on a wait list. And, you know, you could even argue, and I think we did a couple of times that for the majority of folks, they were maybe even having somewhat of a positive impact because we were able to get them processed, get them in sooner.   And, you know, there's obvious benefits that go along with lower case load sizes. So we often relay that only about 10% of eligible individuals were going on a wait list, and 90% were meeting that criteria for those with a most significant disability, which was our open category for a good bit of our seven years. I will say people were a little wary of that stat. They kind of had a hard time believing that, and I think that it's because that term MSD or most significant disabilities, it definitely has meaning. But also we found it could be a little bit misleading. You know, people thought, oh, to be MSD, someone must look like this, right? And we actually found that those meeting that MSD criteria were really a more inclusive group than maybe that term people would perceive that term to imply. And that was just another educational opportunity for our stakeholders and our referral sources.   Carol: I like that you talked about the communication piece around all this, because that really is important. It's almost as important as all of the plans you're putting in place. All the things that Chris told us about that need to go in developing that communication plan, that goes along with how you discuss this out amongst all the stakeholders and such, is super important. I know, Chris, do you have any insights on this part, on the stigma or anything you wanted to share?   Chris: I guess I just had a couple thoughts on like the element of fairness that you talked about in dealing with fairness and at the same time limited resources. So I guess I would just say that order of selection is only one of the cost containment measures afforded to VR agencies through the law and through regulations. And there are other things, too, that VR agencies may want to consider, and that's comparable services and benefits. How we inform people and refer them to other workforce development programs. Those may be our partners or others. How we balance what VR Agencies by in terms of services and what we provide in-house in the cost kind of associated with both strategies. One of the other things that RSA often considers VR agencies to look at when we're talking about implementing an order is kind of carefully evaluating the need to require additional assessments when the law allows and promotes the use of existing information. So sort of not overdoing that eligibility determination process because that often comes with cost. Right. And then finally VR agencies should also be reassessing sort of their routine practices and policies that result in increased cost. That may not always be necessary. So we're really looking at kind of the entire fiscal picture of the program, not just those VR service costs that are provided to eligible individuals.   Carol: That's good. I'm glad you brought all of that up, because we often do talk about these other factors. And I asked people, are you also looking at what are you getting bang for your buck? And not that we're trying to bang on vendor communities, but do you have vendors where people never like they're never done with service, they never graduate, they never get to the end? I mean, maybe it's looking back at that and going are the ways in which their training really working for your clientele? Maybe not. Maybe you need to circle back and work with them or have a parting of the ways and think about that. I also like the thinking about really leveraging our partners. I mean, the whole rehab act, when it was redone, you know, and we had the 2014 WIOA comes out of that. We always had partners, but I don't think we were very good at leveraging what things are they doing. And I feel like some of this stuff is duplicative. You know, why are we offering these same sort of trainings that are now at the one stop that people can access and go to those courses or whatever, you know, types of things that they're offering. So it does force you to take a look at that and really actually live in to WIOA and leveraging the partnerships and the funds across all these systems. I like that. Thank you Chris, for saying that. Order Selection also has to be a super thoughtful process. And so, Chris, I know you talked about the data points that folks should look at. Theresa, what are the data points you look at regularly? And I like it because some directors talk about kind of they're reading the tea leaves to complete your fiscal forecasting, or there's some other things that you like to do.   Theresa: Oh gosh, yeah, We could talk all day on fiscal forecasting. But to just kind of be brief, you have to look beyond just what did we spend last year and apply that and assume that. And I think if you don't have programs talking to fiscal sometimes that is the fiscal assumption. Right. By fiscal staff being made. So with the pendulum swings that we tend to see in VR, which of course are highly driven by trends and applicant and participant counts, you really need to have a very layered approach to forecasting. This is where, again, that program knowledge and fiscal knowledge, it's essential that they're paired up. Just a few things to consider would be beyond the basics right. What is your data show? What are your trends? Show. But what's in your state plan? What are the goals? What are the initiatives that you have in place? There may be a fiscal impact to those, right? There may be a staff resource impact to those. So for instance, a very obvious example in our state plan, we have some goals around increasing enrollment in post-secondary training. There's some fiscal impact there. We need to know what that is, how to apply that, and then really have an understanding of our ability to sustain that goal into the subsequent years.   Again, the applicant and participant growth trends are super important. So keep your eye on and then any impact of any other outreach or collaborative partnerships that might be contributing to some of that program growth. You know, more people served generally is going to mean more expenses. And then just quickly, from kind of a fiscal standpoint, something that might be a little bit unique beyond, again, all the basic essentials of fiscal forecasting is we really have to account for carrying over a certain portion of our dollars. And that really comes down to making sure we don't have, you know, disruptions and services and can comply with this period of performance requirements. So we find in Indiana that, you know, carrying over like 20 to 25% works well for us, ensures that we can continue authorizations past 9/30 and not have that challenge of waiting until ten/1, you know, to encumber new funds. And that just keeps the flow of services going. So I'll just add that as maybe a nuance that others aren't always thinking about.   Carol: Yeah, I appreciate that because I think that having that strategy I did too, as a director, wanting you have your sweet spot of what you like to have in that carry over, because it really does promote that consistency when you have that hard start and stop, and especially in an era of continuing resolutions, you know your whole strategy with how you're flowing into the next year and how all that's going to work. You need to think about that piece for sure. Now, I know a big problem has existed around priority categories and the most significant disability designation. And many programs have three categories, but almost 90% of the customers are in category one, which makes it difficult, you know, when you're implementing an Order of Selection. How did you address that in Indiana?   Theresa: Yeah, that's exactly what we saw. And we balanced this by a couple of key strategies. One is that we did not release anyone from the waitlist until a little over two years into our process. That's  kind of how we, how bad of a cycle we were in. And again, it's a lever. It's  that dial. We had some targets like caseload sizes, retention rate that we were tracking as a gauge to when we could start moving people off that waitlist. So just for example, average caseload size is getting to under 100, turnover being less than 20%. So those were some indicators to watch to start releasing folks. Another strategy that was really helpful is that we opted to do larger releases each quarter instead of kind of smaller, more frequent releases. And this gave us the opportunity to really have our staff know that it was coming the same time each quarter. They could carve out time because it is a lift on top of the day to day, right? You've got to reach out to folks multiple times. You've got to schedule them for meetings. You've got to get IPEs in place. And then with those reviews of the, you know, again, we might look at like 2 to 300 people to see, can we take 300? Can we take 200? Is it somewhere in the middle? How does that break down across your 26 offices? And inevitably each quarter, one office got hit with a high number. And then there were a few that had very little. So we also had to weigh that and see where we could balance our resources to make those work. You know, at the end of the day, you ultimately have to release more people from the waitlist than new people who came in as eligible that quarter in order to get ahead of it. So that was another data point that we looked at.   Carol: Did you find that actually learning kind of through Covid, a lesson, you know, with working remotely and all of that, did that help as you're looking at distributing across the 26 areas? Because you can I mean, and I've talked to other directors about this now you can work with people. Maybe you're in this part of the state, but you can work with other folks as well to keep them moving. So maybe there isn't this huge one off, it's just got 200 people and the other offices get one, you know, they don't have any. Did you find some ability to flex that around the state?   Theresa: Absolutely. That's exactly what we did. So those offices that were hit hard, of course, they were also the offices with the highest number of vacancies. It just seemed to be how it fell every quarter. So absolutely, our region managers really did it. We have five of those five regions. They really did an excellent job troubleshooting that, you know, we helped where needed. But they for sure did that looking across offices in their region and even across the state. We also have about 7 or 8 working lead counselors, kind of floater counselors. So we were able to deploy them to the areas with the highest need. And then as we progressed through the order, we had a pretty robust outreach process. As we were getting ready to release folks, we ended up centralizing that a little bit to take some of that load off of our field staff as well. So, you know, you kind of have to adjust as you go. Move your resources where you can. But absolutely, we found that to be a great strategy.   Carol: Chris, you have any thoughts on that about the priority categories and the most significant disability? I just wondered because I know folks struggle with that. You were looking contemplative, so I thought maybe you might have something to add.   Chris: My philosophy with a lot of things, Carol, has always been less is more. And you mentioned that most of our agencies have three priority categories. And if I were able to say this is a requirement, that would probably be what I would say. But, you know, VR agencies have flexibility to develop more than three. I would just caution that as you get more complicated, things get more complicated for applicants to understand and for VR counselors to implement. So again, I would just say that the law requires that the significant disability category be identical to what's in the rehab act and the regs, and that that most significant category needs to build upon that. So we often see agencies talking about more functional limitations, more services being needed, more time needed to help the person reach their employment goal. So the more specificity there, the better is. I think that helps VR counselors kind of understand where to place people when they're determined eligible.   Carol: Yeah, that's really good advice. Now I know, Theresa, also, you have talked about wanting to bust the myth that nobody gets off the waitlist. And how can we better do that?   Theresa: I can't tell you how many times I've heard that in Indiana, and that was part of the a lot of the grief is that there was this thought that we'll never get out. So we know that's not true. The facts are there. You know, there are many states. And Chris shared, you know, 25% down to less than ten. So less than ten states. So we know it happens. There are states who've done it. I don't know if we do enough to highlight that to kind of our stakeholders, you know, at large and celebrate that. So maybe that's part of the answer. You know, we have those actual examples. That's an important part of the communication to internal and external stakeholders. The other piece here is outlining the conditions that need to be in place to progress, to opening more categories, to ending the order, and then people can see you hitting those target milestones. They may start believing that, oh wow, there's some actual notable objective progress here. We are getting closer to the end. This does seem doable.   Carol: Yeah, I think going back to that communication strategy for sure can help. I know with our SRC, and I had laid out the plan like I had all these points that we needed to do to kind of get through our struggle. And as things were met or we were able to achieve other savings in certain areas without impacting, you know, a quality of a service. Man ,it was great. Like no stone was unturned as we did that. But I wanted to be super transparent. Here's all the things. And I kept a little chart, like, here was this savings, or here we met this thing so people could see we were actively working a process all the way through, versus okay, we are pulling the lever and the lever is just staying closed down. That's it. They don't see the other end. All that work that's being done behind. So what is your best advice for state directors contemplating pulling the lever?   Theresa: Well, we definitely looked at it as that lever or that dial, and we felt that that gave us an opportunity. We really would not otherwise have had to take action on addressing a really significant foundation or core issue while slowing down that incoming train a little bit and refocusing our resources, staffing and fiscal building adequate resources and capacity. It's an ongoing effort. It never ends. It's one of the more difficult things, probably, that we do, but it's so critical to carrying out services in general, let alone good quality services. And it requires a very thoughtful plan and a lot of simultaneous strategies. You know, all the strategies we implemented from salary adjustments to, you know, creating those working lead counselors I mentioned, we developed a layer of case coordinators to take on some of the case management aspects. I think some states call them rehab techs. Lots of gaining of technology, you know, modernization and efficiencies and then some. Right. It ultimately helped us with two really big systemic needs. And one was getting cancer caseload sizes to manageable levels and reducing our VRC turnover. I mean, those things are gold when it comes to staff capacity.   Carol: Now, Chris, I don't want to steal your thunder, but what I'm going to say to folks too is call RSA. Like, reach out to your liaison and talk to them about your situation. You want to start those conversations because the worst thing I would think is you're a state liaison at RSA and you just get this boom, we want to do it. We need to go on March 1st and today is January, you know, 24th. You want to have that partnership all the way along. And I know, Chris, you can speak a little more to that for sure.   Chris: Carol, you know, we often talk about with clients early and sustained engagement. And I would encourage VR agencies to take the same approach with us at RSA. Reach out early and keep that conversation going. The order of selection approval process is going to be iterative. In 99% of times, RSA will have feedback and will have questions, and we'll want to see justifications be made as strong as possible. So to your point, Carol, our ability to approve orders of selection overnight is not possible. Theresa talked about sort of a nine month on ramp. I wouldn't say it's going to take that long on our end, but it will take at least a couple of weeks. And the stronger the justification we receive, the better. Again, I would just say that consider all of the flexibilities that the Rehab Act offers to VR agencies when it comes to managing the program, in addition to implementing an order. And we talked about some of those before, but they could mean cost containment from financial participation to preferences to instate services, to looking at the administrative costs that you might pay for providing services, your staffing capacity, and really leveraging the ability of your SRC. To advocate for the program, we often talk about the return on investment of the VR program, and it really is unlimited. Our program offers a lot of flexibility to be creative, to help people meet their career goals, and that's kind of the best thing we have going for us to argue for the sustainability of the program moving forward.   Carol: Yeah. Excellent points. The SRC can do so much more than we can do, really, and a lot of venues and have a different voice and a seat with the governor. You know, they're appointed by the governor. They have a different mode of communication that they can use that we cannot. So we definitely don't want to forget about them. All right guys, so we're coming to a conclusion. Any last parting thoughts from either of you for our listeners?   Theresa: Well, I'll just add, I think we've touched on a lot of great lessons learned in communication. Number one, really important. And we've hit on some ideas and strategies around that. And then the second, having that game plan, it's  critical so that we're all viewing Order of selection, not as that end result right, or that indefinite status, but as that lever or that dial that can be adjusted to address the situation at hand and then get back on track, get out of the order, be able to serve everyone who needs those services.   Carol: Awesome. I really appreciate you both and appreciate having this conversation. And for our listeners who were taking notes, because I know you guys read the transcript because that will help you with all of that. You can go back through and highlight the things you need to do. Thanks so much for being here today. Appreciate you.   Theresa: Thank you.   Chris: Thanks, Carol.   {Music} Outro Voice: Conversations powered by VR, one manager at a time, one minute at a time, brought to you by the VR TAC for Quality Management. Catch all of our podcast episodes by subscribing on Apple Podcasts, Google Podcasts or wherever you listen to podcasts. Thanks for listening!

In this episode of “Answers From the Lab,” host Bobbi Pritt, M.D., chair of the Division of Clinical Microbiology at Mayo Clinic, is joined by William Morice II, M.D., Ph.D., CEO and president of Mayo Clinic Laboratories, for a conversation about quality management. Specifically, they discuss: The benefit of investing in quality management for patients, staff, and the organization.How Mayo Clinic's Department of Laboratory Medicine and Pathology in Rochester evolved and grew its quality management program.The advantage of holding 5–10-minute huddles each day.How the lab leverages education on quality tools and Gemba Walks to empower all staff to invest in quality management.

Topics and terms such as biosafety, biosecurity, containment, and contamination are things most of us have heard of and think about at some level, but with the pace of molecular biology moving faster than ever, these are topics with implications that are reaching farther than ever. We're joined by Dr. Ryan Burnette and Dr. Lauren Richardson from Merrick and company for this episode, and they're ace communicators that help walk us through the expanding horizon and implications of these topics.This conversation starts on the basic topics, like what biocontainment is and what's needed for each of the four levels of biosafety labs, but it quickly moves beyond, shining a light on the security and containment needs for more than just the organisms. We hear about how the data and methods used to do modern molecular biology, as well as the data generated in the experiments, are equally precious and in need of protection and containment. With public health and safety on the line, and an acknowledgement that the pace of science moves faster than that of policy, we get into the idea of who really owns responsibility for protecting data. Your role might be more important than you know, so don't miss this conversation that will make you pause and think! Subscribe to get future episodes as they drop and if you like what you're hearing we hope you'll share a review or recommend the series to a colleague.  Visit the Invitrogen School of Molecular Biology to access helpful molecular biology resources and educational content, and please share this resource with anyone you know working in molecular biology. For Research Use Only. Not for use in diagnostic procedures.

Spend a little time with the Amazon Web Services team as we talk about the future of reporting, especially around AI.  How will AI help us find data faster?  Listen and find out!

The importance of setting key objectives can't be understated. They help drive continual improvement and reflect a business's key metrics for success in various areas. They are also a key aspect of implementing an ISO Standard, with most specifying a dedicated Objectives clause. While most businesses will have objectives irrespective of any ISO certification, many may fall into the familiar trappings of having separate objectives for different departments, which only serves to fragment your measurement of success. In this episode Ian discusses the importance of setting key business objectives, and why you should be aligning these with your strategic direction.   You'll learn ·      What is the Annex SL format and why was it introduced? ·      What is meant by ‘Strategic Direction'? ·      The importance of risks and opportunities in objective planning ·      Who are setting key business objectives important? ·      How can you align objectives with a businesses strategic direction?   Resources ·      Isologyhub     In this episode, we talk about: [02:05] Episode Summary – Ian discusses how to align objectives with the strategic direction of the business, and why it's important to do so.    [02:55] What is the Annex SL format and why was it introduced?: The Annex SL format refers to the standard 10 clause structure that we now see in most ISO Standards. Introduced back in 2015, it sought to address the issues with integrating multiple Standards, in addition to making them more accessible to every sector. Prior to 2015, many ISO standards were designed with specific sectors in mind, using terminology that would make sense to them, but perhaps not to others. The Annes SL format now uses the same language across all ISO's, making It easy to integrate multiple ISO compliant Management Systems. [06:10] What is meant by the term Strategic Direction? Leadership: This is a term that appears in ISO 9001 5 times. We first see it in Clause 5 – Leadership, where it states: “Top management shall demonstrate leadership and commitment with respect to the management system by ensuring that the policy of objectives are established for the management system and are compatible with the context and strategic direction of the organisation.” This is where it's made explicitly clear that leadership / management are responsible for ensuring the Management System aligns with the way their business runs, in addition to integrating it into existing processes. [07:05] What is meant by the term Strategic Direction? Management Review: It also appear in clause 9.3 Management Review, where it states: “Top management shall review the organisation system at planned intervals to ensure its continuing suitability adequacy, effectiveness and alignment with the strategic direction of the organisation.” Again, this reinforces the need for top management to be involved to ensure that the Management System is in alignment with their overall goals. [08:40] What is meant by the term Strategic Direction? Context of the Organisation: It also appears at the very start of the auditable clauses, in Clause 4 – Context of the organisation, where it states: “The organisation shall determine the external and internal issues which are relevant to its purpose and its strategic direction.” This involves looking at issues from a legal, technical, competitive, cultural and economic point of view, and many of these will be determined by top or broader management within the business. They ultimately have the most influence in how a Management System is built, therefore have the most influence on how the policies and objectives are created. [10:45] The importance of risks and opportunities in Objective planning – Clause 6 (Planning) is where we address risks and opportunities raised in clause 4. It states that ‘Objectives must be established at relevant functions, levels and processes.” For us at Blackmores, we directly relate the findings from a risks and opportunities assessment (such as a SWOT & PESTLE), and link these to our objectives to try and minimise those risks. We also leverage the opportunities, by making them real tangible goals to work towards – seems obvious but we often see businesses missing the link between these exercises! [12:00] How can you set Objectives in alignment with Strategic Direction?: Many businesses now build their mission, values and strategic direction around sustainability and general ESG. When building a management system, you need to consider how it affects those sustainability / ESG goals, because that is essentially the context of your organisation. So, you'd need to consider: How does environmental performance, health & safety performance or legal compliance contribute to the success of the management system as a whole? You don't have to be going for ISO 14001 or ISO 45001 for these things to matter, even a quality management system can contribute to sustainability goals. This can be through improving economic performance by reducing waste ect. Also, don't be afraid to relate economic performance to your management system. If you have a turnover goal of X, mention that in your context documentation, and also consider how the management system can contribute to achieving that goal i.e. through processes, controls, monitoring and improvement activity. Also consider your client requirements, they may require an accident rate below X which can also be included in context documentation and can then be factored into your management system measures and objectives if need be to achieve that. [16:55] How do you establish your objectives? – First you must establish context, and that context must be relevant to the purpose and strategic direction of the business. The context setting must include those who understand that context, strategic direction and the purpose of the business, the risks and opportunities must be assessed in relation to that context, which in turn is already aligned with strategic direction. Finally the objectives must be set in relation to those risks and opportunities. It's all about having the right people to identify the relevant issues affecting the organisation, and setting concrete objectives in order to improve that. 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This Manager Minute episode spotlights how the Massachusetts Commission for the Blind and MassAbility are leveraging AI to improve service delivery. Host Carol Pankow discusses innovative AI applications with guests Lola Akinlapa, Nathan Skrocki, and John Oliveira. They explore an AI-assisted intake platform designed to streamline processes, enhance multilingual support, and enable faster access to services. The conversation also highlights AI-powered tools like policy lookup systems and data visualization platforms like Tableau. Emphasizing accessibility and transparency, the episode showcases AI's potential to alleviate administrative bottlenecks, support staff, and empower consumers while preserving the human touch in service delivery.   Listen Here   Full Transcript:   {Music} John: We were looking for items that might be helpful to our staff. As many of our veteran counselors move on to retirement, it became imperative that we find a way that the newer counselors could find access to information quickly.   Lola: We're not looking to reduce workforce. We're not looking to reduce your day to day operations, right. We're looking to streamline and to make the consumer's journey at MassAbility more accessible to them.   Nate: What we're doing is just enhancing and streamlining the process to better understand and strengthen their policy knowledge, to make their jobs a little bit easier.   Intro Voice: Manager Minute brought to you by the VRTAC for Quality Management, Conversations powered by VR, one manager at a time, one minute at a time. Here is your host Carol Pankow.   Carol: Well, welcome to the manager minute. Today joining me in the studio is Lola Akinlapa, director of strategic initiatives in Massachusetts. Nathan Skrocki, Policy director at the Massachusetts Commission for the blind. And John Oliveira, Commissioner for the Mass Commission for the blind. So how goes it, Lola?   Lola: Oh, everything is good. Thank you for having me, Carol. I think this is a really great forum to kind of spread the word on what we've been doing at the state of Massachusetts.   Carol: Excellent. How about you, Nate? How are you doing today?   Nate: Happy new year. Doing well. Glad to be here. Thank you.   Carol: Excellent. And last but not least, John, how is it? How are things? You got a new role.   John: Everything is great. A very cold day today, but we'll get through it. Uh, it's close to zero wind chill. So very cold day here.   Carol: Ah, it's like you guys are in Minnesota...   John: Yeah, I think so.   Carol:  Joining Jeff and I...   John: I think so.   Carol: Yeah. We were three below today. It was fabulous. Well I'm super excited about our topic. So artificial intelligence, although it's really not a new concept, it's gained significant attention in the recent years and the field of AI research was officially established during a workshop at Dartmouth College in 1956, where researchers optimistically predicted that human level intelligence machines would be achieved within a generation. However, it became clear the challenge was really greater than anticipated. But today, you know, we have AI everywhere seamlessly integrated into our life. You know, we've got Siri and Alexa. I rely on them all the time to your biometric scanning at the airports and the list goes on. And I had the good fortune to find out that Massachusetts is really standing out as a state that has embraced the broad implementation of AI and incorporating it extensively across various aspects of daily life and governance. So I want to dig in and learn some more from you guys. So I'd like to start out because our listeners like to get a little insight into all of you. If you could tell us about yourself and your role. And for our my two friends from the Blind agency a little bit. How you got into VR? And Lola, I'm going to start with you first.   Lola: Thank you, Carol. So a little bit about myself, as you mentioned, Lola Akinlapa, I am Director of Strategic Initiatives at now, formerly what used to be the Mass Rehab Commission and now known as MassAbility. I came into the agency back in 2014. I actually started in research and development, doing a lot of the analytic work. I actually was voluntold, I would say, to assist in a new project that we were implementing. It was a statewide case management system for our different divisions at MassAbility. Through that process, I was able to kind of take a step back to say, well, what do we need at this agency to push us toward the future?   Carol: Yeah, Lola, it is great being voluntold, because that leads to some of the best things when you're working on different things. So, Nate, how about you? How did you land at Mass Commission for the Blind?   Nate: I landed at MCB about eight years ago. At this point. I've been a manager within state government for many years and ended up at MCB. Hopefully this is where I'll be staying for many more years. I really like the mission of MCB and the work that we do as an agency to provide services to residents of Massachusetts.   Carol: Good stuff, good stuff. And John, you've switched roles, so I've known you for a while. But tell our listeners a little bit about yourself.   John: All right. Carol, I've been with the agency for, wow, 37 years.   Carol: Oh my gosh.   John: And started out in services and worked with the senior staff, senior consumers, and was in vocational rehab for a while, worked as director of staff development and training for a while. I headed up the assistive technology program for a while. I was deputy commissioner for something like 12 years, oversaw the programs, and I've been commissioner now for a year and a half.   Carol: Good for you. Well, sure good to see you again. So in the fall, I had the had the chance to attend an AI convening with Tony Wolf, who is the MassAbility Commissioner. And Tony was mentioning she kept talking about all these really cool things happening in Massachusetts. And I just I needed to learn more. So now, Lola, like, how is MassAbility moving in this AI space? And I know you're doing some things that are helping the consumer experience be quicker and easier. What's that look like?   Lola: Oh my God. It's been quite a journey to say the least. At our agency, we as many other agencies identified bottlenecks, identified issues with maybe the bureaucratic side of things where it takes longer to get someone from point A to point B. It was through, actually, our centralized intake unit where we discovered there's area for improvement here. And that area of improvement could be resolved through an assisted intake form. So at MassAbility, we're developing an AI assisted intake platform that's meant to support our staff at MassAbility, who are doing the intakes to allow them to have more leeway on doing what's more important to the work, which is getting our folks to the services they need. Through this intake form, we're actually removing the repetitive task. We're looking at some speech to text technology and then also some guided workflows. And we're also able to get multilingual support. And through the intake, it's meant to guide a lot of our consumers to feel a little bit more empowered to get from I'm stuck here, how do I get services that I need, whether I'm going to work or looking to live or transition into the community, instead of waiting months before someone can speak to you to get you through the process.   In this platform, we're actually able to allow our staff to have more time to be dedicated to more personalized interactions with our clients. So it's been a journey to kind of develop what that roadmap looks like. But we are super excited about this. We actually will be going live early this year through our MassAbility site, through our consumer portal, where it will be housed, and individuals will be able to go in, log in and fill out the form, and the form would guide them through the entire process without human interaction. And for us, I think it's really important to take a step back and really understand the purpose of this. Right. It's not to remove the individual from their work, right. It's to make some processes a little bit more streamlined, but then have our staff, our counselors, our case managers be able to focus on more of the human interaction. It's been quite a journey for us, to say the least.   Carol: So, Lola, are you working on that with your own state IT folk or who kind of is helping you mastermind all this?   Lola: So this is in collaboration with our IT folks at Executive Office of Technology. Also, we're working with a contractor who's been helping us build this platform out. They've been super great. It's been a very collaborative effort across the board. I would even have to throw in Microsoft because there's some work that they're assisting us doing, and it's been a team effort to get it to where it is today. And we're actually very proud of what we've done in such a short period of time.   Carol: Very cool, I like it. I know Lola, you had talked to me too, you were interested in doing something kind of in this data realm because I know data isn't cool always. But you were trying to do some stuff with Tableau and AI. So what does that look like?   Lola: Tableau. For folks that don't know, it's a visual data tool that we've been using at MassAbility for a little bit over four years now. The really cool thing about technology is as the years go on, the tools get better. Tableau was another way that we were using to kind of drive our data decision making at the agency. You know, things that are really core to the MassAbility beliefs in our missions. With Tableau, we're able to have a chatbot, and the chatbot would be utilized something similar like ChatGPT, where you could say, show me how many individuals are getting X services, or show me how many individuals are served in certain parts of the region. Right?   Carol: Yeah.   Lola: very cool things like that where you don't have to be a data analyst or a data science...   Carol: right.   Lola: to use Tableau. It kind of makes it more user friendly and at your fingertips. I think of it like on demand data. So that's something that we've been looking at that is in collaboration with an initiative that we have over at Northeastern. And we've submitted a proposal for that. So we haven't started, but we're looking forward to some of the cool and innovative things, because I think many state agencies will agree. Data is really, really interesting to look at, especially when you're looking to tell a story, when you're looking to improve just the overall outcomes of your agency, depending on what you're looking to achieve. So it's really been something great that we're looking forward to getting started. And then also on the back end, kind of showing and empowering our own staff as to what this data means, right? Because not everyone is a data scientist. Not everyone enjoys. It's a very dry subject, but I think this is a way to keep folks engaged in terms of what's really going on at the agency, and it kind of tells a story without having to truly understand the data to tell the story.   Carol: I love that. I think you'll find if you guys can make that all happen, there's going to be a lot of folks across the country that are going to be super interested in that piece because data has been so critical, especially as WIOA passed, and we're looking at so much more of the data and what really is happening for individuals with disabilities and getting into employment. And so I feel like sometimes we're data rich, but we're analysis poor. And people are like, I don't know what all this means. You get a little bit overwhelmed by the data. So I think that would be great for people to be able to do the old ChatGPT kind of thing and just ask a question and get the answer.   Lola: Absolutely.   Carol: I love that, that's very cool. So when you look at AI, there really has been considerable impact, too, for individuals who are blind and visually impaired. And Nathan and John, I mean, what are you guys seeing with the customers you serve? Just in general, when you think about AI and the work you're doing now?   John: Well, obviously in the assistive technology field, there's always been a lot of talk about incorporating AI to serve consumers. And over the past 4 or 5 years, many of the wearables have become very popular. And every year when you see these items, they get better and better. And that's benefiting a lot of our consumers tremendously. I'm sure that you've all heard about the meta glasses. Tremendous assistance for our consumers. You put on this pair of glasses, you can take pictures of the environment you're walking through. You can use it with description services such as Aira and Be My Eyes. And it works great for someone who doesn't know the area. For someone who's trying to do some work and needs to access print immediately, a great way to do this. Many other things are coming down the pipeline, but we were looking for items that might be helpful to our staff. As many of our veteran counselors move on to retirement, it became imperative that we find a way that the newer counselors could find access to information quickly. We do the trainings the usual way, but that takes quite a bit of time. And if you have questions and you want answers right away, we were looking for a solution and we came across this solution in Outlook Insight. I read about it somewhere, I called them, I spoke to an individual at the company and we agreed that we would meet at the NCSAB Conference. And I turned them on to Nate and his policy team. And he can give you more of the story about that journey going forward here.   Carol: So what do you know, Nate?   Nate: Thanks, John.   Carol: John is the idea guy and he's like, Nate, go do the thing.   Nate: And it works out great. So what we did was we connected with Outlook Insight, and we wanted a tool that would allow kind of a quick reference lookup for our case managers. So it could be that they have questions themselves and the policy or procedures. And making sure a case is executed properly or consumer may have a question and they want a quick reference for that. So what we did with Outlook Insight is develop a tool that takes all of our internal policies and all of the other policies that govern us, and kind of housed it all in one place and very similar to ChatGPT or some of these other AIs out there. You can ask it a question and it will provide a response. And when it provides a response, we have the ability to really take a look at where it's coming from. So it will include all the resources that it's pulling from with the response. So it will cite the documentation. So it might be some direction from RSA or some of our internal policies or another piece of policy that is out there, another piece of guidance that is out there. And it will cite that particular piece of policy where it's coming from. You can click on it. When you click on it, it will bring that policy up and you can read further, but it will also provide that response. So if you ask it what form is needed at this step of a case procedure, it will bring up what form is needed. Bring up the form and you can go from there.   Carol: Nice. So where are you at in the process with this rolling out?   Nate: We have rolled it out to some staff. It's not officially rolled out yet as an agency. It's something we're still testing. But we did roll it out to some staff to test to really kind of understand what they're using it for. Another piece of it is we're allowed to add tiles to this particular system. We can create these buttons or tiles above the search bar that will have preloaded questions. So say a consumer is going to college and we you know we might have a button that has the question on it. What is college reimbursement for a student at MCB. You can click on that and we'll bring up all the information about what's appropriate for college reimbursement, how much that college investment can be, so on and so forth. We wanted to get an idea of what people were asking it. We wanted to get an idea of what they're using it for, so we can kind of load in those different tiles on the top as well. And as we go through certain cycles in case management, those will change over the year, in the future when we do roll this out. And we also just were curious on what people were looking up for quick reference. And people are using it. It is a very good tool. It's been helpful for us in the policy unit. We're not getting as many questions for people that are using it, because they're going to that first to see if they can look up the policies on their own and get a response on their own. We do caution people though, because it is AI, so sometimes it does not provide the full picture. I guess is the best way to put it. It might give a partial answer. We haven't seen where it's giving any wrong answers yet, but sometimes it doesn't fill in the whole picture. So that's why we include the policies with the response, because people can go in and search further within that policy if they need to formulate a decision a little bit better.   Carol: Yeah, you bring up a really good point. You always have to trust but verify, even ChatGPT you throw something in there. And I use it a lot because it's super helpful and it'll be going along. It's really great. It gives this response and then you have some kind of wacky line comes in there and you go, I don't really know where that came from, but that isn't right. So you can't just turn it all over to the bot. You still have to use your own kind of critical thinking skills and take a look to apply it.   Nate: For sure. The advantage that we have, as opposed to like an open source AI, is we control what goes in and out of where it's pulling from. So we're the ones putting the policies in. Or as Lola had mentioned before, if you want statistics or something like that, you can put it in a document with certain statistics and it can pull from that. But we control everything in there. So it's not pulling from this open source where it might recognize something as helpful, but it really isn't. It's everything in there. We've kind of vetted and we understand it's something that is needed by the agency.   Lola: Absolutely. And just to Nathan's point, open source, we're talking about like Google, you know, you can get millions of results back and very true at MassAibility. Similarly, we obviously have regulations that we're following with RSA. And there are things that we have to control just to make sure the language is correct. So we're putting in what needs to be said at the bot kind of just follows that logic. So that's kind of the nice thing where you can still have that control, even if it is kind of AI, but it's still guarded. It's not as loose as just an open source would be.   Carol: Yeah, absolutely. It's a great point, Lola. And I know for the both of you, you know you're doing things that are impacting the staff. So staff can definitely have a reaction to this. Sometimes positive, sometimes not. Like we're all super excited. I see your smiling faces like, yay, we're doing the thing. And then they're like, you know, people feel like back what I was saying in the beginning, like, we're going to replace everybody with robots or something. And so staff can get concerned. So I'm going to kick this to you first, Lola, what's been kind of the response from staff about the things that you guys are trying to do?   Lola: Well, I'm very fortunate to work at an agency where folks are very open minded. Change is a little different, but we're very open minded at MassAbility. I think it's all about the messaging and the purpose on why we're doing certain things right. For sure. There are people that are going to have, you know, pros and cons about it, but I think how we message it is we're not looking to reduce workforce...   Carol: right.   Lola: We're not looking to reduce your day to day operations, right? We're looking to streamline and to make the consumer's Consumers journey at MassAbility more accessible to them. The option that we have right now and how we've messaged it to staff is it's an option, right? We're not removing the human aspect of it, but it's an option for individuals who are in certain circumstances that need to get something done a little bit faster, right? It takes a little bit longer to talk to individuals, but if it's something that they feel like, you know, I'm just going in and I'm looking for a job, I know everything I need to have. This is another outlet that they can use where the system itself is like, I'm not a person, but I can guide you like an individual, right? At the end of it, you will be meeting with a person. You will have that personalized experience, that interaction, but mostly for the admin and the data entry, right? We can repurpose that. We can shift that burden to some of the tools that we have available to us, like the AI assisted intake form. So that's really the messaging behind it, right? The messaging is not to impact staff. It's not to scare staff.   Carol: Right.   Lola: But it's more to help think of allowing people to have different options to come into the agency that aren't so impactful or don't feel like a bottleneck.   Carol: Yeah, I love that. I love that point. How about you guys, Nate or John? Have you seen any initial responses from staff, maybe different than you thought or how has it been going?   Nate: I think for us it's a little bit different too, because we're providing human services, so we're not replacing that in any way with an AI tool. We're not going to be replacing us, going out and sitting with a consumer and meeting them where they're at and providing the services that they need to be successful. What we're doing is really just enhancing and, like Lola said, streamlining the process to better understand and strengthen their policy knowledge to make their jobs a little bit easier. We haven't really explored any type of AI that would help with case management work or anything like that, and it's really tough because like I said, in the human service field and in Lola can probably also agree with this. Every consumer is so different. We're meeting with them a lot of times in person, especially at our agency, and providing the services that they need. A lot of it's hands on services, something that we're not going to be able to do with AI. What we're really looking at is how do we enhance their ability to provide and streamline services and make the experience better for the consumers and for our workers. And that's what we've done with this first policy tool. And I think it's been successful. I don't know if you have anything to add there, John.   John: Yeah, we're supporting the staff at this point. So it's not that we're trying to take staff out of the process. We're making it easier for you to do your job and for you to answer questions that you may have about the process of moving the client through the system, or even questions that a consumer may ask you, and you can explain to them. And if you're missing any of that data, you can pull it up on your laptop. And that tool is always with you. You can ask it at that point, or you can refer to other resources we have on that machine. So you could certainly help them get the information they need faster and help yourself process the information they've given you faster.   Carol: Well, having done technical assistance for years with state agencies, and I see the hundreds of pages in all your policy manuals and all this craziness, I'm sure staff will greatly appreciate anything that streamlines some of that work that they have to do, and all the things they have to retain. And you've got your policy and your procedure and your desk and your 14 other directions. It's a lot. I mean, it's a lot to keep track of, as well as just paying attention to the individual that's sitting before you. And so I think anything you can do to streamline that is great. I'm wondering if you all have other ideas. I know Lola, when I talked to you before, you are full of lots of thoughts. Do you have any next steps for accessibility that you're thinking about?   Lola: I have a couple of next steps right now. I have to rein myself in. We're for sure right now really focused on getting our automated intake form out. We're at the tail end of testing and everything has been looking great on the up and up. So we've been really trying to get our messaging around what that looks like, especially to our constituents that are looking for services. So folks just understand the purpose, the why and how we're trying to make this a little bit better. I'm hoping eventually one day I can take this to phase two where the eligibility pieces may come into play, but we're not there yet. Right. We're taking baby steps.   Carol: Yeah.   Lola: I'm really excited we've gotten this far. I know Nathan and I have had conversations a few months back about looking at something similar to what they're doing with the policy, because we have our own policies, right, that are kind of everywhere. They need to be updated and staff need to reference them or individuals are looking for them. So I think definitely what MCB has been doing has been in the back of our minds a little bit. But like we said, we're taking baby steps and hopefully we can get there. But I think across the board, these are all great initiatives.   Carol: Yeah, absolutely. How about you Nate and John are you guys looking at, you thinking a 2.0 on anything or some other areas you'd like to dabble in with AI?   Nate: I think it's rolling this out first and kind of once we get this completely rolled out to staff and kind of understand how well it's working, I think we can take those next steps. We're always keeping our finger on the pulse of technology and how it's advancing, and if it can assist us in any way, and we'll continue to do that. I think an interesting, it kind of fits in with AI is, you know, one of the biggest barriers for our consumers is transportation. And as far as AI goes, one of the big conversations in that community is automated cars and those type of things. And we have in the past provided some input about automation. And when they're creating those type of things for transportation, how to think about how it would benefit people with disabilities and those type of things. It's a long way off, but it's something interesting and something I personally get asked about a lot when I'm out speaking in different areas is, where is that? You know how close that is?   Carol: Yeah.   Nate: That's nothing we'll ever do as an agency. We're never going to be providing, you know, services. But we have provided some just some input in the past on that. But as far as like case management and service to consumers and those type of things, like Lola says, eligibility is something that's very interesting. If there's something that can help with that, it's for different programs within our agency. You know, when you're coming to MCB, we're a little bit different than MassAbility. By law, you have to be registered with us if you reach the threshold of legal blindness in Massachusetts. So you're registered with us. It's the law. But depending on what services you're receiving and what programs you're in and those type of things and maybe something interesting to look at in the future.   Carol: Yeah, definitely. Blind agencies have a lot of moving parts and pieces. So how about any advice you all might have for states that are starting to think about this? Because states are in all different, you know, places and people are kind of, their administrations. Some are very proactive, some are not. Do you have any advice, as you've been working through these projects that might help other people that are starting to dabble? Lola, I'll kick that to you first.   Lola: Yeah, I think that's all dependent just on where you are as a state agency, right? It's taken us a while to come to the realization, like, maybe there's something more we can do to kind of help the process that we're in. And it just so happened some of the things that we've identified as pain points, it looks like AI and technology would really help alleviate. And I'm not going to say remove because we're always going to have issues, but it would help alleviate some of those pain points. I think one of the things that would be insightful for folks to know, and just because the disability community loves the community, it's just when it comes to technology, we have to be very careful, right? We need to be mindful of some of the biases that come along with that. We need to make sure that the accessibility is actually accessible. It's usable, right? To Nathan's point, we serve various consumers ranging from different types of disability. And I think sometimes that gets lost in the conversation because we're so much let's get it to the next level and let's make it work for us and automate it. And I think we forget to take a step back and remember who we're doing it for, right? We're doing it for the folks that maybe don't have mobility, the folks that can't always read or have low vision, or the deaf or hard of hearing individuals. We really try to make this form all about the people. So I think as agencies are probably trying to embark on technology, those are some of the things that they might want to keep in mind. And it depends just where you are in the process. Just it was great timing for us, and I'm sure Nathan would agree. It was probably great timing for his agency to start some of the discovery process around how we can utilize AI.   Carol: Good advice. John, do you have anything you want to add?   John: Yeah. When you're going down this road, be prepared that you understand the process that your state has, because there's many other departments that come in and want to take a look at what you're doing and ask for a lot of different documentation. And so that all has to be done before any product can be deployed. And depending how bureaucratic the state is, it can be different. A large state might have a whole bunch of departments Moving in and wanting to take a look in a smaller state may not be as complicated or as cumbersome process as it can be. So just be aware. Once you understand the idea and you think of a potential product, make sure that you've understood all the steps you have to do at the state level to be able to deploy that product and not have it pulled when you're halfway through, or you've spent money on development so that it gets scrapped in the development stage. So just be very aware of how to get that process through the state.   Carol: Yeah, that's  very good advice. Nate you get the last word on this.   Nate: Patience. For a lot of reasons and pointing at both what Lola and Commissioner Olivera talked about here. You got to have patience to go through the process. But you also have to have patience to make sure that it is accessible. Here at MCB, we obviously have a myriad of different folks using it and with different abilities and ways that they approach the system. We got to make sure it works for all those different ways. And that wasn't easy either, but more so for the process. It's a long process. We're still in the middle of that process, but it's worth it. I do want to say that have the patience, but it is definitely worth it. AI is extraordinarily able to just provide a way to save time. You know, a question that may come up to us where we research a question, decide on what the answer is, reach back out to a worker, give them the answer and they go to a consumer. Give them the answer. It could be days. This is seconds. The time that it saves. And maybe even if you, depending on how it's deployed, the cost it could save in the long run. It's extraordinary and worth the time put in.   Carol: I love that you would mention that. There used to be something that I compared every year that came out from RSA, and I'd compare to the previous year, and so I'd always look at, you know, I'd do this side by side, kind of mark up what all change, what language changed. And it used to take me hours, you know, just to look through the document. Now I send it through a tool and literally in a minute it highlights everything that changed from one year to the next. I'm like, boom, done. You have it. People always are asking us questions as a TA provider, and I'm like able to immediately tell them what change they're like. How'd you do that analysis so fast? Well, I used my friend, you know, an AI tool that was able to do it. It really is an amazing Time saver. So how can our listeners find you guys? Could you leave us with like, an email address or something? Lola, would you mind saying your email address for the listeners in case somebody wants to reach out to what you're doing there?   Lola: Yeah, absolutely. I can be reached at Oluwafunke.Akinlapa@mass.gov. The spelling is o l u w a f u n k e dot a k I n l a p a at mass.gov.   Carol: Oh that's great. And then Nate or  John, do you both want to give your email or who's the contact there.   Nate: It's Nathan.w. Skrocki@mass.gov and I'll spell that out. It's n a t h a n dot w dot s k r o c k I at mass.gov.   Carol: Oh, that is awesome you guys! I really am looking forward to seeing your stuff roll out. You need to give me an update. I am super happy about this. In fact, we were having an AI conversation the other day on our GW team and I said, hey, I'm doing a podcast this week and they're like, you got to give us the names of the people, because some folks are working on something, they like, they're gathering up information from across the country. So I said I'd be happy to share. So thanks so much. And please do keep in touch. I wish you the very best with your projects.   Lola: Awesome. Thank you Carol.   John: Thank you Carol.   Nate: Thanks.   {Music} Outro Voice: Conversations powered by VR, one manager at a time, one minute at a time, brought to you by the VR TAC for Quality Management. Catch all of our podcast episodes by subscribing on Apple Podcasts, Google Podcasts or wherever you listen to podcasts. Thanks for listening!

In this episode, Joe sits down with MICPA Senior Vice President, Peggy Jury, CPA, CGMA to talk about the new quality management standards for accounting firms, which include risk assessment, communication documents, and annual monitoring. 

In this episode, we go back to the future with the groundbreaking book by Dr. W. Edwards Deming - "The New Economics." Join us as we explore this goldmine of wisdom on leading organizations that are built to last. This podcast is a no-holds-barred breakdown of Deming's System of Profound Knowledge and its four key elements:Appreciation for a system Knowledge about variationTheory of knowledgePsychologyWatch or listen to learn why pursuing short-term wins often leads to long-term ruin, and how to cultivate an organization-wide focus on quality as a strategic priority. With insights on leadership, teamwork, continuous improvement and more, this episode is a must-listen for managers, executives and anyone passionate about building great organizations!!!= = = = = = = = = = = =Watch on YouTube= = = = = = = = = = = =Subscribe on YouTubeApplehttps://podcasts.apple.com/us/podcast/agile-podcast/id1568557596Spotifyhttps://open.spotify.com/show/362QvYORmtZRKAeTAE57v3Amazonhttps://music.amazon.com/podcasts/ee3506fc-38f2-46d1-a301-79681c55ed82/Agile-Podcast= = = = = = = = = = = =Toronto Is My Beat (Music Sample)By Whitewolf (Source: https://ccmixter.org/files/whitewolf225/60181)CC BY 4.0 DEED (https://creativecommons.org/licenses/by/4.0/deed.en)

Bianca is a Dynamic professional with over 10 years of expertise in quality audit, research, risk management, and innovation in social services. Skilled in strategic planning, quality assurance, compliance, and stakeholder engagement, she holds an MSc in Psychology, ISO 31000 and ISO 9001 lead certifications, and is PCQI certified. Currently serving as a Quality Audit, Research, and Lead Risk Manager, she oversees quality assurance processes and manage risk frameworks. Her passion lies in fostering communication and collaborative approaches in organisational settings, ensuring that diverse perspectives are integrated into decision-making processes. Alongside her professional achievements, Bianca enjoys exploring storytelling through reading and writing sci-fi, fantasy, horror, and psychological thrillers. An avid gamer, she immerses herself in intricate narratives and complex problem-solving scenarios. Her investigative and curious nature drives her interest in quality and risk, enabling her to approach challenges with a unique perspective. Committed to continuous improvement and effective problem-solving, she blends her professional expertise with creative pursuits to foster positive change.

Join host Carol Pankow in this thought-provoking episode of Manager Minute as she sits down with VR fiscal powerhouses Katie Marchesano, Chris Merritt, Allison Flanagan, and Sarah Clardy. Together, they unpack the pressing fiscal issues shaping the vocational rehabilitation (VR) landscape, including: ·  Navigating fiscal forecasting challenges · Addressing technology gaps · Strengthening collaboration between program and fiscal teams The conversation highlights the vital role of policies, training, and institutional knowledge in sustaining VR programs while anticipating future shifts, such as technological advancements, fiscal constraints, and potential WIOA reauthorization. Don't miss this episode, packed with actionable insights and expert reflections to keep VR programs thriving!   Listen Here   Full Transcript:   {Music} Katie: I'm really excited for that tool to be shared, and I think it's going to be a really helpful tool for the agencies.   Carol: This job takes constant attention to detail in what is happening. It is always going to be work.   Chris: More people are going to be reaching out asking for fiscal forecasting and understanding how to look at this program in the future.   Allison: One of the things that pops in my mind that might happen over the next three years is reauthorization of WIOA.   Sarah: I think we're going to see some new resources, hopefully in the technology world develop, that will assist our agencies so that their focus can remain on the customers where it belongs.   Intro Voice: Manager Minute brought to you by the VRTAC for Quality Management, Conversations powered by VR, one manager at a time, one minute at a time. Here is your host Carol Pankow.   Carol: Well, welcome to the manager minute. Joining me in the studio today are my colleagues Katie Marchesano, Chris Merritt, Allison Flanagan and Sarah Clardy. So this might be a little bit of calamity for our listeners, but we're going to do it. So how y'all doing today?   Sarah: Great   Chris: Great.   Allison: Good.   Katie: Wonderful.   Carol: Awesome to hear it. Well, we have had quite a journey on the QM for the past four years. The fiscal focus was a new aspect of the grant, and we are so grateful to then Commissioner Mark Schultz for realizing that TA in this area was an essential element to the work. And since we're in this final year of the grant, we wanted to have a chance to visit together, share our insights with the listeners into the whole fiscal picture across the VR program, and discuss our perceptions and perspectives. So buckle up, folks, and we're going to dig in. So I want to start with how you each found your way to VR. And I'm going to start with Chris to talk about your journey into VR.   Chris: Well thanks, Carol. Mine's a little bit different than most people. I did not start in VR. I have a very different background. All fiscal for the most part. But I came to work at a fiscal state unit and learned about VR there. Loved it, loved it, loved it. And then was kind of asked to be part of this Ta team and couldn't say no because it's just an incredible program and it's a little complicated. So being able to help the states understand it better is what brought me to this team.   Carol: Well, not you, and you're being modest now. Tell them about like a little bit more of your background because you have an interesting educational background and all of that.   Chris: Yeah, I do. So I'm an environmental engineer by trade. Worked in that field for a while. Learned that sampling sludge was not a cool thing to be doing. So went to work for a small business that was just starting on Department of Defense World. Loved all the fiscal part of that. Went back to school and got my MBA and have been doing fiscal stuff ever since. So yeah, it's a long road that brought me here, but I'm happy I took it.   Carol: Yeah, we're glad you're here. How about you, Miss Allison?   Allison: Well, it's kind of hard to believe that I have over 30 years in this VR journey, and it actually started out in the field as a VR technician, and I just fell in love with the mission and purpose of VR. So I quickly changed my direction to be a VR counselor, and then that evolved to other promotions and positions throughout the year, where I ended up being director of both Kentucky Blind Agency and then moved to Florida as the General Agency Director. And when the VR TKM opportunity came about, I was ready for a change, especially after being a director through the pandemic and through the implementation of WIOA. I was looking forward to just a new opportunity, new learning areas, so this has been a great jump for me. I've enjoyed it very much.   Carol: Why don't you tell them too about your other gig with NRLI a little bit. We'll make a plug there.   Allison: Yeah. So part of the VRTAC-QM is the National Rehabilitation Leadership Institute through San Diego State University. I have the honor of continuing Fred McFarland's legacy, who began this program about 25 years ago. And it is a program that is building the future leaders in the vocational rehabilitation field. And it's been a joy to see these leaders be promoted throughout their careers. Being stepping up, having an interest at that national level, the issues that are facing VR. So it is definitely a part of my job with QM that I hold near and dear to my heart.   Carol: Yeah, it's good stuff, I love it NRLI of our favorite things to participate in when we get to do training. So Katie, over to you next.   Katie: Well, my journey with VR started when my brother was receiving VR services, and he actually is who inspired me to go and get my bachelor's degree in psychology and work in social services. That led me to Department of Workforce Services, where I spent 13 years in various roles and capacities, which ultimately led me back to VR.   Carol: Awesome sauce. And last but not least, Sarah Clardy.   Sarah: So I started out about 24 years ago out of college. I was working in banking full time and going to school full time, and had an opportunity to come on with a state and Missouri vocational rehabilitation, had an opening for an assistant director of accounting and procurement. They had some systems and processes that were a little out of whack and needed some help with reorganizing pretty much the whole accounting structure. So I came over at that time and started in with Missouri, and then spent 20 years there and got to spend half of that time in the field directly with our field staff and counselors and really take this program to heart, and then had an opportunity four years ago to join the VRTAC-QM. I had said for a long time we needed technical assistance in the fiscal realm for years and years. I was thrilled that Mark Schultz saw the vision and made it happen.   Carol: Good stuff. Well, now we're going to enter the danger zone because I have some questions for you all. Not exactly sure how this is going to go, but we are going to do our best. So y'all jump in when you want. So what has been your biggest realization or aha moment since you started with the QM. And Allison, I'm going to have you kick us off and then other folks can jump in.   Allison: Honestly, Carol, there's been a lot of those aha moments for me over the last, you know, almost three years with the Technical Assistance Center since my experience in VR started in the field and I was a counselor, kind of the program side is where my comfort level is or my knowledge and experience. So when I joined the fiscal team there, definitely there was a lot of those aha moments, mainly a lot of the things that I did not know or did not realize even as a director when I came over. So one of those aha's is the director. Even though I received these beautiful monthly budget reports for my fiscal staff, even though I had a leadership team that we reviewed budgets with, understanding the fiscal requirements in and out, the uniform grant guidance and all the regulations. And, EDGAR, all of that, I think, is critical for any director or their leadership team to have knowledge of. And that was definitely one of my aha moments. And one of those things I go back, wow, if I could go back and be a director, I would be a lot smarter after being on the technical assistance side. And like I said, there's been a lot of those aha moments. I could share tons of them, but a couple other ones that jump out is just that critical need for that program side of the House and the fiscal side of the House, to always be communicating and always making sure they're checking with each other. On whether it's a new implementation, whether it's expenses, contracts, doesn't matter. There needs to be that collaboration happening at that level. And then probably the technology challenges is another one of those constant aha moments in the year that we're in and how reliant we are on technology. I am still amazed that there is not technology out there that will do what VR needs it to do, right off the shelf.   Carol: Amen, sister. You said it all. No, but I'm sure there's people that want to say some more.   Chris: I found it interesting when I came over that not every single, not a single state has it right. I thought that there would be more that are fully knowledgeable and are running with it and doing all the great things they are doing, the great things. They just don't have 100% right.   Carol: You are making me laugh with this because I'm just going to say I have to jump in on that. Sarah and I right away, in the beginning, anytime we had met with RSA we learned something new, we're like, uh, I gotta call back to Minnesota, tell them, because we realized, like, hey, we thought we were sort of doing it right, but we all realized things. We went, uh, yeah, we had a little slight misstep on that.   Katie: I would agree with that. Like, we came from a state that was in an intensive agreement. And, you know, I was like, man, we really got it wrong. But then, you know, it's a huge learning curve and there's a lot of people that are putting in their best effort, and they're still just a few things that aren't quite right.   Chris: Absolutely.   Katie: Another realization that I had was we have this table of contents for a grant management manual that we send out to agencies. And when I received it in Wyoming, I was intimidated by all the things that needed to be included. But my aha moment was when you break that down into individual items and you really look at it, it's things that are already in place, the policies and procedures that you're already working on. It's just finding a way to get that on paper and put it into some sort of policy and procedure and internal control. So realizing that states have the capacity to do that, just figuring out how was an aha moment for me.   Sarah: You know, when I came in, I was thinking back to 2017 and RSA came out with guidance on, I'm going to say it, Period of Performance. And it dominated our whole agency for a good nine months, trying to understand the guidance, looking at systems. We had to do a whole overhaul with the way we looked at obligations, just we spent a massive amount of time and effort to right size our systems, internal controls and all of that because prior to performance sets the beat for all of financial within a VR program. So coming into the QM, I really assumed that more agencies knew of Period of Performance and had gone through at least similar steps, or at least had internal conversations. And what I found was completely the opposite. Somehow a lot of folks missed the memo and that work hadn't been done. And of course, we've been running Fred Flintstone style, trying to help agencies get up to snuff. So that's the piece. I think that's been the most interesting. I think for me.   Carol: I think along that same vein for me was really that realization states are more different than I thought because I figured we all had the same information. We all kind of operated sort of the same. You might have your own internal systems, but I remember, Sarah, you and I talking that first year just going like, oh my gosh, everybody is organized so completely differently. They approach their work so completely differently. There isn't just one size fits all. Like, hey, you should do it this way. And like, everybody can do that. Uh uh, it is like having an IPE for how the fiscal is managed. Individualized we need to give very individualized TA. So what do you guys view as the number one challenge facing our programs nationwide? And Sarah, I'm going to have you start us with that.   Sarah: Okay? I'm going to say it I think Allison said it earlier. We are lacking in the technology space. I think a couple of things we have, the pendulum has swung to the other direction and before it was spend, spend, spend, a lot of agencies made adjustments so that they were increasing their spending. The large carryover balances weren't so large. Now my concern is how are we looking at our finances to see if we can still sustain that. And in order to get accurate projections and for leadership teams to have the conversations about where they stand financially, we have to have technology systems in place that are reliable, are tracking period of performance, can provide those fiscal calculations in terms of where we stand on all of the different requirements, so that we have a constant pulse on where do we stand as an agency. And I liken it to being in private industry and a CEO knowing at all times how much does it cost to make the widget? How many widgets are we making and what amount of time? All of those kinds of things. And I feel like in that space right now, we have agencies that are trying to figure that out, and we have some that are in a very delicate position, and it can cause a lot of catastrophe and crisis if that's not solidified. So really, it goes back to having reliable technology that will take care of all of that. And that includes our CMS, our Case Management Systems space. A lot of our vendors are struggling in that Period of Performance area, and we're not there yet. We have a lot more work to do.   Carol: Well, it's like a $4 billion industry, you know, and I feel like we're still using an abacus or something in some cases for tracking the money. It is the most insane thing I have ever seen.   Allison: And, you know, related to that technology challenge, though, is knowing that, that challenge is there, knowing that the technology is not correct. I think what adds to the complexity of that is the fiscal staff or the just the staff within the VR agency. They lack the fiscal knowledge enough to know if their system is working correctly or not, or know how to go in and make the adaptations needed to assist them. And that's a challenge within itself.   Chris: And I will piggyback right on that, because the thing I think that we've struggled with is we have lost so much institutional knowledge that people don't stay in jobs like they used to. And so if these policies and procedures are not written down, you get new people coming in, they don't know what they don't know. And if the technology is not working right, they don't know that that's not something that they can handle. So it's a lack of that long time knowledge that used to be in this program.   Katie: Yeah, Chris, that is exactly where I was going as well, is the loss of staff and institutional knowledge is huge, and it really highlights the importance of getting policies and procedures in place and not waiting till that person has their foot out the door and is ready to head out to make sure that you're getting that in writing. You know, succession planning and really building up success in the team.   Carol: I think for me, one of the things I see, because I love that whole organizational structure and non-delegable responsibilities, I love that area. I think one of the biggest challenges facing the program is the whole shift in how things are organized between if you're in a designated state unit within a designated state agency, and that centralization we have seen of all the fiscal functions along with IT and HR and all of it, but I feel like VR has lost control. And so as these services are centralized, and not that they can't be, but that they get centralized to a point that the VR program has lost complete input control direction. I mean, you've got directors being told you can't spend anything over $5. It has to go through 40 layers. You can't hire anybody. Staff cannot travel to go see customers like all of that. If we can't fix this structure of how things are put into play in each of these states, I really see kind of the demise of the program. As we see things get buried, the program gets buried down within these big agencies. The lack of control ends up leading to problems with them and being able to carry out the mission. And it's really hard to get a handle on that. And I know Congress has given, you know, this leeway so that states can organize like they want. But boy, the way they're organized right now, it's pretty tough.   Allison: It's a double edged sword when you think about it, because you're probably like me Carol, as former directors, we wanted more money going into the consumer services. We wanted it going to support our customers. We wanted to find ways to reduce any kind of administrative type expenses so that that money can go there when the centralized functions were really being pushed at the state levels. In my mind at first, I will say this, at first I saw, yes, this is a benefit because we're going to have these shared services, we're going to be able to spend more of our funds on our customers. And I still somewhat agree with that approach because it is a cost savings. But what has to happen, though, is that balance, what you talked about, the balance where VR still has control over the decisions or they are included in those decisions and the restrictions that have been put in place has to be lifted. But I do see the benefits of those shared services as long as the structure gets set up right.   Carol: Right. And that's been few and far between.   Allison: That needs a national model.   Carol: It does. And that's been a problem. I mean, if there's anything anyone can work on, little congressional assistance in that or whatever, you know, getting some of that rewritten, how that looks.   Sarah: Well, and I came from an agency that was able to retain an entire unit of 13-ish folks when all of those consolidations were occurring because within our Department of Education, our commissioner understood the complexities of our award and knew that if all of those positions rolled up to a department level, they weren't going to be able to support the program and were able to coordinate with our state leadership. And it served the program very, very well. So I think we have a little bit to be desired still in that space to get agencies the support that they need 100%.   Carol: So what has been your favorite thing to work on or accomplishment in your role? And Katie, I'm going to kick that to you to start us off.   Katie: Well, I've really enjoyed my role here with the QM. There's a lot of things that I enjoy, but the task that I've enjoyed the most is really having the ability to dig into the new uniform grant guidance that went into effect October 1st of 2020. For one of the things that I did while doing that was I took the old uniform grant guidance and the new ones and did a side by side where all of the things that were taken out were redlined and all of the things that were added were highlighted, and I'm really excited for that tool to be shared with the agencies right now. That's with RSA to get the stamp of approval, but I've used that tool already to help update all of our things on the website and all the tools that we're sharing with everyone, and I think it's going to be a really helpful tool for the agencies.   Carol: I love that tool, Katie, so much because even when we were down doing to last week and some of the just the nuance pieces that came out, when you're reading it and you go, okay, that language did change. Like there is a slightly nuanced variance to this that I hadn't completely grasped until you see it in the red and the yellow, and it all highlighted up. I mean, it was pretty nice.   Katie: Yeah, they did a lot of plain language changes, which is really evident when you look at the side by side.   Chris: I'll jump in here and tell you what my favorite thing is. And it's when we were working with a state intensively and, you know, we've been working with them for a long time, and you get to know them really well and you understand their environment and how things work, and they come to you and say something really profound, like, I was watching this training the other day and they got this wrong, and they got this wrong and they got this wrong. It is like a proud parent moment. When you go, they understand what the program is supposed to be doing, and they understand when other people not necessarily are getting it wrong, but mostly they're able to recognize what's not absolutely correct. And it just makes you feel like, oh, we have come so far.   Carol: It's like fly, little bird, you're flying.   Chris: Yes.   Allison: That's probably one of my favorite parts too, Chris, is the state work that we've done and how you get to know these state people. There's so many amazing VR staff across the country, and their hearts are all in the right place, and they want to do good. That's what I've enjoyed is getting to know these people better, broadening my network as well because I learn from them. But just being that resource I do like, I'm one of those weird people that likes digging into the laws and regs and finding where is that gray, vague area that we can interpret a little better. So part of the TA work, you know, really digging into some of the laws and some regulatory guidance I've enjoyed as well.   Carol: I have a story I love to share. I was having a breakdown probably a year ago, Sarah's laughing at me, I had a breakdown. You know, you're providing TA to state you're so ingrained with them, especially when they have a corrective action plan, you feel like you're part of them. I always say we, you know, when we're talking because I feel like I'm part of their team and we've been working on a particular piece of it, and nothing that we sent in was anything RSA wanted. All I knew was that this was not what they wanted, but we couldn't exactly figure out what they wanted. And it was driving me crazy. And I'd called Sarah and I said, I think I have to quit being a TA provider because I suck at this. I'm not able to help them. I haven't been able to figure this out. I am done, and I went to bed that night. I actually was on site with another state and I woke up at two in the morning and I do my best thinking as I'm sleeping. It's so weird. I've done it my whole career. I wake up in the middle of the night and have an idea. I woke up at two in the morning. I'm like, oh, I know what they're talking about. And I got up and I typed, I typed for like three hours and then got up for the day and got ready for the other state. But exactly what was needed was that, I mean, when we ended up meeting with the state and then they met with RSA, and that was the thing. It was the thing that was needed to get accomplished. And I felt super proud that we could kind of like, figure it out. It took a while. I almost quit, but, we got there in the end.   Sarah: You know, being in the final year of the grant, everybody's asking the question, what comes next? And of course we don't know what comes next. But I think my favorite part is looking back and building the relationships. So kind of touching on what all of you all have said. Relationships are important to me. Building the trust we are learning alongside of them just like they are. I always say there's no top of the mountain that any of us are ever going to reach when we've arrived. It's a daily learning process, but the program financially is so complex and trying to take those federal requirements And each of the state's requirements, which we've acknowledged already are all different, and bring that together in the center. And there's never been a resource to help agencies get down in the weeds, look at their systems, look at their processes, and help them navigate through that. And so just having something to offer and having directors send an SOS text at 9:00 at night, or we've talked to directors who have been in tears or excited because something really great has happened, and they want to share the success. It's all of that. Just being able to provide that valuable resource and support them along the way has been very rewarding for me. I know, and you all, but especially I think for the States.   Carol: So if you had a crystal ball, what would you predict regarding the financial state of the VR program over the next three years? And Chris, you get to start us on that lovely prediction.   Chris: Okay. Well, since I don't have a crystal ball, I think Sarah touched on this a little bit earlier. So for several years, the message from RSA and from Congress has been to spend, spend, spend. And so there's been a lot of changes in all the agencies to be able to spend more, to spend quicker, to do everything quicker and faster. And I think the spending is catching up. And I think that it might go too far. Like Sarah mentioned, the pendulum is going the other way, and I don't think the fiscal forecasting is robust enough to be able to predict when it's going to get hard. And since most directors do not come from a fiscal background, most directors come with the VR heart that you know is what a counselor has, paying attention to that. Fiscal forecasting is going to be a critical, critical point. And I know that most states are not doing it right. So that's my prediction. More people are going to be reaching out asking for fiscal forecasting and understanding how to look at this program in the future.   Sarah: And I think to tack on to that, I think we're going to see new technology and new resources emerge that will assist our agencies. Again, like Carol said earlier, some days it feels like we have our big chief tablet out and we're still doing things old school. And I think the only direction to go is up. So I think we're going to see some new resources, hopefully in the technology world develop, that will assist our agencies so that their focus can remain on the customers where it belongs.   Allison: And I would have to say ditto to both of that, especially the fiscal forecasting and the pendulum swinging the other way. And a lot of states considering order selection or going into order selection. But one of the things that pops in my mind that might happen over the next three years is reauthorization of WIOA. I know the discussions are happening with Congress right now, and if that implementation happens, you know, what's it going to look like? Because ten years ago when WIOA was passed, it was a huge impact on VR. And it still is. I mean, we're still challenged with trying to get everything implemented, trying to spend the minimum of our 15% on Pre-ETS. There's just so many things that we're still working on through. So very interested to see where that's going to go.   Carol: And I definitely think like nothing ever stays the same. So we always think like we're going to get to the place and it's just going to be even flow, like it's all going to be cool. We don't really have to pay a lot of attention, and I don't think that's ever going to be the state of the VR program. Like it's going to constantly need people paying attention. Whether the pendulum is one way and we have loads of money or it's the other way and we have no money now, like we have to somehow try to like even this out with the fiscal forecasting and all the things you're doing. But if you think you're going to get to the place where like, oh, I've reached it, Nirvana, it's all great. That's never going to be like this job takes constant attention to detail and what is happening. And so it is always going to be work. It's going to take a lot of effort from a lot of people. And as all the new people keep coming and going, figuring that out for the team so that you can sustain the practices and things that you have that help you to understand what's going on.   Katie: Yeah, I would just agree with everything that everyone already said. One of the big pushes that was brought up at CSAVR, is technology, and I think it is going to be interesting to see what kind of technology is introduced in the next three years that's going to help assist our programs.   Carol: So what is your best piece of advice for our listeners? And I'll let anybody open that one up.   Allison: I'm going to say you need to have a deep bench of leaders who are adverse in the financial requirements, maybe incorporating fiscal training for all staff on an annual basis, whether that's just refreshers or making sure new folks being hired understand all the requirements. But fiscal needs to be part of your ongoing training with staff. It's just critical.   Carol: I'd say, for directors coming in, I know the tendency is to want to be like, I have to know everything. I'm the director, I need to know all things. And even when you don't know the things, you pretend, you know the things. Don't pretend you know the things you don't know. Like you need to be humble and figure it out and learn and be willing to learn. For a lot of folks that are growing up in the VR system, having that sort of physical part of your brain, it may not be completely there. You're like, I went into VR because I didn't want to do math, and now you're in charge of, you know, $300 million in a program. And so you've got to just continue to learn and chip away and figure out how you can gain that really strong understanding, because you cannot just hand that off to some other group and think someone's managing that for you, because the buck really does stop with you in the end. As far as the responsibility over the control and allocation of the VR funds. So please keep learning, as Allison said, and be open and be humble when you don't know things and ask.   Sarah: There's a song by the Beatles called With a Little Help from My Friends. Everybody needs a Little help from time to time. And I know over the years we've worked with most of the agencies, but there are some that we haven't, and I've always assumed they're good. They don't need us. They're fine. It's not always necessarily the case. So acknowledging if I pick up a phone and call a peer or a fellow director, or hopefully the TAC continued to exist beyond this grant cycle. Reaching out and asking for help is okay, and it's encouraged.   Katie: Yeah, mine will be through the lens of policy and procedure. That's where I keep hitting. That's my passion on this QM team. We have a ton of resources available, and if you're struggling, you're looking at that table of contents saying, I can't do this. Reach out, give us a call. We can help you with prompting questions just to get the thought process going. And you can do it. It's going to be okay.   Chris: Ok, my piece of advice is to make connections. And I think everybody has kind of said that in their own way. But make those connections so that you have people you can reach out to and ask questions of whether it's us at the TA center, other states, other fiscal people. You need to be able to ask, how do you do this? What do you think of this idea that I have? How would you handle this? I mean, being able to have that connection and that type of conversation is critical 100%.   Carol: Well, I sure appreciate you all. And while we're still around, all our listeners can still connect with us. And we do have a QM fiscal email address. I will spell out for you. It is QM f I s c a l at v r t a c-qm.org. So qmfiscal@vrtac-qm.org. So please do reach out. We still are around for a little while and we can be your phone a friend. So thanks for joining me today guys I really appreciate it.   Chris: Thank you Carol. This was great.   Allison: Thanks for having Us.   Sarah: Thank you.   Katie: Thanks.   {Music} Outro Voice: Conversations powered by VR, one manager at a time, one minute at a time, brought to you by the VR TAC for Quality Management. Catch all of our podcast episodes by subscribing on Apple Podcasts, Google Podcasts or wherever you listen to podcasts. Thanks for listening!

with Hosts Simile Miller and Jeremy Gibson-Roark

Working Smarter is joined by Martin Teasdale, the founder of Get out of Wrap, a UK-based podcast and consulting firm that specializes in contact centers...or is that centres?  Martin talks about his career, the challenges of finding a vendor, and the Calabrio "Voice of the Agent" survey results that were recently published.

In this episode, Jill Stuber and Tia Glave discuss their extensive experience and passion for leadership development within the food safety and quality industry. Jill and Tia share their personal journeys into the sector, offering insights into the importance of shifting mindsets, building self-awareness, and practicing intentional leadership. They highlight real-life examples of how their programs have transformed leaders and teams, emphasizing the importance of culture, human connection, and investment in people. This episode is a call to action for leaders to proactively develop their leadership skills and create supportive environments that uplift their teams. Episode Highlights: 07:55 The Birth of Catalyst LLC 12:43 Ideal Clients and Leadership Development 22:09 Building Self-Awareness 31:26 Key Attributes of Effective Leadership Catalyst LLC is the preferred provider of leadership development and culture solutions for the food and beverage industry. Founded by award-winning leaders Tia Glave and Jill Stuber in 2021, Catalyst drives world-class cultures that build strong leaders in food, people skills, and dynamic organizational management. Through coaching-based solutions, they empower professionals to unlock unforeseen opportunities and reach their fullest potential at work and home. Learn more about Catalyst and its mission to transform how people lead in food at www.foodsafetycatalyst.com.Jill Stuber, the Vice-President and Co-Founder of Catalyst, LLC, has over 25 years of food safety and quality experience in food manufacturing. As an ICF-certified coach with a BS and MS in Food Science and an MS in Quality Management, she engages with organizations that believe in developing individuals and teams to increase confidence and clarity and build community so they can achieve the success they deserve as technical leaders in food.Tia Glave is the President and Co-Founder of Catalyst, LLC with over a decade of experience in large and small food companies. Being a master-certified coach and chemical engineer, she uses systems, data, and proven methods to develop and implement a food safety and quality strategy, all while using servant leadership principles. How to connect with Jill and Tia: Website: www.foodsafetycatalyst.com. LinkedIn: https://www.linkedin.com/company/foodsafetycatalyst   For more insights: Follow me on my YouTube Channel: https://bit.ly/47GgMdn  Sign up for my Weekly Newsletter:  https://bit.ly/3T09kVc Sign up for my LinkedIn Newsletter: https://bit.ly/49SmRV3   See omnystudio.com/listener for privacy information.

Join us for this enlightening episode of VRTAC-QM Manager Minute, where we explore the transformative power of Value-Based Purchasing (VBP), also known as Performance-Based Payment (PBP). In the studio, we have Chip Kenney, Co-Project Director of the VRTAC-QM, and Lisa Mills, a consultant and subject matter expert in VBP, sharing their expertise. VBP is more than just a financial model—it's a strategic shift designed to drive better outcomes for individuals with disabilities. By aligning provider incentives with measurable performance outcomes, State Vocational Rehabilitation Agencies (SVRAs) can enhance the quality of services, improve consumer results, and optimize costs. Tune in to hear Chip and Lisa discuss how SVRAs can harness the power of this approach to revolutionize service delivery and create a meaningful impact. Whether you're considering adopting VBP or seeking to refine your approach, this episode is packed with insights you won't want to miss! Value-Based Payment Methodologies to Advance Competitive Integrated Employment: A Mix of Inspiring Examples from Across the Country   Listen Here   Full Transcript:   Chip: Virginia reached out and they wanted to include value based purchasing specifically in their Disability Innovation grant. I said, this is an opportunity we can't pass.   Lisa: Is there anything about our payment structure that incentivizes or rewards this kind of quality that we're saying we're not getting, thus reduce the amount we're investing in unsuccessful closures.   Chip: When we can get to that point where we can identify and measure and demonstrate and get quality outcomes that will move this whole system a gigantic step forward.   Intro Voice: Manager Minute brought to you by the VRTAC for Quality Management, Conversations powered by VR, one manager at a time, one minute at a time. Here is your host Carol Pankow.   Carol: Well, welcome to the manager minute. Joining me in the studio today are Chip Kenney, Co-Project Director of the VRTAC for Quality Management, and Lisa Mills, Consultant and Subject Matter Expert to the QM on Value-Based Purchasing. So here's a little context for our listeners. Value-Based Purchasing, also known as Performance-Based Payment, is a model that offers financial incentives to providers for meeting certain performance measures. And as state rehab agencies look to improve outcomes for individuals with disabilities, the quality of purchased VR services, and overall cost effectiveness. A Performance-Based approach might be an option, so I don't want to steal their thunder, and I'm going to let my guests discuss what they're doing today. So let's dig in. Lisa, lets' start with you. Can you tell us a little bit about yourself and how did you find your way kind of into this VR space?   Lisa: Sure. So I've been in the world of disabilities for my career, for the entire career. So, 33 years, I think where now I've lost count. But about 20 years ago, I got really interested in employment working with Self-advocates way back before there was such widespread support for ending Subminimum wage. You know, the support that we do see now, but that was at a time when that it wasn't even being discussed. But Self-advocates were very clear that they wanted to earn more money and have more opportunities. So I got interested in supported employment and why we weren't using it very much. And so I started working with Medicaid and long term support agencies on improving employment services and outcomes. Back then, there was something called the Medicaid Infrastructure Grants, which allowed states to create Medicaid buy ins for working individuals with disabilities. So I really dug in around what were we doing around employment services. And of course, that brought us to the relationship with VR. And about 16 years ago, I started working on customized employment and developing ways to pay for customized employment, and worked with a couple VR agencies at the time on payment structures for customize. And then most recently, I'm a mom of a transition age son who used VR supported employment services to get his first and second jobs, and he's been employed in competitive, integrated employment since 2020. He's about to turn 21 and that has changed his life. So I'm a firm believer.   Carol: Good for him. That's really cool to know. I always love it finding out the stories people have, because you never know, we all get here a different way. But I love your path. So Chipper over to you. And I'm going to say Chipper because I'm naughty. He Chip is my colleague. So for our listeners I do like to rib Chip a bit. So Chip, how did you find your way into the VR space?   Chip: So very similar to Lisa. My whole career has been in public rehabilitation for a bit then technical assistance centers, but fast forwarding to about 2009 was interested in customized employment and its applications, and the need for VR systems to have an employment system that really addressed what people with the most significant disabilities needed to be successful, and I was sort of glommed on to that space ever since. And then with the passage of WIOA, it just seemed a really necessary connection that VR agencies and systems have something new they can offer. People who would have considered going into sheltered employment now are coming out. What are you going to offer them that's new and different from when they went in and have been at it ever since, mainly focused on the implementation side of it, because there's a bunch of trainers in that space and they're all really good. But we learned early on that it takes an infrastructure to embed, implement and sustain customized employment over a period of time. And so that's been my focus the last several years. I mean, we're still learning a lot. And rate structure is part of that, which, I mean, I've known Lisa for years too, but rate structure is something every agency struggles with. And when the opportunity came to work with Lisa on this and move this forward, I thought, this is a big missing piece that we have to fill.   Carol: Absolutely, I'm underscoring that 100% because we know we get a lot of rate work with our QM work and the whole idea and customized employment with that sustainability. You can have the great idea. And we're going to do the thing and we're all excited. But then what happens. Year one and two and three and four as it goes on and it all fades away. And we don't want that to fade away. We need to have that good sustainability plan. So Chip, how did you get involved in bringing Lisa on board? What was kind of the impetus of that?   Chip: Virginia reached out. The state of Virginia reached out to us and they wanted to include value based purchasing. And they mentioned that specifically in their Disability Innovation grant, and somebody referred them to me. I mean, I knew a bit about it, but then as soon as I saw the Lisa connection and started reading her work on it, I said, this is an opportunity we can't pass, even though I don't have any experience. But Lisa brings all that and the knowledge and the background and said, it's really important to be a part of this.   Carol: Very cool. So, Lisa, I understand you have a very unique superpower. You can speak and interpret languages across multiple partner systems. How did you develop that?   Lisa: Well, I guess I'm a bit of a policy wonk. I did a lot of interviewing of people from different systems to try to understand what was going on with partnerships, what were the challenges. And this was probably 12, 13 years ago. I was doing some work with ODEP at the time, blending and braiding. And when I was doing a lot of my interviews interviewing the different partners, including VR, I figured out that a lot of what was going on at that time was sequencing. It was really not blending or braiding, and if we wanted to get to braiding and ultimately to blending, I felt like we really had to find what was going on then as something foundational, you know? And that's where I kind of coined the term sequencing and said, this is really what we're doing, but we can help people understand then what it means to switch from sequencing to braiding, what it means to switch from braiding to blending, and really start to get people interested in the advantages of moving away from sequencing. So it really was just wanting to dig into each system enough to figure out what solutions might improve collaboration and outcomes. Sometimes it can be easy to lay out all the issues, right? Everything that's not working, but to really dig into each system and figure out where could we align ourselves, where are we aligned, and we just don't realize it? That was more, I guess, the policy wonk side of me.   Carol: I love that because I think I've been on lots of work groups over the years, I mean, I just have when we've worked between, you know, departments of education and your state Department of like maybe developmental disabilities or whatever you are calling it back in the day. And then in the VR system when we all had different ways of describing everything and we could get stuck in the what's the problem? Here's all the problems. We got problems. We have a million problems. Here's all the hundred problems we have to get through before we can get to a solution. But if you go in and go, I love that. Like, how are we aligned right now and what are the things that we could build off of right now instead of always focusing on that whole myriad of things? But I think understanding each other, how we speak about things and we may say the same word, but it means something different to each of us. Once we can kind of clear up that dictionary and talk the same language, it makes it much easier to comprehend what's going on in each other's systems and how that can then work together. I love that you have that. So what is the essence of Value-Based Purchasing?   Lisa: So to me it's quality service combined with efficient service that results in quality outcomes. So I think about that. Efficiency without quality that would not lead to quality outcomes. We'd hurry up and do things, but we wouldn't really see the quality outcomes we wanted to see. And at the same time, if you have a quality service that goes on and on and on, you lose the cost effectiveness and you typically you lose the job seeker. They're going to give up or go find a job some other way. So to me, we have to recognize we need both quality and efficiency in the way services are delivered and that we have a set of quality outcomes we want to achieve. And we have to ask ourselves, to what extent are we getting those quality outcomes? And to me, if we can figure out a payment structure that balances rewarding quality and efficiency and is really clear about what is quality and service delivery, what is efficiency and service delivery, and then what are we looking for? As quality indicators and outcomes? We can design a payment structure that really will deliver on that. And I think as you start to think about that, you realize how the existing payment structures really aren't set up to do those things for various reasons. And that really, I think, helps people buy into the idea that there might be a better way to do this. And this idea of value based purchasing might actually have some legs.   Carol: So that payment structure piece, that's my interest. How did you really dig in and kind of figure it out? Because it sounds good and I understand all the things you're saying about quality outcomes, but how when it comes down, like putting the rubber to the road, do you get at the nuts and bolts of figuring out the payment structure?   Lisa: So everybody always wants that. Next they say, so tell me what it is. And I always say it is what you need to develop locally in your system. You need buy in from those who are purchasing and those who are providing, and you've got to bring them to the table in a constructive way. So in a really collaborative way, sometimes we talk about it as co-creation and you dig into what do we agree is quality service, how do we differentiate quality service from service that we would say is not high quality. And then what do we agree is efficient service? How do we differentiate efficient service from service we would say is inefficient but very important to VR agencies, at least those I've spoken to. Are these quality outcomes, the career path outcomes, the jobs with benefits, the jobs with more hours and better pay? You know, some of these things, you're just not necessarily seeing a lot. You're getting outcomes that you can count as a 26 closure, but they aren't the kind of quality outcomes that, and you see some revolving door effect of certain people who and I know that's a big issue in some states or you see a lot of dropouts in the process. So in every state it's important to sit together and figure out what should we be doing better, what does better quality look like, and then what is quality and efficient service look like? That's how you get the buy in to establish a payment structure that where people want to implement it and intend for it to work. I can certainly share examples of how that co-creation works going on elsewhere and what the ultimate outcome was, but that is what happened there. And I really like the idea that and really believe that you've got to do a local co-creation process to get to something everybody's bought into and something that has a high probability of working. I would never say, oh, Value-Based Purchasing is this. It's only this. Or you just take this model from this other state and you plunk it down here. That won't work.   Carol: Yeah, I can see why you sing to Chip's heart there. Because he's all about systems work, you know, and that whole and everybody's systems in your state are so different. How you're set up, what your relationships are like between your providers and yourself and other entities and all of that. So I do like that you're speaking to that and you can't just pick up and replicate because you've got all your nuances that are happening in your state, and you need to understand those before you can get to the agreeable solution. That makes a lot of sense.   Chip: And it's not only that, and we're finding this to be true now that providers are not a monolith, that there's not a state where you can go, okay, every provider looks like every other provider. There are a lot of uniquenesses, a lot of variables that have to be taken into account to bring at least the majority of them on board. And that's we're finding that to be true as every state system is different, every provider network or non-network is different.   Carol: Absolutely. And even when you think about the states, kind of just the like the geographic challenges they have and the things that are going on, we've saw such an increase, especially after Covid with people moving and some of the states go like our cost of living in certain areas has gone up exponentially, like 300% or something. And so you've got everybody like, decided because they could work from anywhere. We're all moving to this town and then other areas become depleted, maybe from people, and there's less resources available and harder to get providers to serve an area even though you have customers there. I just feel like we have a lot of geographic and economic challenges across states, even tiny states. It's been super interesting. We've found that work as we've been just doing plain old rate setting with states, so let alone what you guys are digging into. So what are some of the biggest challenges in implementing this value based purchasing?   Lisa: I would say the time it takes to do it right. I think sometimes state agencies and I'm not singling out VR, but they want quick solutions. You know, they think about it for a long time and then they say, okay, we want to do it. Let's get it done. Can we get this done in three months or can we, you know, and you have to say probably not in a way that would be successful. And so it is something not to take lightly and to really commit to invest in. I think there's a lot of additional benefits to doing this, including provider relationships and the learning that goes on. Providers now understand what it's like to step in the shoes of a funder. Funders understand what it's like to step in the shoes of a provider. I always think that helps with everybody getting on the same page and agreeing to a model they think will work, but it takes patience, it takes partnership. Some states are, they're very uncomfortable with bringing providers in. They tend to develop things and then release them to providers. So you've got to have a level of trust when you identify the providers you want to involve. I always encourage to identify who are your high performers. They are the providers you want this model to work for because you want more high performers and you want those that you have to expand their footprint, for example, to go into geographic areas that are underserved or to hire more staff. So always thinking about partnering with the high performing providers. But there's a bit of reluctance, you know, and risk in doing that and saying we're going to create something together. Lots of outside the box thinking. It's really hard to get away from payment models that you've been invested in for a long time. Milestone fee for service. Just to think beyond those can be very difficult, but I think once people start to and that's something I do, is kind of bring ideas and thoughts and stimulate thinking to get them to move away from those models and really say, what should we be paying for? What is important to value in the payment structure? I think it really gets to be very exciting, or at least I think so. You really need data to you cannot develop a model without good data. Sometimes the data is readily available. It's reports that VR agencies are already pulling out of their system. Other times the data's in the system, but they don't typically pull it. And so we have to work with them. And it helps to have a data analyst to assist with this process, to be able to pull pieces of data or data analysis and different ways that informs what we're doing. We want a data driven approach. And sometimes, of course, you probably know that data analysts are very, very busy or they're off doing something else. And it may be hard to get them committed to the work.   Carol: Have you seen improvements since? I'm just thinking since WIOA and kind of the requirements that RSA has put on state agencies about collecting a vast amount more of data. Have you seen improvement as you're working with states that they actually have data they may not have had years ago that you can get at. I mean, there might be a little bit of a problem with the staffing or getting your data analysts to pull it, but that availability of the data you need to really to dig into this, that it's actually there.   Lisa: Yeah, I do think the systems are pretty sophisticated, and it's a matter of helping them understand how to use more of the data they have, because we have the standard WIOA measures. We have the way that VR talked about its performance prior to WIOA but I think we're digging in to get it more data elements that help us understand. One of the most important things to understand is demographic information and how that affects maybe how difficult or how easy it is to serve someone. So, for example, adding criminal background to someone's demographic profile, or we know from history that, you know, that does create a challenge. So it's weeding out what are the things that differentiate people who VR would serve and try and understand better how that relates to cost. The other thing that's really important that I don't typically see is what's the average cost of a successful case? So I see this is the average cost of successful closures. So taking all successful closures and dividing it by the number and then average cost of unsuccessful closures, then average cost of a case. But for me what matters most is what are we paying for a successful case if we're including everything we're paying. So including all the that we're spending on unsuccessful closures in that and saying, basically this is what it costs to get a successful case, because we also have to pay for the unsuccessful closures and trying to focus on how do we reduce, how much we're paying for unsuccessful closures, and to really make sure more of the money that we're paying flows to successful closures. There's a little bit of complacency that goes on with every system where if we just compare ourselves to other states, we may say, look, we're doing better. We should be happy with our performance. We are better than 75% of the states. But if we stand back and compare that to people without disabilities and their participation in the workforce, I think that's when we say we're comparing it to school. Like if you got 60% on a test, would you pass it or would you fail it? So I think we have to challenge ourselves to say we may be doing better than so many other states, but we are not performing at a high level and we want to move up. We want to not just judge ourselves by other states. Now, 100% success is unrealistic. I don't think there's anybody who would disagree with that, but it's important for the providers and the funder to come together and say what kind of improvement above where we've been. Do we want to try to incentivize? Do we want to see and to develop the payment structure, to say we believe this structure will directly influence our ability to move those percentages up over time and thus reduce the amount we're investing in unsuccessful closures without reducing the number of people were serving, without cherry picking, but truly improving outcomes.   Carol: I love that that is a good way to challenge the thinking that's going on out there, because people sort of, I don't know, poo poo or they just this is over there in that bucket and they let it be. And we're kind of complacent with just, you know, we're doing better but is better. What's the next state like. You know, like better than what. And so what does that matter.   Chip: But I think I mean, the key to me is the concepts of quality, the quality of services and quality outcomes. And if you can define and you can measure and you can demonstrate quality of services and quality outcomes, it seems like you don't need to compare yourself with other states. You can say this is quality in our state. This is what we're doing. This is how we're doing it. These are the outcomes. So state by state national comparisons are way less important. So when we can get to that point where we can identify and measure and demonstrate and get quality outcomes that will move this whole system gigantic step forward.   Carol: 100% Chip. So what would be your best advice for states as they're listening. Right. You know, they're listening in and they're thinking, well, I want to do something, but I don't know what to do. Like what would be the next steps? What should they do?   Lisa: To me, it's, start the conversation. I find that the process of bringing state people together with providers, that they're all learning together about this different way of thinking, And it helps because it does take a little bit to get your mind around what Value-Based Purchasing is and how it's different from milestone payments or fee for service. And I've often seen like people have come up to me sometimes and said, you know, it was the third time I heard you talk that the bells finally went on, you know? And I said, that's fine. I think it's just the way it is. It's complicated in a way, because it's so different. So getting the conversation started and thinking about, you know, asking yourself questions like, is there quality in the outcomes that we want as an agency that we're not getting quality and service delivery? We don't feel we're getting quality and outcomes we're not getting. Then think about your payment structure and say, is there anything about our payment structure that incentivizes or rewards this kind of quality that we're saying we're not getting? Sometimes maybe there's something there. Sometimes you could say, no, there's absolutely nothing in the payment structure that does that. And then I always say, think about the providers that you think are doing the best work for you. Are they financially benefiting? Are they doing better financially. And in some cases I've seen no, there's no difference. I'm performing better, but financially that's not being recognized. And in other cases I've seen they're actually earning less because they're doing such a good job and they're very efficient. You know, they're producing quality with efficiency. They're actually doing more poorly financially than some of the providers who are performing at a lower level of quality. So I think when we start to think about those questions, people see that the need to try to figure out a different way to do things, then they're willing to, you know, let's talk about what this Value-Based Purchasing is what the principles are, how it's different, and begin to think about how we might bring our high performing providers into a conversation with us about this.   Chip: My advice for states is that you're in this for the long haul. To Lisa's point very early in this discussion that this isn't a quick solution. That's something that can just be laid in the state and just immediately adapted. It does take that level of discussion, that level of understanding, collecting data. It's complex. And sometimes I think to myself, why am I choosing to get involved in the complexity of Value-Based Purchasing overlaid the complexity sometimes of customized employment, but I think in the end result we will have a much better system, much more equitable service delivery system for everyone, including providers, including customers and job seekers. But just keeping the discussion going on things like this, things that CSAVR presentations Getting this into the national discussion, I think, is the first step.   Carol: Those are really good tips. Where outside of VR is Value-Based Purchasing being implemented?   Lisa: So definitely in the Medicaid world, most of your listeners are probably aware of that, but mostly in the Medicaid world, it's on the acute primary care side. So hospitals and doctors, primary care physicians and things. So I always caution people there's things we can learn from that and those examples. But it's not a wholesale import those approaches over to VR. I don't think that would work. But there are some principles or strategies that we can use, like there's a concept called shared savings. There's some other things that I think we can think about and use, but we still have to develop something that's specific to employment. In my work on this around employment on the Medicaid side has been with the long term services and support agencies, the DD agencies, the mental health agencies, managed care organizations who are doing LTSS and employment is a perfect place to start with them around their thinking, around Value-Based Purchasing. They're facing some pressure. I would say some to use Value-Based Purchasing because it's seen to be working on the acute primary side of Medicaid. So they're saying, why aren't we using it in LTSS? And they want better quality and better efficiency too. They want to see people supported to achieve their highest level of independence. They want their high performing providers to do well. So we worked on it with employment because it's so obvious that fee for service, which is the typical payment model, disincentivizes all the things that we associate with high quality supported employment, the better you are at getting people jobs, the better you are at coaching and fading because you're good at it. We reward providers under fee for service with less money. And those providers are performing more poorly, end up with more money. So it's not hard to get people to see why fee for service doesn't work for supported employment. So we've worked on models for job coaching that pay for hours worked rather than hours of coaching, so that providers are appropriately financially compensated if they do better at fading, which goes back to what kind of job did they get people, as well as how good they are at coaching. That model incentivizes them to get people more hours. So if you start with 12 hours a week, that doesn't mean you stay with it. If they're doing well, the employer wants to increase that. The person wants that they can get paid more in the model. Fee for service providers don't get any financial remuneration for increasing people's hours worked, even though we say that's a goal. So that's been a lot of where we see some of the value based models developing. We're paying for things up front services like exploration, which I'm really happy to see the results of states that have added exploration and exploration to their waivers, because we now have a way to tackle people who say no thanks in a planning meeting or I'm not interested, or their families say that we've been paying for developing payment models for that. That's an outcome payment. So they complete the service, then they get paid based on the quality of the information they submit and the efficiency. So there are ways to align what we're doing. Providers certainly appreciate that they would like to be paid the same way. Typically once they experience being paid in a Value-Based structure. So that's where it's happening. But think about just the general business world. There are so many examples of payment based on performance or quality, right. Sales Salespeople earn incentives for sales. So business has long been doing this in terms of creating those kinds of incentives and even nonprofits. Now, United Way and others are funding nonprofits based on outcomes and deliverables. They're no longer funding them to just provide service. So I think if you look, we're seeing it everywhere, really.   Carol: So you brought up a whole lot of points. If people are interested in more information, do you have resources we could send them to?   Lisa: Well, in 2021, I did a publication that looked at examples from around the country that I'd been in some way involved in. That's on the Lead Center website as well as there are a series of webinars we did at the time with representatives from various states. I have a lot of information about what's going on in the Medicaid side. Et etcetera. So I guess I would say that was my thinking in 2021, I continue to learn and evolve my thinking, and I think we're at a point now where we're trying to do in Virginia, is move beyond both fee for service and milestones, because neither are working very well, right? So you've got some state VR agency saying we're paying fee for service. It's not working. Should we move to milestone? But if you talk to states who are using milestone, they will also say it's not working very well. Some of them are thinking about going back to fee for service. And I'm thinking, I don't think we should do either. I think we should work together to figure out what's the next way we attempt this that addresses the shortcomings of both. And I think that pathway is Value-Based Purchasing.   Chip: and helping moving states to. Well, I'm a little concerned about the unknown. What we have may not be working now, but it's the known. I don't really know what's ahead, but I think where in Virginia at least, has done a really good job of creating that safe space. Like, let's explore this together and keep this comfort zone of what we currently have, but move forward into something that's more equitable and beneficial for them.   Carol: So, Chip, if people wanted to reach out, what would be the best thing? Should they contact you or what would be best?   Chip: Either one of us is if it's a state agency, probably me if it's others listening to this. Lisa.   Carol: Do you want to give them your email address?   Chip: It's r k e n n e y at SDSU (San Diego State University) dot EDU.   Carol: Awesome. And, Lisa, do you mind sharing your email address?   Lisa: No, but I'll warn you, it's long. So here we go, Lisa Mills l L i s a M i l l s, all one word, at M as in Michael, T as in Tom, D as in David, D as in David, dot On Microsoft, all one word, com. And that was my IT friends who gave me that ridiculously long email, which I hate.   Carol: Holy smokes, that is long. Well thank you both. I really appreciate it. And I will put a link in our podcast announcement out to your publication from 2021 as well. Then folks could at least see that. But thanks for your time. I really appreciate the conversation.   Lisa: Thank you.   Chip: Thanks. We really appreciate this opportunity.   Outro Voice: Conversations powered by VR, one manager at a time, one minute at a time, brought to you by the VR TAC for Quality Management. Catch all of our podcast episodes by subscribing on Apple Podcasts, Google Podcasts or wherever you listen to podcasts. Thanks for listening!

One of the biggest announcements at the eClinicalWorks Annual Conference was the advancement of the Sunoh.ai medical scribe product that automates the creation of clinical notes for the clinician.  If you've followed us for a while, you know we're big fans of everything that's happening with AI Medical Scribes and the impact for good they can have on clinical documentation. Of course, while it is great to hear about AI medical scribes in general, it's always better to hear the first hand experience of actual medical practices that are using these products.  In this case, we sat down with Geli Brown, Senior Director of Quality Management at HHM Health, to talk about her organization's experience rolling out Sunoh to their clinicians.  Learn more about HHM Health: https://www.hhmhealth.org/ Learn more about Sunoh.ai: https://sunoh.ai/ Health IT Community: https://www.healthcareittoday.com/

Today on the show, we have Ruslan Nazarenko, the Head of Growth at Scale AI.In this episode, Ruslan shares his approach to boosting retention in marketplace models through strategic engagement and quality management. He dives into Scale AI's unique model for retaining skilled gig workers, emphasizing how tailored experiences can overcome common marketplace retention challenges.We then explore the role of dormancy and reactivation in maintaining a resilient workforce, and how Scale AI balances high-quality standards with user engagement to create a robust marketplace ecosystem.We wrapped up by exploring the critical role of company culture in driving sustainable growth, the value of setting ambitious goals, and Ruslan's insights into building a resilient, motivated team that drives growth. Mentioned ResourcesScale AI  Substack  Respeecher RefaceQuokkaBirdEtsyPanel AISuperhuman      Gaurav Vohra UberLyftLIME AI   HotjarChurn FM is sponsored by Vitally, the all-in-one Customer Success Platform.

Join us for the latest episode of the Manager Minute podcast, where host Carol Pankow sits down with the incredible Serina Gilbert, Cheryl Carver, and Peter Pike from Colorado's Pathways to Partnership DIF Grant! In this episode, they dive into their groundbreaking Pathways to Partnership project, a collaborative initiative designed to enhance outcomes for children and youth with disabilities. Discover how they're embedding VR counselors in schools, launching the innovative “Map My Transition” app, and partnering with Centers for Independent Living to create a brighter future. Tune in as the team shares valuable insights, learning experiences they've faced, and what's on the horizon for the grant's second year. Don't miss this inspiring conversation about transforming lives through partnership and innovation! Listen Here   Full Transcript:   {Music} Serina: To support the families that are surrounding these young adults with disabilities, as well, to help them gain the skills to be able to help those students move into competitive, integrated employment.   Peter: The centers for Independent Living are required to deliver core services in one core service is supporting young adults transitioning into high school.   Cheryl: We will actually incorporate those components of the six core skill sets and the age ranges, along with all of those local partners into map my transition.   Serina: Gosh, there's so many things we're doing.   Intro Voice: Manager Minute brought to you by the VRTAC for Quality Management, Conversations powered by VR, one manager at a time, one minute at a time. Here is your host Carol Pankow.   Carol: Well, welcome to the manager minute. Joining me in the studio today are the Tri-Force from Colorado, Serina Gilbert, Cheryl Carver, and Peter Pike, Co-project, directors for Colorado Partnerships for Partnership DIF Grant. So how are things going for you, Serina?   Serina: I'm doing fantastic. I like that word Tri-Force. It feels really, really fancy. It's October here and it's like almost 80 degrees, so I'm happy.   Carol:  Ahh, good for you. You know what? In fact, I had to use a little ChatGPT because I said, well, how could I describe a fearsome threesome? And they gave me all these different things. And I went, I'm going to go Tri-Force. I really liked it.   Serina: So don't tell people your AI secrets. You came up with that all on your own. you did it.   Carol: I know, I know, how about you, Cheryl? You are old hat at this. I got to talk to you a couple years ago, which was super fun. So Cheryl's like the podcast queen now. She's on this twice.   Cheryl: I'm with Serina, though. I liked that word too. I thought it was empowering. I think this is awesome. We're going to have to use that again. Things are going well. Always busy though, you know, and the DIF grant has added to that, but in an awesome way in terms of growing, expanding and learning. So we're excited to be here today.   Carol: Awesome. And Peter, welcome to the podcast. I'm so excited you are on. How are you doing?   Peter: Well, I got to tell you, I'm a little nervous. This is my first time joining a podcast, so I'm not sure how it's going to go, but I appreciate the opportunity. And I'm coming off of two big meetings today, one with the Centers for Independent Living, where we get to get caught up on priority topics, and of course, our Disability Innovation team meeting. We meet on a regular basis. So the timing is great.   Carol: Good. Well, you're all bringing the energy. So that's great. So I just want to do a little quick refresher for our listeners so they understand what the earth we're talking about. So I have been doing different series on the Disability Innovation Fund grants. And this particular grant has to do with the Pathways to Partnership grant that was funded by RSA, and it supports projects aimed at fostering deeper collaboration between agencies. Turning these collaborations into true partnerships, and the projects aim to enhance service delivery by piloting cohesive models that better manage resources, while coordinating efforts to improve outcomes for children and youth with disabilities and their support systems, ultimately facilitating smoother transitions. And Colorado is wrapping up the first year of the grants. So let's dive in and see how things are progressing. All right. So let's get into it Serina, I'm going to kick off with you first. Could you just start by telling our listeners a little bit about yourself and how you got involved in VR?   Serina: Sure. So you already know my name is Serina Gilbert, and I'm currently a program manager under our youth services team with the Division of Voc Rehab here in Colorado. I actually got involved with VR because I was a recipient of VR services way back when, when I was in college, and while I was receiving services, I kind of flipped the script around, I was like, well, what do you do? This looks fun. Like, I want to learn this. So I got my master's and a few years later, here I am. So I've always enjoyed working with youth. That's always been my passion and I'm super excited to even be in this role.   Carol: Awesome. So, Peter, what's your journey to get to VR? Tell us a little bit about you.   Peter: Well, that's a great question. My name is Peter Pike and I work for what's called the Colorado Office of Independent Living Services, which is part of the Division of Vocational Rehabilitation. And I got to tell you, for a couple decades, I actually worked outside of the Division of Vocational Rehabilitation as a vendor and as like a community partner on different grants. And a few years back, Colorado established this Office of Independent Living Services, dedicated to working with nonprofits called the Centers for Independent Living. That's how I got involved with the Division of Vocational Rehabilitation, and I'm also a person with a Non-visible disability. And so this fits very nicely in terms of my philosophy and being part of the Division of Vocational Rehabilitation.   Carol: I love that because you bring a whole other perspective. Having come from that vendor field. So you've got some things going on that can contribute greatly to the agency and this project for sure. And Cheryl, last but not least, you know, it's been two years, but let's tell our listeners again a little bit about you and your journey into VR.   Cheryl: Well, mine is not as direct as Peter's or Serina. Again, my name is Cheryl Carver. I am the second program manager we have here in the state of Colorado under Voc Rehab for our youth services and transition programming. So Serina and I work very closely together. I kind of fell into this by accident, but I have always been in healthcare related fields. I've worked for the independent living centers. I've also worked in assisted living and I worked as a vendor as well with DVR in the mental health sector. After that, I really lucked out and was able to apply for a position. That was 24 years ago and I joined the youth services team 20 years ago, so it's been an indirect path, but once I found my niche, I have loved growing in this position with youth services at the administrative level.   Carol: I love it, you know, no matter which way, if you come in a direct way or lots of people, it's kind of a long and winding road to get into VR. Whatever way you get here, we love the energy you all are bringing, and we think it's great because people are bringing all kinds of different perspectives to the work now. I was super excited about your project when I was reading through RSA's website and looking at the little synopsis, and I'm like, oh, I got to grab the Colorado people first. You're the first in my group on this particular topic, and I understand that your project has multiple components. Can you give our listeners a little overview of the project and what you aim to accomplish? And I think, Serina, you were going to kind of give us the big picture to start out with.   Serina: Yes, it's a very big picture. So I'm sorry. We dreamed really big when we saw this grant posting last spring. We saw a lot of opportunity in our state to maybe help build some capacity and some connectedness throughout the state. So one piece of it is we started out by deciding to build what we're calling interdisciplinary teams. And what that is, is traditionally in Colorado, we don't usually have DVR counselors housed specifically in the school districts. We do have counselors that liaison with the district, but they are not like actually full time there. So we actually just did some hiring, and we'll have a couple of counselors starting in the next few weeks that will be housed directly in the local school districts and embedded with the school transition teams to make sure that services are able to be delivered to the students with disabilities within those districts. Another super exciting part that coincides with that is that there'll be services provided by the Centers for Independent Living, which Peter will talk a little bit more about as well, to make sure that there's a dedicated service provider to be able to help support those teams. And one really big, huge thing that we're really excited about is what's going to be called Map My Transition. And we jokingly call this the You are Here Website. So it's going to be a website and iOS app and an Android app designed for students, their families, educators and service providers and other community agencies within the state of Colorado. And the way that it'll work is we'll start from the student perspective, as the student will create an account on the site, they'll be asked a few questions about where they reside and what their long and short term goals are, and then they'll be presented with customized resources and videos that are specific to what their needs are, and specifically, how to get connected with the agencies that can support them. The super exciting part about that is that that also allows kind of that turnover resistant piece of things, because The educators and the service providers can also see that same list of community providers that are specific to their geographic region. So if somebody leaves a position, the next person can come into that position and get connected on this website and instantly know who their community partners are within their geographic area to connect with.   Carol: I love that app idea though.   Serina: I'm so excited about it.   Carol: Well, you know, when you talk about kids like students, man, they're not. Don't email them. They're not out looking on the internet.   serina: No.   Carol: like their phone is their life. Like they need everything to be direct connect that way. That's how they're going to, you're very smart to go that route.   Serina: Yeah. So we're super excited. Also gosh, there's so many things we're doing also to support the students. We are partnering with our family led organizations to support the families that are surrounding these young adults with disabilities, as well, to help them gain the skills to be able to help those students move into competitive, integrated employment. But then that's not all, I feel like a game show host.   Carol: Do tell more.   Serina: I know, I know. I'll have Cheryl talk a little bit about our interagency transition building as well, because that Map My Transition is also going to support that aspect of what we're doing here in Colorado.   Carol: I think that's cue to you, Cheryl.   Cheryl: I was just going to say, is that my cue? so five years ago, Colorado began an initiative through the National Assistance Center on Transition Coalition, and we began looking around the state to identify where our own gaps and weaknesses were as it pertains to interagency coordination teams. What we discovered were several of the components that Serina has mentioned that we hope to build into Map My Transition. Things like we were having trouble sustaining interagency transition teams, and that was due in large part because of turnover and staff. When interagency transition teams were coming together locally, they placed those responsibilities with an individual instead of their position. And as a result of that, once that person left, there was nobody to continue on with the work. And these interagency transition teams just eventually dissolved. Additionally, they really didn't have any goals that kept them together and gave them a reason for continuing to come together. So we wanted to help the local partners rediscover their interagency transition teams, identify tools that would help bring them together and give them an actual purpose. As a result of that work, what we created was a workbook for all partners that come to the table locally in these interagency transition team efforts, every partner at that table is required to identify within six core skill set areas that we've put together an age range, what services they actually provide. That way, when education is working on developing an IEP, an Individualized Education Program, or other entities sitting around the table like the division of Voc Rehab, developing their individualized plans for employment, we can look and see what areas does this student need to grow in, depending upon their age and their skill gap. With that, then we can pick and choose and strategically work together towards the same goals with that student. So we actually have coordinated student outcomes. We are not duplicating services. The challenge we faced was that the workbook, because we didn't have any backing to help us complete this, is overwhelming and it's difficult to use. And as a result of that, again, this is where Map My Transition comes in. We will actually incorporate those components of the six core skill sets and the age ranges, along with all of those local partners into Map My Transition so it will be easier for all users, whether it is the youth themselves or a family member, or any one of the number of entities that sit around an interagency transition table to be able to go in and see, we know what the students ultimate goals are, and these are the areas we are working on. So let's take a look at and consider what are the choices for the service providers. So I am also extremely excited about Map My Transition, because I think it is going to be fabulous in terms of what we are envisioning to create, as well as to help interagency transition teams accomplish that coordinated student outcome.   Carol: I think that is going to be super replicable across the country, like the work you guys are putting into that, because I know that's one of the things with the DIF grant, they're hoping that some of the things you all create are going to help other states out there. And that particular piece, I think that's fascinating. I think that sounds really cool.   Cheryl: I agree. So with that, we'll take it to the next level, if you will, and continue to enhance, we hope at least. What else would do you want me to kick it back to you, Serina, for apprenticeships or family member training?   Serina: I forgot about our apprenticeship piece because we're just doing so many things. We shot for the moon, right?   Carol: Yes, yes you did. There's like, 20 moving parts on this thing. I'm like, wow.   Serina: Cheryl is correct. One other aspect was to make sure that we're connecting young adults with apprenticeship and pre-apprenticeship opportunities. So we are partnering with our apprenticeship representatives here in Colorado within the Department of Labor and Employment, called Apprenticeship Colorado, and they will be helping the counselors and the interagency teams learn about how to connect with employers for apprenticeships and actually be developing apprenticeships in the areas that we're serving. And then they're also going to create training for us to put on Map My Transition for future reference, but also train our staff on it. I did talk a little bit about the family led organizations in the training, but what we didn't talk a lot about was the Centers for Independent Living Partnerships, and I'd love for Peter to be able to cover that a little bit for us.   Carol: Peter, I know you're passionate about those CILs for sure.   Peter: Yeah, I always love the opportunity to talk about the Centers for Independent Living. And maybe a starting point is to just briefly talk about what is the Center for Independent Living, right? These are nonprofit organizations that actually exist in every state of the Union. And so in Colorado, we have nine centers for independent living that are focused on helping people with disabilities of all ages, any disability type, living as independently as they can. And I want to be clear, that doesn't mean they are residential facilities. These non-profits are not residential facilities. They are non-profits that we have contracts with to support people living independently in the community, and they are a key partner. One of the great things about this grant is there was a requirement that Centers for Independent Living be part of this grant. And so with that, it really accentuates some of the strengths that they have. There are two things that come to mind. Number one is the Centers for Independent Living provide peer support services. What that means is that these organizations have over 50% people with disabilities from the board of directors, all the way down to their entry level staff. And that is key because an emphasis of this program is peer support services. So in their work for this grant, that's what they're going to be doing, is working with young adults in high school, transitioning out of high school to Address and navigate some of the adult issues that come up, whether that be employment, post-secondary education and otherwise. So that's an important strength. The second strength that I believe the Centers for Independent Living offer is that this service system you don't age out of just because you turn 18 doesn't mean, oh no, now there's another program I need to join. As I said earlier, Centers for Independent Living serve all ages of all disability types. So that provides a key continuity of services as folks transition out of high school into what's next. So in addition to that, the Centers for Independent Living will have contracts with the centers for Independent Living, serving on the interagency teams and some of the expectations in terms of the services they're going to be providing are things like benefits, planning services, things like financial literacy. They'll be focused on supporting and educating people on accessing what are called ABLE accounts. Able stands for achieving a Better Life Experience, but it's an opportunity for these young adults to actually increase their assets and resources. In addition to that, they will also be serving as vendors for the Division of Vocational Rehabilitation. And so those are key elements that they'll play in working alongside the interagency transition teams with the school districts, with the Division of Vocational Rehabilitation. So it is a great opportunity for those organizations to really illustrate their strengths and the difference they make in the lives of people with disabilities.   Carol: I love that you are leveraging the Centers for Independent Living, because I think sometimes people I don't know, they're there, but you sort of forget about them as being a resource for more than maybe folks are thinking about. Oh, somebody needs a ramp to get into their house. Let's call the CILs, you know, type of thing. But they have a lot more going for them. And they're strategically positioned throughout your state and in every state. You know, they're all throughout all the geographic areas. So they're excellent partner to leverage. When you're looking at an endeavor like this I think that's smart.   Peter: You know Carol, it also fills one more gap. Like the Centers for Independent Living are required to deliver core services, and one core service is supporting young adults transitioning into high school. So with this particular project, they're actually working with youth in the schools. That's not necessarily part of their core services. So it really complements the opportunity to start the work earlier and support it ongoing even when they're out of high school.   Carol: Yeah, I really like that, Peter, I think that is so great. So I know you guys are you know, you're at the end of year one and you made it. You made it through year one. What kind of learning experiences. And I love it because I'm not going to say what sort of challenges did you have? What learning experiences have you had so far? Cheryl, I think I'm kicking that to you.   Cheryl: You are. So while this is a multi-pronged approach that we are taking, if you will, with several different outcomes for each one, we have encountered challenges that we have had to overcome or lessons we have had to learn along the entire way, starting from the very beginning with communication. Even between this Tri-Force. And I don't think it's a terrible thing to mention. That was one of the things that the grant reviewers brought up how, as three managers, are you going to do this job together? And we were like, we can manage this, we can handle this. We did. We had to learn how to communicate well together. We had to understand one another's styles and figure out what worked best for each of us in order to come together, agree upon things and respect when somebody didn't, and hear them out, even if that was not the direction we were going to go in. Inclusion has been another one. While we put above everything equity and diversity and inclusion. Just because we are the division of Voc Rehab, it's still easy to overlook or forget to give certain audiences the opportunity to have a say in things, especially something this large. And when you're moving forward and you've got deadlines and timelines, having to take a step back and say, wait a minute, did we check with everyone is really, really hard. So fortunately, again, because there's three of us, we always have that one that raises their hand and says, wait a minute, did we do that? So it's good to have that piece there. When we're working with our planning and advisory team or other partners around the table, we are also learning all about marketing and how to go about getting the marketing. We need to message things correctly and deliver that message out there to the communities about things as simple as trainings that we hope to offer to family members in partnership with our parental consortium here in Colorado. We are maintaining, I think maintaining is a good word, maintaining a huge, massive budget and having to be willing to be flexible within that budget. We are given certain parameters to operate within, and we have to go about getting changes approved periodically. But every time we turn around, there's been another new need or a new requirement or oh, wait a minute, we calculated that wrong. So we've got to go back and recalculate it. It has absolutely been, I think, a learning process for all of us. Another area that we have worked very diligently in is just as a state government, where we have had to learn different processes and procedures. Things have taken longer than we expected, having to write reports in certain manners or fill out certain forms. That in and of itself has been a hurdle that we have had to overcome together in regards to learning things.   Carol: You guys are not unique. I mean, I do ask this question of everybody when I'm talking about the DIF grants, just because the learning opportunities you've had this first year, it is really common because there are so many systems and practices and processes within each state. Everybody's got their own little nuances and things. And when it isn't your everyday job to navigate those and you now are co-directing, you know, this Tri-Force and this lovely DIF grant, and you're getting exposed to all these other processes that you didn't know about. It is quite a learning curve just to get through all of that. And once you get it figured out, then you fundamentally go, okay, you know, year two gets easier. It's like, all right, now we figured out all the pieces of the process and it gets better as you go along. So that is common. Everybody, I don't think I've talked to anybody across the country that hasn't had that as well. So I think you guys stated that really nicely. Now I know you all when I got to visit with you a little earlier, you had mentioned that you had this really important realization about your service model and that maybe it doesn't work like you thought it was going to work. When you are conceptualizing something and then you're going to put it into practice. So I don't know. Peter, can you talk a little bit more about that?   Peter: Yes, thanks. I'd be happy to. So as we've been talking, we talk about establishing three pilot sites or three interagency teams. And so we went through a process with our planning and advisory team, came up with a matrix, and we were able to identify three sites. And so we have this vision in this model about how those sites are going to be implemented and moving forward, including the Centers for Independent Living. And so one of the communities where we are working to establish a pilot site is in northwestern Colorado. And the school district that's involved is based out of a rural community, but it's also a mountainous resort community. And so what that means is the cost of living in that particular area actually is pretty high. And there's been articles on it within the city and across the state talking about challenges, just filling some government positions in that community. And so as we were having conversations with that interagency team, particularly the Center for Independent Living, that serves not just that community, but a five county area, they talked about the challenges. If we're going to have a contract with and bringing on a staff because the wage and the affordability for someone to live in the community that they're serving don't align very well. And so we've had to sort of pause and talk with our local partners about, man, what does this need to look like in order to meet the needs of the students and families in that school district, and at the same time, navigate some of these real issues around the cost of living. And so we're taking some extra steps in working with the Center for Independent Living and the school district to identify maybe where do we need to bring in new partners or other partners, or what are alternative ways to deliver the services that are necessary to meet the needs of the youth and families, right? Just because you're living in a resort area doesn't mean everybody is of the same economic class. And so our aim with this project is to make sure we're serving underrepresented communities. And sometimes socioeconomic status is kind of an important factor in that way. And so we have to take more time and understand how best to meet the needs of that community and how it might look different than the other two communities where we're continuing to move forward with all the parts.   Carol: That's a really excellent observation. I know VR has been facing this ever since the pandemic, kind of across the country, especially as people moved, you know, we had like floods of people moving to Florida, people moved into Idaho and different communities. And I know the directors have said, boy, it's impacted the program in different ways because now you have whole communities where they've had this big population move in and all the prices have gone up. And so it's tough even to get counselors and different staff working in these different regions and even to get vendors in those regions because the cost of living is so expensive. So you've got people there who've been there for many years, but yet new people are coming in and you've just got this kind of mire of crazy economic conditions that make it really difficult to navigate all of that for the consumers that are in those areas. So that is a really good realization you had. Now, I know we're on year two like you're three days into year two. You guys, what are your plans for year two? Miss Serina.   Serina: Sound like I'm in trouble.   Carol: Oh, no.   Serina: No, no. We have a lot like we talked about it a little bit earlier where we're hiring the school based rehabilitation counselors. We're well into that. And making sure that they have the training and support that they need to get started with everything. We're super excited because we're in the early stages of planning their kickoff meetings, where we'll be on site with each of the teams and help them, A, get on the same page and like kind of level set everything like so everyone has all the same information. And then one of the bigger pieces is that they all walk away with a tangible plan for how they're going to initially start collaborating and coordinating services with one another. So we're super excited about that. Another thing that I'm really personally excited about, because I'm kind of a marketing and social media dork in a way, is we're going to be coming up with some branding and a way to refer to this grant that resonates with the people that we're serving with students, families, educators, and, you know, the service providers that are working with us. Saying DIF grant, unfortunately, doesn't mean much to the average person. And there's a lot of DIF grants now. I believe they just funded the fifth or sixth round of them. So.   Carol: Oh yeah, and there's like 28 of those or something.   Serina: Yeah.   Carol: so there's a bunch   Serina: There's a lot. So we're super, super excited to get some branding and social media going and things like that to get people excited about what we're doing. Um, what else are we doing? Team what am I missing? Those are some really big things that we're doing.   Carol: Do you have anything cool that you're doing with the branding? Like can you share if there's something little or is it all top secret right now.   Serina: No, we just, thanks to our grant manager, Lauren Riley, and our program assistant, Amy Smith, they found us a marketing agency, and we're going to be meeting with them in the next couple of weeks so that they can talk through kind of what our needs are and things like that, and then they're going to have some focus groups with stakeholders to get their input and see what resonates. So I'm super excited.   Carol: Very cool. Very cool.   Peter: You know, Serina, thanks, sort of opened up an opportunity to talk about family and youth engagement. And one of the opportunities we have with this project is we actually can pay honorariums to young adults and families to participate, particularly on the planning and advisory team. And so we definitely want to hear the voice of the people we're serving and bring them to the table so that as we bring this to life, we have their input from the beginning.   Carol: Yeah, I love that, that's great, you guys, the energy of the three of you, it is super funny. I can feel it like our listeners can't see it. But coming off the zoom screen. Like it is so fun. I think you three complement each other very nicely. Now, I know for our listeners, you know, sometimes people want to reach out to you. I know you're in your initial stages, but sometimes folks just have questions or they're super interested, like Map My Transition, they're gonna be like, when's that going to be ready? Because we want to borrow it like we want all of that. Do you have an email or something you can share with our folks on a way to contact you?   Cheryl: We'd like to direct those questions to our actual grant manager, who is Lauren Riley, and her email address is l a u r e n dot R i l e y at state dot co dot US.   Carol: Excellent. Now that's helpful because otherwise the stuff goes kind of all over. And I do end up hearing back from the different folks we've had podcasts with. They're like, oh, we had some people reach out. So I'm hoping folks will do that. Are you three going to be at the CSVAR conference?   Cheryl: Not the upcoming one.   Carol: Possibly in the spring?   Cheryl: Maybe.   Carol: Yeah, because then people can track you down there as well.   Peter: I'd like to. Next time you talk to Kristen, say, hey, Kristen. Sending Peter to the CSVAR conference?   Carol: I'll put in a plug for you, Peter. That's awesome. Well, you three have been an absolute delight and I really appreciate your time. And I'm hoping I get to check in with you down the road to see how things are going. And I wish you the very best with this project. Have a great day.   Cheryl: Thank you, Carol.   Serina: Thanks so much, Carol.   Outro Voice: Conversations powered by VR, one manager at a time, one minute at a time, brought to you by the VR TAC for Quality Management. Catch all of our podcast episodes by subscribing on Apple Podcasts, Google Podcasts or wherever you listen to podcasts. Thanks for listening!

Irina Hollatz stops by the podcast to explain what RightWFM does, and why it is important to challenge the norm.  The discussions also leans towards how software development takes place, and how Calabrio approaches the multiple demands of creating dynamic software that people actually want to use.

The RISE-UP project is a transformative initiative to revolutionize rehabilitation services for underserved populations, focusing on racial and ethnic minorities. Dr. Mari Guillermo and Dr. Mark Tucker, Project Directors at San Diego State University's Interwork Institute, highlight how this project seeks to drive systemic change through state agency partnerships and tools like QA Advisor Plus. RISE-UP strives to reshape vocational rehabilitation and improve employment outcomes nationwide by fostering equity, inclusion, and access.   Listen Here   Full Transcript:   {Music} Mark: QA Advisor Plus, a tool that agencies can use to check their RSA 911 data for errors and to help facilitate or expedite analysis of their own data.   Mari: How do we close this gap? Where are people not being served, what populations specifically are not being served? And the emphasis is on systems change because we can't improve these outcomes without really looking at what needs to change within that system.   Mark: So we hope that when you see information about the survey coming out, that you take a few minutes to fill it out and can provide us with information both about what they see as needs related to serving underserved populations. But also, we're asking folks to identify any promising practices that they're aware of with respect to providing effective services to underserved populations.   Intro Voice: Manager Minute brought to you by the VRTAC for Quality Management, Conversations powered by VR, one manager at a time, one minute at a time. Here is your host Carol Pankow.   Carol: Well, welcome to the manager minute, Dr. Mari Guillermo and Dr. Mark Tucker, are co-project directors with San Diego State University Interwork Institute. And they are joining me in the studio today. So how are things going in San Diego, Mari?   Mari: Uh, well, it's warming up. It's going to be in the 90s by tomorrow, but it's also the start of the semester at San Diego State University. We're in our second week, so things are still trying to settle down, but it's been quite a good busy two weeks for sure.   Carol: Oh, good for you. Well, I was in San Diego back in June and I'm going, okay, why isn't it warm here now? It was warmer in Minnesota than it was in San Diego. It was so crazy with that kind of, I don't know, marine layer or whatever hangs out. Yeah. How about you, Mark? How are things going for you?   Mark: Going well, yeah, That marine layer in June we that's like a typical thing June Gloom we call it. And then we pay the price in September. September is usually warm for us, but we'll get back to our normal San Diego weather in October.   Carol: Nice. I do love your fair city though. It is really awesome. Well, I thought, and I'm so glad I could get you two because I've been trying to snag you. I think I've been talking to you since last December, but now is finally the sweet spot. I thought it was super timely that we talk about the project given you're at the end of year one. October is also National Disability Employment Awareness Month, and I really think the project that you guys are embarking on could have a significant impact on the employment arena for underserved populations. As a little side note, we're super happy as part of the George Washington University team to be a partner on this project. So I want to give our listeners just a little bit of background. Over a year ago, RSA competed a discretionary grant, and the grant was specifically related to section 21 of the Rehab Act, as amended by WIOA, which requires RSA to reserve 1% of the funds appropriated each year for programs under titles three, title six, and seven to provide grant, contract or cooperative agreement awards to minority entities and Indian tribes to carry out activities under the Rehab Act. Secondly, minority entities and Indian tribes to conduct research training to or a related activity to improve services provided under the act, especially services provided to individuals from minority backgrounds. Or thirdly, state or public or private non-profit agencies or organizations to provide outreach and technical assistance to minority entities and American Indian tribes to promote their participation in activities under the Rehab Act. I learned a whole bunch. I know for our listeners, you're getting a whole history lesson, but I thought this was cool. And so under this priority, the department provides funding for a cooperative agreement for a minority entity or an Indian tribe to provide training and TA to a minimum range of 5 to 15 state VR agencies over a five year period of performance, so they are equipped to serve as role models for diversity, equity, inclusion and accessibility in the workforce system by implementing policies, Practices and service delivery approaches designed to contribute to increasing competitive, integrated employment outcomes for individuals with disabilities from underserved populations. And the other cool part is that you also need to contribute via our research and really good practices that promote access, and this will be really of great benefit across the whole country. So I'm super excited. Let's dig in. So, Mari, typically our listeners like to know a little bit about our guests, your backgrounds. So can you tell a little bit about yourself and your background?   Mari: Yeah, I'm originally from Hawaii, born and raised in Honolulu, Hawaii. I moved to San Diego in the late 80s to as a graduate student in the rehabilitation program at San Diego State University. So since moving to San Diego, I haven't moved very far from San Diego State University and our rehab counseling program. I'm currently faculty in our graduate program, but I've been with the Interwork Institute since its beginning, when it was started by doctors Fred McFarlane and Doctor Ian Champion, and just worked with some incredible number of leaders in our rehabilitation field. And upon graduating from the master's program, I started working with Doctor Bobby Atkins. And for those of you who few of you who are not familiar with Doctor Atkins, she is a leader. When we look at all diversity initiatives and in fact, when we look at section 21, that was started with her groundbreaking research looking at the involvement and participation of African Americans in vocational rehabilitation. But I worked with Doctor Atkins upon graduating from the program in the capacity building projects funded by this same pool of money. And Doctor Atkins was the national director for the Rehabilitation Cultural Diversity Initiative, which then morphed over into the Rehabilitation Capacity Building Project. So I worked with her from the 90s. All the way up to like 2015 I think is when the project ended. So a lot of the work that we are doing in Rise Up really builds on the foundational work that we did with Doctor Atkins back in the 1990s. So it's an incredible honor.   Carol: I think that is very cool. You've come full circle. Oh my gosh, I love that. I had no idea. And for our listeners too, I just want to say a word about Doctor Fred McFarlane. Fred had passed away this summer. Fred has been a good friend to many, and many of our listeners have benefited from Fred's work with the NRLI and the Leadership Institute. Fred was the founding person developing that and really did such an amazing job touching so many VR professionals over his career. And his legacy definitely lives on. So I just I needed to say that because Fred is definitely missed. So, Marc, how about you? Why don't you tell us a little bit about your background.   Mark: Sure, I've got a Master of Science in rehabilitation counseling, and I'm a certified rehabilitation counselor. And in fact, you know, when I was applying to the graduate program in rehabilitation counseling, Fred interviewed me. Uh, that was a few years back. But that...   Carol: Yeah, 1 or 2.   Mark: Yeah, but he was there right at the start for me. And then kind of in the profession, I got my start in community based non-profit agencies and then from there joined the Rehabilitation Continuing Education program for region nine at Interwork and SDSU in the early 2000. And when I was there, was involved in all kinds of different technical assistance, training and research projects, while also kind of teaching in an adjunct capacity in the Rehabilitation counseling graduate program at SDSU. And then eventually the Rehabilitation Continuing Education programs transitioned into the Technical Assistance and Continuing Education centers. So I continued doing that same type of work with what were called the TACE centers, and then in 2014, joined the Rehabilitation Counseling Program faculty at SDSU full time. So that's sort of where I spend a lot of my time. But I still continue working with, you know, Interwork. The two are just so intricately joined. It's really difficult to be part of one without being part of the other. So I continue doing work at Interwork. One of the recent projects that Mari and I were both involved in a few years back was the California version of the Promise Projects. It was a 5 or 6 years of work with transition age youth who were recipients of Supplemental Security Income. Presently, I'm the coordinator of the Rehabilitation Counseling program at SDSU, and do that while maintaining connections to a variety of projects at Interwork.   Carol: Yeah, you're always wearing about 40 hats. I always think of you, Mark, as being the data guy though, too, because you love the data. I mean, everybody likes data, sort of but you love the data. I mean, you've done some really amazing things with our national data.   Mark: Thank you. I enjoy that. I appreciate being able to bring that to a lot of the projects that I'm involved in. Yeah, you're right. I think I find it fun maybe at times where other people are like, oh, we'll leave that to somebody else.   Carol: Yeah, absolutely. Oh my gosh. So why don't you guys tell us a little bit about your project? I know it's called Rise Up. Maybe you can tell our group like what's that stand for? Everybody's got their fun acronyms and what you're trying to accomplish.   Mari: The name really captures the overall vision for this project, and we have to give a shout out to Doctor Chaz Compton because after several failed acronyms, as we were writing the proposal, it was Chaz who came up with the name. And RISEUP stands for Rehabilitation Improvements in Services and Employment for Underserved Populations. And so that really captures what we're aiming to do, improving the services and in the process of improving services, improving the outcomes for underserved populations, in competitive integrated employment, in careers, in academic achievements and accomplishments now underserved populations. There's many ways we can look at that, but RSA has defined it for us and it concentrates on race and ethnicity. So it encompasses individuals who are black, Latino, indigenous, Native American persons, Asian Americans, Pacific Islanders, and other persons of color. And so that is the specific focus for this grant and the population that we hope to impact ultimately with the work that we do with the state agencies. An important component of the project is the partnerships that we aim to build with ten state agencies. And that partnership is really important because while we think about this work is okay, we'll do training and technical assistance and all these different topics and how it intersects with these different populations based on evidence based practices and promising practices. But we can only do so much with training and technical assistance. We really have to look at, okay, how does this then translate into the work that goes on in the agency and not just in the agency? How does that look at the different levels within the agency? How a director would translate the training will look different than how a counselor or a technician would translate. We hope that it complements each other, but everyone has a different role in this process. And that's the other part of the project, is that we want to really look at the whole agency and all the different levels, and being able to provide that support to them where they need it. And really looking at how do we close this gap? Where are people not being served, what populations specifically are not being served within a state or a section of the state? And the emphasis is on systems change, because we can't improve these outcomes without really looking at what needs to change within that system. And there's different components that we're going to be incorporating into the project in our partnerships with the state agencies to look at what are the strengths and weaknesses within your agencies and what are the opportunities and gaps. And while there are big challenges that we all are aware of, there's also some great things going on and we want to highlight that, and we believe we'll be able to find that also within each of the state agencies.   Carol: I like a couple of things about what you just said. Well, I like it all, but a couple things stick out to me because holistically, we've seen it as we do TA and as people put in new initiatives in place. If you really get the whole agency going in the same direction, it is the rise or fall of that project for sure, because maybe the director is all in, but the mid-level managers and the counselors are like, I don't even understand what's going on. You're asking us to do this other thing? I don't get it. It seems weird. It's extra. I don't want to. I'm not going to. And then it doesn't happen. And so you really have to get everybody in sync. So I think you're smart to look at the whole organization and how everybody interprets the information and the training and how it actually gets implemented, because it isn't the director implementing it. It's the boots on the ground folks, it's your counselor. You need your line folks engaged and involved and giving you feedback and understanding what's happening. So that I think that is brilliant. Secondly, the data I think it's been interesting and I think Mark, it's some of the work that you've done over the last couple of years that I've known you as well, that as people start to get better about looking at their data, I think folks were looking really high level, not getting into the real intricacies and seeing the maybe the disparities that are happening in employment as you start looking at different races and ethnicities and who's getting what kind of work and what those outcomes are. And then we've seen states be completely shocked, like we didn't know we have a huge problem in this area. So I think getting at the data is super important. So I know, Mark, you and I had spoken to and you talked about this special wrinkle, and we're not using wrinkle in a bad way. It was in a good way. But you have a contractor called Encorpe and they're bringing something special to the project. Tell us a little bit about that.   Mark: Sure, and this relates a bit more to the data aspects of the project that we were just talking about. So Encorpe is a partner on the project. It's an organization that's headed by a couple of individuals with considerable experience with the public VR program, and they offer a tool that's known as QA Advisor Plus. So this is a tool that agencies can use to check their RSA 911 data for errors and to kind of help facilitate or expedite analysis of their own data. So users of the tool can run custom queries on their data. They can do things like track changes from quarter to quarter in things like population served on a variety of measures that might include things like applications or eligibility plan services, competitive integrated employment outcomes. Those are the kinds of things that are of interest, particularly to us as part of the Rise Up project and built into this project is that Rise Up will pay for one year of QA advisor Plus for participating agencies if they elect to use it. So agencies aren't required to use QA Advisor Plus if they don't want to. We have other strategies for helping and assisting with data analysis if they elect not to use it, but that's there as an offer. Rise Up will cover one year of the cost of that service. And I think one of the things that we're trying to get at is that through the project is to kind of help facilitate kind of long term attention and ongoing attention to things like population served and differences in services and outcomes, and to use that for more data informed planning, in our case, particularly around underserved populations. But agencies can certainly pretty easily extend that out to other groups of interest or other aspects of the rehabilitation process. That may not be maybe the central focus of what Rise Up is doing. And one of the things I sort of want to underscore here is that the project is intentionally designed to make considerable use of data that the state agencies are already gathering and reporting to RSA anyway. So if agencies are interested maybe in participating in Rise Up, but they're like, oh, I don't want there to be like an additional heavy burden on my data folks or my direct service folks. Our intention is that things will be fairly light with respect to those kinds of demands, because we'll take advantage of existing data that's already being gathered, and then we'll either use QA Advisor Plus or some of our own staff to assist with the analyses.   Carol: That's the beauty of this project really, I love that because it isn't like you're going, okay, state, we're knocking on your door to like, come and do this thing. And then you need to add like ten positions to pay attention to this. And I think it's great because I got a chance to look at that QA Advisor Plus. I saw the Encorpe guys at, CSAVR and they were like, hey, do you want to see a little demo of this? I was like, oh my gosh, I know as being a small blind agency director, we had one data person who's doing a million things, and so we were very surfacey. We got a little bit of stuff, but it was really hard. You have one person there doing a million things, and so that tool, I liked how it kind of rose up little things. It had that cool feature and it would just flag something for you to go like, hey, what's going on in this particular area? That would have been so lovely because I know a lot of our programs are small, so you might just have a half a position or one position that's working in this area. They don't have a whole team that's got all this really developed deep skill set in there. I just think having that added resource is amazing and could really take that level of sort of your data analytics to a whole different place than what you've been able to do so far and not, you know, not disparaging anybody's current skill level at it. It's just that people don't have time because there's so many demands. So when you can add like a feature to help with analyzing that data, it really is a great gift. So who are your agencies that are currently participating in the project?   Mari: So we've had initial conversations with a number of agencies, and certainly there were a number of agencies who had written letters of commitment when we wrote the grant, and that was really important. I don't want to mention the states yet until we have agreements in place out of respect for the agencies, our goal is to have by the end of year two, our goal is to have six agreements in place and by the end of year three, another four. So that will be a total of ten. But we've already started to have that conversation and people are at different starting points, right? And trying to map out how will this make sense and be of value to your agency and mapping that out in an individualized agreement with each of the states? So maybe we'll be invited for a second visit a year down the road, and I can at least give you a few more names more specific than what I'm giving you now, Carol.   Carol: No,  that's totally fine. Absolutely. I wasn't sure if, you know, like, are you needing some people? Because sometimes our listeners are like, hey, I want to be part of that project. I want to be in.   Mari: No, absolutely. And we're more than happy to talk to agencies throughout this whole process, because really the intent is we targeted ten agencies because we want to make sure that with the resources that we have available to us, that we use that in a way to really make that impact, to really try to get to that systems change because again, change doesn't happen overnight and it doesn't happen on a zero budget, right? But the hope is the lessons that are learned from the ten agencies in this work will be relevant to the rest of the country.   Carol: That's what I've loved about all of these different discretionary grants that RSA has put out, because I've been talking to people for the last year, and there is such cool things being done and demonstrated that now they're sharing out, you know, with other people and just that wonderful plethora of ideas. It makes it super fun. And everybody gets really excited planting the seeds of a different way of looking at things and doing things. So you are at the end of year one, and I love it when I talk to all our grantees that have gotten these grants, like, what have been your challenges this year?   Mark: I would say some of the challenges that we've encountered are things that it's not like they're not doable. It's just that they're the time and process demands are, you know, things have sort of taken longer, I guess I've started to come to kind of expect it. But still, when you're anxious to kind of get going and get rolling, these things sort of surface as challenges or frustrations. And so some of them are, I think, very predictable things like fleshing out the project staff, developing and executing subcontracts. I think Mari, she's nodding her head often. It's a little bit more complicated or involved than you think it might be. We've been working on things like establishing the technical infrastructure for the project, information management, information sharing systems, and we have a website that's in development that will ultimately use to share information coming out of this project, with many more than just the ten state agencies that we work intensively with. So there will be kind of dissemination of project learning far beyond those ten. We've been comprehensively surveying the literature related to underserved populations in VR, and it's not really just a challenge. It's just kind of a time consuming thing that we're kind of working our way through. We are going to be implementing a national survey of state VR staff around both challenges and opportunities related to serving underserved populations and the instrument development process is always a little time consuming, and you get a lot of feedback and you make revisions and there's several feedback and revision stages. So that's something that will be surfacing in the near future. That's just it's taken time, but we'll get there. Or going through things like the human subjects institutional review process, just to make sure that everybody's, you know, treated well and treated ethically. So those are all, you know, just things that have moved along or are moving along and we're squaring them away. But for those of us who are like, would like to just get going, all of that process stuff at the beginning is a little bit of a challenge. One thing that I think the team is wrestling with a little bit, and this is something that I think were a challenge that we will contend with going forward, and I've got confidence that we'll be able to address it, but it's just going to require some thought is that, you know, as Mari indicated earlier, the underserved populations of interest are defined by race and ethnicity. And we know already from looking at our data over a long period of time that our clients, like everybody else, often are multiracial, and they check a whole bunch of boxes So we're not going to necessarily be able to look at clients who are folks don't fall neatly into very convenient categories, right. So I think we're going to have to be very sensitive to that dynamic in the process and probably develop multiple ways of looking at race and ethnicity, so that we don't kind of miss any really important lessons that are coming out of this project.   Carol: Absolutely. And regarding that national survey, is there something our listeners can do to be of help in that or something they should be looking out for?   Mark: We're still in the process of piloting it like we want to get it right before it goes out, but we will be working with one of our project partners, which is CSAVR, to disseminate this national survey. It'll be an electronic survey, and it's really designed to go to VR staff at all levels. Like we talked about earlier, involvement of folks, feedback from folks at all levels in VR system really important. So VR staff at all levels, folks like SRC members will be disseminating it through CSAVR. And we would encourage everybody to, you know, I know we survey ourselves all the time in society here in the US. But this one is important. And to me and I think to the overall intent of the project. And so we hope that when you see information about the survey coming out, that you take a few minutes to fill it out and complete it. It will be anonymous. It won't be linked back to you. So we hope people will respond candidly and provide us with information both about what they see as needs related to serving underserved populations. But also, we're asking folks to identify any promising practices that they're aware of with respect to providing effective services to underserved populations. I think both of those types of information can be really helpful to us in terms of planning out the future of this project, designing effective training, effective technical assistance efforts. So we see it as one way of kind of triangulating that information. We will look to triangulate it with other forms of information, but really critical to kind of building some of the key infrastructure to the project.   Carol: Good.   Mark: Yeah.   Carol: And we definitely can be a help to in passing out the word when the survey comes out. I know Chaz, he'll be like, Carol, can you get that out in our email groups too? We have lots of different ways. We communicate out. We have different COPs. We've got lots of mailing lists and such, so we can help kind of promote the word to get at the different groups of folks. So you get kind of a wide range of participation. So I know, Mark, you've alluded to a few things that really you've learned so far this year. One, because always year one's a learning year because people don't fall neatly in boxes. Are there any other kind of learnings you've had from year one so far, or Mari, too. either of you?   Mark: Yeah, I'm going to defer to Mari on this one.   Mari: We've learned a lot. And when you say, what have you learned so far? It's almost what has been confirmed. The whole reason why this funding opportunity is available because there's a gap there, right? And so what the conversations that we've had with agencies is just confirmed that there's a lot of work that we need to do and that we need to do better. But every agency is at a different starting point. Who they consider underserved will vary from state to state, or even from city to city within the same state. Right And where those gaps and inequities occur will also vary. For some states, it's just getting the outreach to communities to that door exists in their area, to certain populations dropping out before they even reach the point of developing an EIP, and other agencies are seeing where the EIP is developed. Things start to roll out and then for different reasons that we want to dig into, we lose people, you know, in certain populations compared to the overall populations being served. And so one of the things we are learning is that we really need to direct the training and technical assistance to where each agency wants to start, but also helping them and working together using that data that Marc talked about to confirm or not confirm whether these actual inequities at different points in the process are occurring. And then of course, the environment and the climate that agencies operate under impacts what they're tackling, something that we've heard repeatedly. And I'm sure, Carol, you've heard often, is the staffing challenges that our state agencies are experiencing upwards to 40% of unfilled positions, and that will certainly impact the work and the progress and the impact when we start to work with the agencies. Some agencies are further along in the process where they've really looked at the data from their comprehensive statewide needs assessment and saw a hole there and actually started to develop a goal to address that. And so they've already have that beginning understanding and now are at the stage of, okay, what do we do with this information? What kind of training and technical assistance can we provide our staff, and how can you help with this. And getting us to move the needle, at least move the needle forward, right? And I know we're going to get a lot of new information or confirming knowledge from the national survey, but also using that national survey to start the conversation with each of the individual agencies. You know, how does this national data look for you? Is it true or how different it is? And so I think we've learned a lot, and there's a lot more that we're going to unravel in this process.   Carol: I love it. The CSNAs, you know, I think states for a long time did it as a check the box. We have to do the thing. We're going to contract to somebody to do the thing. Here's the thing. It's 300 pages. All right. We put it on the shelf. It's in the electronic folder. But I have noticed this over the years we've been doing the QM work. People are really taking the CSNA and actually paying attention to it and starting to put all the dots together, linking that as the basis for then what flows into the state plan flows into goals and priorities and really connecting and spending more time. The thing I've been very hopeful of is spending time with direct staff so that they understand the whole process, because staff will hear about this stuff, but they don't really understand it or what is that about? And now people are linking like, here's why we're doing all of this. We're actually finding out what's the situation in our state, and we're taking this and we're putting together goals and priorities within our state plan based on this data, this information. So it all links together, because I think people feel like everybody's just doing these random activities, but they actually all come together.   Mari: Yeah.   Carol: So that I have seen as a change, definitely in the five plus years I've been doing TA work now, I've seen a big swing and I've loved it, because now people are digging down in the organization and including not just your executive leadership and middle managers. They're including the line staff and having them have an understanding of what's going on so that they can understand their contributions to this overall big picture. So I love that.   Mari: Yeah, and we learned that from the Cal Promise Project We had this whole large, comprehensive database and our team were able to put together, I guess, reports of here's what the data is looking like, here's how your region is being impacted, and the transition specialists, the people who are meeting with the families and with the students, like we've never seen this before. We're always feeding data to our supervisor. Our boss is always asking for data, and so we give it to them. But we never know what happens to it. And now it makes sense. This is how my work is impacting people.   Carol: Absolutely. It's mind blowing to the staff because when you go out, you're talking and you're like, okay. They're like, well, why is Congress doing all this crazy stuff with our money or whatever is going on? I always tell them, I go, the only way your story can be told because they don't know all your anecdotal, really neat. You got Joe, a job like this is awesome and it's a great career and you know, all this great things are happening. They don't know any of that. They only know by the data you put in the system. And when you put data in the system, that isn't very good. That's the picture, the story that your agency is telling. This is the only way for other people to make decisions. You just see this. Aha. Like people are like, oh well this stuff actually does matter. And it is being used for something and then they can figure it out. And I love it when you get down in regional levels because then they go like and they'll know what's going on. Sometimes up here the management's like, oh they're trying to figure out what's happening in that region. Talk to the staff. They see boots on the ground, what's going on. So the data confirms what's been happening in that area. And then the whole agency having that conversation, it's really exciting and super empowering and energizing. I feel like for their customers and what's going to happen for their people, I love that. The other thing I was going to say, Mari too, is we've been seeing a slight improvement in staffing levels. Now it seems like things for some reason, because we work with a load of states and we talk a lot about this particular issue, the staffing levels, it's been leveling off with that whole people leaving, leaving, leaving, leaving, leaving. And now I've had a couple agencies in the last year where they were sitting at 25, 30% now. They're at 5% and 8% turnover. Like there have been significant changes because of all of the things they put into play to not only get staff, but to keep them, to retain them. So we've been trying to do some efforts on our end and we can't say it's all us, you know, but people have been putting a lot of strategy into this, and it's really fun to see on this other side, this more encouraging landscape for the staff out there.   Mari: Wow, that's great to hear.   Carol: Yeah. So I'm hopeful for you guys as you're carrying this out. So now what are your plans for year two as you go into year two? What are you guys hoping to accomplish this year?   Mark: I think it'll be a busy year for us. I think one of the major efforts, you know, we've already kind of alluded to a little bit, which is get the national survey out there to get that information back, have our team kind of start analyzing the results. We'll use that data. As I said before, we'll triangulate that with other information sources that we have our team working on. You mentioned comprehensive statewide needs assessments and state plans. Our team is doing an analysis of that specifically through the lens of underserved populations to see what can be gleaned from those statewide reports. And they're triangulating that also with kind of other forms of published literature around underserved populations. So there's a lot of kind of building that kind of database of information will be focused on executing agreements with the first of the agencies that are going to be involved with kind of the intensive phases of Rise Up, while at the same time kind of establishing the groundwork for agencies that we will add to the Rise Up group, you know, to as we work towards our goal of getting to up to ten state agencies. And then I think as we work with each of the agencies, kind of to begin to identify the populations that they want to focus on for, you know, kind of sustained efforts to enhance getting folks in the door, getting them into plan, getting them services. The outcomes will also begin to kind of roll out. You know, one aspect of Rise Up will be training. Some of it will be technical assistance. That will be kind of systems change focused efforts. We'll begin to roll out initial training. Some of those will focus on topics like cultural humility And then we'll be using the literature search, the national survey, consultation with the agencies that we're working with to lend direction to the development of additional trainings that will be kind of targeted towards all levels of the organization. And then within the agencies that we begin to work with, we'll also begin kind of identifying the targeted and specific areas of need for technical assistance that will be unique to each of the agencies. So I see those as kind of the major tasks that will be kind of getting into in the beginning of year two and then kind of sustaining through the next year.   Carol: That is super exciting. I'm really excited about this. I would love to talk to you guys too, again at the end of like next year to see where things are at. Now, I understand you to, I believe, or somebody coming to CSAVR and people may want to chat with you. Is there a way folks could reach out to you if they are interested in talking to you about the project?   Mark: Sure.   Mari: Yeah   Mark: Yeah, so we will be at CSVAR, our project coordinator, Letty Vavasour will be there. Mari will be there. I will be there. So we're certainly kind of approachable there. As we mentioned before, CSAVR is a project partner of ours, and we mentioned encore. I think they're going to be there as well at CSAVR. And one other partner we haven't mentioned, but we should give them some credit, is a major partner with us is the George Washington Center for Rehabilitation Counseling, Research and Education. They're also a project partner with us and will be instrumental in kind of our efforts. So CSAVR is one place where folks can connect with us. Our team is working on a website, so we should have that up kind of in the near future. That's another way to get a hold of us. Email is always a good way to get a hold of us. I'm easy to get a hold of by email at MTucker at SDSU.edu and Mari is MGuillermo@SDSU.edu. So those are kind of really easy ways to get Ahold of us. And then of course Interwork Institute and the VRTAC-QM, we're sort of housed right there and involved in a number of those projects going on there so folks can track us down through Interwork or the QM.   Carol: Excellent. And, Mari, would you mind, Mari, would you spell out your email address? Just in case, because like me, it's like, how is that spelled?   Mari: And for those of you who know Spanish, my last name is Guillermo, which is William in Spanish, but it's m g as in George. U I L L E R M as in Mari o at SDSU.edu.   Carol: Excellent. Thank you. I really appreciate you taking the time. I'm super excited. And I wish our listeners could see like, the excitement on both of your faces about this project because it makes me like, super happy. I mean, the project couldn't be in better hands. You guys always do really good work out of Interwork, and I'm really excited to see what comes. So let's definitely chat again down the road.   Mark: That would be great.   Carol: Thanks for joining me.   Mari: Absolutely. Thank you Carol.   {Music}   Outro Voice: Conversations powered by VR, one manager at a time, one minute at a time, brought to you by the VR TAC for Quality Management. Catch all of our podcast episodes by subscribing on Apple Podcasts, Google Podcasts or wherever you listen to podcasts. Thanks for listening!

Having a quality management system in L&D can help ensure that the final learning experience is of high quality. In this episode, the author of the new book, Quality Management in Learning and Development, discusses her book and shares tips on how to embed a quality management system in the L&D process. Hadiya Nuriddin is an award-winning talent development professional with over two decades of experience in learning strategy, instructional design, elearning development, and facilitation. With Duets Learning, she's worked with many companies in various industries on strategy, design, and quality management projects. She holds an MEd in curriculum studies, an MA in writing, and several other learning and quality management designations. She wrote the books StoryTraining: Selecting and Shaping Stories That Connect and Quality Management in Learning and Development, both published by ATD, the latter of which was released on June 25th 2024. Duets Learning https://www.duetslearning.com Book: Quality Management in Learning and Development https://www.amazon.com/Quality-Management-Learning-Development-Nuriddin/dp/1953946607/?_encoding=UTF8&pd_rd_w=u5oio&content-id=amzn1.sym.d0ebfbb2-6761-494f-8e2f-95743b37c35c%3Aamzn1.symc.50e00d6c-ec8b-42ef-bb15-298531ab4497&pf_rd_p=d0ebfbb2-6761-494f-8e2f-95743b37c35c&pf_rd_r=N46HY3XPXXV5KXTNYW7M&pd_rd_wg=p5IuD&pd_rd_r=1b4ab8dd-78b9-407f-aabb-546e6b6d04bd&ref_=pd_gw_ci_mcx_mr_hp_atf_m

In this episode of the Arguing Agile podcast, Enterprise Business Agility Coach Om Patel and Product Manager Brian Orlando open a door into the world of W. Edwards Deming by exploring his 14 principles for management from his seminal book "Out of the Crisis". Whether you're in software development or manufacturing; whether you're a leader looking to transform your organization, a QA professional seeking to improve quality, or a product manager looking to delight customers - this episode is for you! As applicable today as they were in the 1980s, Deming's points provide a roadmap to improve the effectiveness of a business or organization.Listen or watch (links in the comments) as we discuss ways to implement Deming's principles of creating constancy of purpose, ceasing dependence on inspection, driving out fear, and removing barriers that rob people of pride of workmanship. #Deming #Management #QualityManagement #Transformation #Leadership = = = = = = = = = = = =Watch it on YouTube= = = = = = = = = = = =Subscribe to our YouTube Channel:https://www.youtube.com/channel/UC8XUSoJPxGPI8EtuUAHOb6g?sub_confirmation=1Apple Podcasts:https://podcasts.apple.com/us/podcast/agile-podcast/id1568557596Spotify:https://open.spotify.com/show/362QvYORmtZRKAeTAE57v3Amazon Music:https://music.amazon.com/podcasts/ee3506fc-38f2-46d1-a301-79681c55ed82/Agile-Podcast= = = = = = = = = = = =Toronto Is My Beat (Music Sample)By Whitewolf (Source: https://ccmixter.org/files/whitewolf225/60181)CC BY 4.0 DEED (https://creativecommons.org/licenses/by/4.0/deed.en)

Dr. Jonathan Hill, VP of Science and Technology and co-founder of Wasatch Biolabs joins the podcast today to talk about the future of genetic testing technology. Dr. Hill shares his journey in genetics, starting from his undergraduate days to co-founding multiple biotech companies. They discuss the cutting-edge genomic and bioinformatic methods being developed at Wasatch Biolabs, including targeted DNA methylation sequencing and its significant implications for personalized medicine and early disease detection. Dr. Hill also elaborates on the integration of lab work and data analysis in genetic research, partnerships in diagnostic advancements, the role of AI in the future of genetic testing, and the importance of quality management in product development. Additionally, he speaks about the challenges faced in implementing these technologies and how they are being addressed. The conversation concludes with Dr. Hill's vision for the future of genetic testing and his approach to preparing students for the industry's evolving landscape.00:00 Introduction to the Episode00:25 Meet Dr. Jonathan Hill01:45 Dr. Hill's Journey in Genetics03:27 Understanding DNA Methylation Sequencing06:15 Applications in Personalized Medicine15:06 Challenges in Implementing Assays18:40 Future of Genetic Testing Technology23:14 Importance of Collaborations and Partnerships26:58 Fun and Personal Insights27:43 Conclusion and Contact InformationMore about Dr. Hill:Dr. Hill is the VP of Science and Technology and a co-founder of Wasatch BioLabs, a biotechnology company committed to transforming the field of diagnostics. The company delivers reliable laboratory services, offering transparent testing and accurate results for biotech firms, patients, and research institutions.https://www.wasatchbiolabs.com/ https://www.linkedin.com/in/jonathon-t-hill/  Qualio website:https://www.qualio.com/ Previous episodes:https://www.qualio.com/from-lab-to-launch-podcast Apply to be on the show:https://forms.gle/uUH2YtCFxJHrVGeL8 Music by keldez

As CEO of STOP Foodborne Illness (STOP) since May 2019, Mitzi Baum, M.Sc. is focused on expanding STOP's impact by concentrating on three strategic areas: families and individuals impacted by foodborne disease, company culture and practice, and food safety policy. By instituting a collaborative, consumer-centric operating model, STOP engages stakeholders across the food system to develop and advance solutions to food safety. Prior to her tenure at STOP, which will come to an end in late 2024, Mitzi cultivated a 23-year career at Feeding America, rising to the senior-level position of Managing Director of Food Safety. Mitzi holds a Master of Science degree in Food Safety and a certificate in Food Law from Michigan State University. She received her Bachelor of Science degree from Bowling Green State University and has obtained certificates in Nonprofit Management from the University of Chicago, Quality Management from DePaul University, and Food Safety Management from Cornell University. Mitzi is the 2021 Joseph Leiter Lecturer of the Medical Library Association and National Library of Medicine, an adjunct faculty for Michigan State University's Online Food Safety Program, a certified seafood Hazards Analysis and Critical Control Points (HACCP) instructor, and a Preventive Controls Qualified Individual (PCQI). She also serves as the consumer representative on Council I for the Conference for Food Protection and is a member of the National Restaurant Association's Food Safety Advisory Council. In this episode of Food Safety Matters, we speak with Mitzi [2:57] about: The development and impacts of the Alliance to Stop Foodborne Illness, a program of STOP that joins industry with consumers STOP's advocacy for the modernization of USDA-FSIS's regulatory standards for Salmonella in poultry, for which FSIS recently released a proposed framework, and STOP's thoughts on the new framework STOP's work to include Cronobacter sakazakii on the CDC's List of Nationally Notifiable Diseases, and whether more work is required to prevent Cronobacter infections from powdered infant formula following the 2022 outbreak and supply shortage Efforts to position STOP as a more credible, reliable, and focused organization with greater visibility and improved fundraising outcomes What drew Mitzi to STOP, and her proudest achievements during her tenure as CEO. We Want to Hear from You!Please send us your questions and suggestions to podcast@food-safety.com

Get ready to dive deep into the future of Vocational Rehabilitation (VR) with Dr. Joe Ashley and Dr. Bob Schmidt in our latest episode! Joe, the dynamic Project Director of the VR-ROI initiative at George Washington University, teams up with Bob, one of the leading economists and the Project Research Coordinator, to bring you insider knowledge on revamping return on investment models for VR programs. They're on a mission to streamline and elevate how VR agencies operate, helping them become more efficient, effective, and impactful. Their discussion is packed with actionable insights that will empower your agency to sharpen its data collection strategies, ensuring the true value of your services shines through. Plus, learn how to better communicate the VR success story to policymakers and stakeholders! Tune in to discover how you can maximize your VR impact with the latest advancements from the VR-ROI project. Don't miss out!   Listen Here   Full Transcript:   {Music} Joe: We're trying to make sure we have information that the director can use with policymakers, and something for clients and counselors to use to say, yes, this is the kind of services we're looking for.   Bob: The model we develop is based on readily available administrative data.   Joe: It's built on the individual customers and how well they do and what their outcomes are.   Bob: The human capital development, that's what it's all about a lot. Some things just aren't measurable. So when you mentioned financial return on investment, that's what we're talking about.   Joe: If you can't capture it, you're not able to tell the story.   Carol: Yep, if it isn't documented, it didn't happen.   Bob: That's right.   Joe: Yeah.   Intro Voice: Manager Minute brought to you by the VRTAC for Quality Management, Conversations powered by VR, one manager at a time, one minute at a time. Here is your host Carol Pankow.   Carol: Well, welcome to the manager minute. Joining me in the studio today are Dr. Joe Ashley, the project director for the VR Return on Investment project based at the George Washington University, and Dr. Bob Schmidt, one of the five economists working on the project and the project research coordinator. So, Joe, how are things going for you today?   Joe:  Today they are doing really well. Thanks for asking, Carol.   Carol: Nice to hear it, Joe. and Bob, how are you doing?   Bob: I'm doing well as well, at least, as well as Joe is doing.   Carol: That's awesome. Alright, glad to have it guys. Okay, so for our listeners, Joe is my colleague and we got him out of retirement to serve as the project director for this important initiative. And this project is funded by the National Institute on Disability, Independent Living and Rehabilitation Research, also known as NIDILRR. Now, this is the federal government's primary disability research organization and is part of the Administration for Community Living. Now, NIDILRR's mission is to generate new knowledge and to promote its effective use to improve the abilities of individuals with disabilities to perform activities of their choice in the community and to expand society's capacity to provide full opportunities and accommodations for its citizens with disabilities. NIDILRR achieves this mission by funding research, demonstration, training, technical assistance, and related activities to maximize the full inclusion and integration into society, employment, independent living, family support, and economic and social self-sufficiency of individuals with disabilities of all ages. They also promote the transfer of, and use and adoption of rehab technology for individuals with disabilities in a timely manner, and also ensure the widespread distribution and usable formats of practical, scientific and technological information. And they do address a wide range of disabilities and impairments across populations of all ages. Now, Joe, I know you have a little disclaimer you wanted to make.   Joe: Yeah, I just want to be sure that people understand that what Bob and I are going to talk about today is our opinion of what return on investment should be, and is not necessarily reflect what NIDILRR is looking at.   Carol: Excellent. Well thanks Joe. Let's dig in. So, Joe, why don't you kick us off and tell us a little bit about yourself and your journey in vocational rehabilitation?   Joe: Carol, I've been in rehabilitation for quite a while. I worked with the Virginia Department for Aging and Rehabilitative Services, the general agency in Virginia, for over 25-27 years, most of the time as an assistant commissioner in a variety of roles. I have a master's in rehabilitation counseling from the University of South Carolina. That sort of got me focused on vocational rehabilitation. And then later I had a Doctorate in rehabilitation from SIU at Carbondale that took me on a path of looking at program evaluation and program development. When I got to Virginia, I was working out of the Woodrow Wilson Rehab Center, now called Wilson Rehabilitation Center, and was working in a program that was collaborative across, it was one of the early transition grants, 1985,and it looked at vocational evaluation as a part of a process to help kids learn what they needed to do. And we were working with students from special education and vocational education in the schools, and vocational rehabilitation, and getting these systems to collaborate to help kids find out what they want to do and to be successful in employment and in life. And I got to where I really enjoyed that kind of collaborative work, and I ended up as an assistant commissioner in the agency, looking at developing innovative new programs as a part of my responsibilities and looking at a lot of the ancillary support services like rehabilitation, engineering and other kinds of things. Through a series of circumstances, I ended up as the director of the field services for four years, where I began to get a good sense of what disabilities needed to be in terms of supports to be successful in employment and being able to live successfully in their communities. In addition to that, what counselors and other staff needed to be able to provide those services to them. And then I got into the job that was my favorite, which was something called grants and special programs, where I did a lot of the Social Security stuff, cost reimbursement, work, incentives specialist advocates. We created a new system there to do fee for service for the work incentive services. We did a lot of work with the workforce agencies. I did all the agreements with that, and then I got to do grants and any of the grants that helped people with disabilities be able to live and work and thrive in their communities were things that we were willing to support. And I got to work with a lot of different funding systems and across a lot of different systems, you know, Special Ed workforce systems, behavioral health, a lot of different groups to help people with disabilities have opportunities. So that's what I really enjoyed. And that's where I came across the late doctor David Dean and then Bob Schmidt as a part of that package with Dean. And it was about telling the VR story. And I got real passionate about how do you tell this story in a way that is going to get people like GAO to pay attention, as well as help directors with policymakers and individuals and counselors help make decisions about what's a good choice for them. So that's really how I got to where we are today with this new grant.   Carol: Very cool Joe. I know we all look to your program in Virginia for kind of the cutting edge stuff that was happening, because you all seem to always have just something cooking.   Joe: Yes.   Carol: It didn't matter what. And especially like the disability work incentive stuff that you were talking about and all of that. Oh gosh. I just think you've done a lot of stellar things there.   Joe: Well thank you. It was fun.   Carol: It's awesome. So, Bob, tell us a little bit about yourself.   Bob: Sure. Happy to. Joe mentioned Doctor David Dean. He was a colleague of mine in the Department of Economics at the University of Richmond. He worked on what he called economics of disability, and he started working on that in graduate school at Rutgers with a faculty member there. And he worked on that. So that was in the 1980s. He came to the University of Richmond, and he got me interested in it because he was an outgoing, gregarious, very bright guy and made friends easily. So he got me involved in this probably early 1990s, and we started working with DARS and several other things at the time with Joe, but also Kirsten Roe. I don't know how many people remember her, but she was instrumental in all the work we did. So this is actually our third grant with NIDILRR. The first one was a demonstration grant. So it's a kind of a proof of concept. Second was implementing it. Now this one is refining it and taking it to the next step. That's what we're trying to do with that. So David got me excited about it. Joe keeps me excited and he keeps me honest.   Carol: That is awesome. Well, I know just being around the director ranks for years and folks talking about return on initiative, it's been a, you know, a hot topic. People chat about it, but I don't know that everybody always really understands it. And I think sometimes people think maybe it's something that it isn't and they aren't very good at explaining it, but everybody wants to do it. So you guys are going to unpack all this for us. Joe, why don't you tell us a little bit about the project and what you're trying to accomplish?   Joe: Well, with this current iteration. It's what NIDILRR calls a field initiated project on their development side, and it's got a ridiculously long title. So I'm just going to say it is about updating and simplifying our return on investment model. That's its main purpose, and it's about helping our agencies understand what they can do to be more efficient and more effective, and take a look at the mix of services that they provide, to be sure that they are getting the most out of the resources they have to help people with disabilities obtain, you know, that probability of employment and upon employment, their earnings. And we're trying to make sure we have information that the director can use with policy makers, that agencies can take a look inside their own services to say, maybe I need more of a particular type of service because I'm getting good outcomes, or maybe I need to tweak a service because it's not getting what I want it to do, and then something for clients and counselors to use to say, yes, this is the kind of services we're looking for. We got four goals, and the first one is just really to update the model. Our previous model was prior to WIOA implementation, so what we hope to be able to do is take a look at the data systems and take a look at the performance indicators that WIOA requires. And we can do a correlation, perhaps with the long term employment to see how well they're correlated. Also take a look at Covid impact. The second goal is about intensity. Our other model is you either got a service or you didn't. And if you got the service then how did it affect employment and earnings? Well, the next logical step according to The Economist and we have five on the project as you mentioned earlier, was what is the intensity of the service. Does that make a difference. So that intensity measure could be hours of work. It could be what it costs to do something. It could be units of service. And taking a look at if that is related to the propensity for employment. The other piece that goes with that is how about internals provided services, what we had before in the system, nobody had good measures of the services their own staff provided. So we're hoping with what we're seeing now and we're working with the two agencies in North Carolina, and they've been extremely helpful and collaborative with us on this process is take a look at the internally provided services and see what impact they have on the employment and earnings side of things. And then we've been told many times our third goal is simplify the model. Right now it takes economists to run it. Well that's not always a good idea for some people. So what we're trying to do is see what econometric models could we put in place to simplify this process so that it's more available to rehab agencies. But you want to make sure it's still rigorous enough to give you a reliable estimate of return on investment. So one of the things we're having with that is many of the folks on the who are listening to the podcast may be aware that we did a data analysis and management capacity survey that CSVRA sent out. Our advisory committee supported, and with that, we got 54 agencies to provide us information on what their data capacity is and what this capacity of their staff is. And then what kind of training they might be interested in. We're still looking at the data from that and we'll have some information on that later. But what we find in this may make a big difference on how simplified the model can be, or whether we need to take a different track to help people be able to implement a new model. And then finally, it's about knowledge translation. And part of that is coming to us like we did a consumer and stakeholder forum with the North Carolina State Rehab councils and some other stakeholders to get input on what they'd like to see, what kinds of information and would this information be helpful to them. And then we're going to have another consumer and stakeholder forum probably next spring to say, here's the model as we have it so far. Does this make sense to you and would this be valuable to you? So those are the big overriding goals that we have for the project.   Carol: I really like that you guys are digging into the capacity that agencies have, you know, with that data analysis, because I'm just thinking definitely, as I've been out across the country that you've got to have and the have nots. I mean, there for sure. are folks, I think of our friends in Texas and they have a lovely team there. Just they have like an amazing...   Joe: Oh yeah, they do.   Carol: ...resource team. And then you've got other folks trying to scrape together kind of a half of a position that can maybe do a little smidge of a little something around the 911.   Joe: they may have a resource like a data system, but they don't have anybody that can run it, or they may have staff with the capacity to do the data system, but they don't have the system. I mean, it's a lot of different variables there.   Bob: I'd like to jump in here just on one thing, which was on the simplified VR model. So the model we've developed, thank God it was by economists, is we're trying to address the question here. The goal of the program is to get people into competitive employment or keep them in competitive employment. If they already came into the program with it, maybe build on that. So there are a lot of things that are correlated with how well you do in the labor market, gender, race, Age, education level. All things are correlated, right? And maybe service provision in the VR program. But we'd like to take it from well, it's correlated, but we don't know exactly how or why. In the same way you can say, well, provision of this specific type of service leads to improvement in the labor market, leads to a greater likelihood of obtaining competitive employment. Now that's a different issue. Now the way you normally do that, the gold standard is a randomized clinical trial, right? Where you take people and you randomly select them and it's double blind. So neither the researcher nor the individual involved in the experiment know who's receiving the treatment, or  who isn't. Well, that's clearly impossible in VR. First of all, it's illegal to deny service to someone who is eligible and for whom you have the money. But secondly, it's impossible. So what you have to do is you have to impose statistical controls somehow. You have to do it through some sort of statistical model. And we've developed one which is state of the science. What state of the science inherently means that not everybody can implement it. So even at some universities, they aren't able to implement this particular model. And so we wanted to ask the question, could we come up with a simplified version of this model, a simpler model that can be used possibly in a VR agency or possibly at a local community college or university, something like that. And they could get similar results. So we wanted to see how could we do it? Is that a possible goal? What do you lose when you do it? Does it do a good enough job, or what kind of qualifiers do you have on it?   Joe: Where are the tradeoffs?   Bob: Yeah, what are the tradeoffs? That's a simpler model we're trying to do.   Carol: Should we talk about the model you developed now? Do you want to talk about it?   Bob: That'd be fine. Sure.   Carol: Let's do it.   Bob: Okay. One of the things is that the model we developed is based on readily available administrative data. What that means is you don't have to run a survey. You don't have to go out and do a very expensive sort of research project to find out what's going on. Instead, we use data from agency's own data system, which they collect to report to the Rehabilitation Services Administration, (RSA). they have really, really very good data. The RSA forces them to collect very good data. In fact, for some of our economists, their eyes just lit up when David told them the kind of data that he was able to access it. Whoa. That's great. So there are two levels. One is you get data from the agency itself, and then they will provide data to us that they provide through the quarterly RSA and nine over 11 report to the RSA. And more than that. So we get much greater detail than that if we know how to use it. If we can identify and know how to learn how to use it. And then secondly, all the agencies have given us access, been able to give us access to unemployment insurance sort of data. So quarterly data on that and what the RSA collects upon closure. They're mandated to follow employment and earnings for four quarters after closure, but we don't think that's long enough, especially since WIOA was passed Workforce Innovation Opportunities Act and changed the mandate to work on transition age, transitioning students with disabilities or providing those sorts of services. Well, if you're going to start working with young people who are just entering the workforce, or you're providing college level education or skilled training services to any age. You can't just follow them for four quarters. I mean, if you're just entering the workforce, you're not going to enter it at the highest levels of the workforce, right? So if you want to know what the real impact is, you have to follow them longer. So with the unemployment insurance agencies, we've been able to get quarterly employment and earnings data from 2 to 3 years before they even applied to the program. That's kind of a baseline. But what are the services do to you? How do things change? Well, that's your baseline three years before application. Then we try to follow them for at least five years after application at least. Now the current one starts in 2018. So the earliest applicants we have from 2018, and then we collect all applicants between 2018 and 2021. So already it's a stretch to get five years of data. But we had to start that recent because we all wasn't fully implemented effectively until 2017, 1819. In fact, the fellow North County says preferably 19 or 2021. But then you don't have, you know, this thing ends in 2025 and you don't have enough data, enough tracking. So that's the first thing, is readily administrative tracking earnings over a long period of time, as long as possible. Another thing is generally the way these things are done or have been looked at is you look at the VR program as a whole. You don't look at by discipline, you look at the agency. These are people who apply for services, and these are people who got to the point where they got a plan or plan for employment services. And then how do they do? We look a little differently. We look at by disability type. First of all, we look at for broad based disabilities folks with a cognitive impairment. And that could be an intellectual disability or a learning disability. Folks with a mental illness. And then also we try to find out how severe that mental illness is. Folks who have a physical impairment and folks who are blind or visually impaired or otherwise visually impaired. So we look at and we estimate those all separately because we think services are assigned differently by disability type on average. And also the disability type affects how you will do in the marketplace, for example. What we found out was for folks with physical impairment, unlike folks who have a cognitive impairment, cognitive impairment might be with you since birth, perhaps. And so therefore you kind of have a steady level of earnings at a certain level. But if you have a physical impairment that often comes on very quickly, very acutely, very quickly. So all of a sudden you see their preapplication Application for earnings pretty good. And then boom there's a big plummet, right? And so then you have to do something different with the track that the pre-application earnings. So that's the second thing. The third thing is that this idea that these folks, we look at the folks who received,, who had a plan and therefore received services, we compare those people who didn't have a plan and didn't receive services. So he received service, he didn't. Or, in economics or the social sciences, you call it a treatment group and a comparison or a control group. Well, we thought you could do a little bit better than that. What we look at is we look at anywhere from 7 to 9 to 10 to 11 different types of services things like diagnosis, medical treatments, college education, training, all those sorts of things. We say, first of all, how is the decision made that you're going to receive this type of service? And then secondly, what impact does it have? So what factors influence the decision to We see what type of services and what impact does that service have in the labor market on gaining and keeping competitive employment. So we look at that. So we look at different types of service. So you can see already it's a much richer type of analysis therefore much more complicated types of analysis. And then the last part is that we built sort of a state of the science model. And that's what makes it complicated for many people to try to implement. And by that we mean that this correlation versus causation. So instead of doing a randomized clinical trial you have to take the data as you receive it. So therefore you kind of build control by saying how do you control for different things that might affect this that you don't observe. Now one of these might be motivation, right? So if you have someone who's particularly highly motivated that will might lead them to both apply to a VR program and a plan, follow through and move on, successfully complete the program, and might also quite separately, whether or not they receive services. It helps them in the labor market, right? Because they're motivated to succeed. So how do you distinguish those things? That's tough. You do randomized clinical trial. You can't because both types people end up in both parts motivated and unmotivated. So we have to impose this controls. And that gets a little complicated. So that's basically the model is then once you're done. So then we get impacts by type of service. We also collect cost of providing those services. Cost of the program. We have those impacts. We let them spit out and say what would happen if they kept getting this benefit level for the next five to 10 to 15 years? And then you have to do some what's called discounting in technical and finance and econ. So you do that and then you say, okay, this is the total gain from that service or actually from all the services combined. And this was the cost. And the difference to that is kind of cost versus benefits, right? Hopefully the benefits exceed the costs, right? And that's how much they've gained because of the service per versus both the. That's essentially what you do. And the other thing about that is we can calculate that for each individual in the sample. So we have individual level returns on investment individual level benefits or effectiveness. And you can then aggregate that up and say okay agency wide. This is what it looks like. The agency's return on investment for a particular disability. That's what their return on investment look for males their females. Any group you want to do you can just do it because we have the individual impacts of it. So that's the model. And we want to see whether a simplified model can get us similar sort of information.   Joe: One of the things, Carol, that I find compelling about the model in particular is something Bob just pointed out, and that is it's built on the individual customers and how well they do in this process and what their outcomes are, and it builds up. So it starts at that individual client level. The other thing, when the economists were developing the model and they were looking at the data of people who went through the system, they observed that there's a lot of variability in the types of services that are provided. So they built the model around that variability of services. So that individual service model, that is VR is what makes the variability work for this model. So it's very much tied to the core tenets of the VR program, that individual services model. And that's where the variability comes from. And that's why it can give us some causation. So I think it's really important to note that it is consistent with how we do services and how we provide what we do. The other thing I will say about The Economist is they have been dedicated to understanding how VR works. They often in the early days when we were going out, they would sit down with the agencies and say, does this make sense to you? And then they would look at the model to see what would make it make more sense in terms of telling how VR works or the outcomes of VR. So they've spent a lot of time trying to understand the system and get knowledgeable about how VR works and what the opportunities are, what the process is, so that what they're modeling is consistent with how we do business. So I think that's a key component.   Carol: I think that's really cool that you said that, Joe, about taking it back to the individualized nature of the program because VR, you know, you think about it in an aggregate, we get this big $4 billion in a lump. And, boy, each person's experience within that is so individualized. It is, you know, whether you're getting this or that, you know, are you getting educational sorts of services and access to training and post-secondary and all kinds of different things? Or are you a person on a different trajectory, and maybe you needed some medical rehabilitation type of stuff going on? You needed something completely different. Like, people have so many ways to mix and match and use the things they specifically need to get where they need to go. You probably can't do it unless you get down to that level. So that is very interesting. Now, Joe, I know we've talked about this in our team a little bit even. And I know you said you wrestled with your group, but this whole notion of return on investment or taxpayer return on investment has been a really interesting topic and is fraught with some issues itself. And I remember coming into Minnesota and the general agency director like taxpayer return on investment, and I was brand new in the program. I'm like, I don't even know what you're talking about right now, but a lot of times you tend to hear it discussed that way. But I know, Joe, you've said there's a lot of issues around this. So what are some of those issues?   Joe: It's an interesting little issue. The very first meeting we had, it was at Carver, and we had a number of people from different agencies and state rehab councils come into a meeting, and we were laying out the first model. And one of the directors at that point said, well, are you doing a taxpayer return on investment? And by that he meant returning Taxes, increase in taxes, receipts going back to the Treasury. And that was his definition of it. That was the first one. And then when we were in North Carolina at the consumer forum that we did the stakeholder and consumer forum, we got the question from some advocates and said it doesn't seem to go away. We always get that question, but the issue is what is the appropriate way to determine the return on investment for a particular type of program. And it was interesting. We got this question so often, even from some of our workforce friends that are the economists said about writing a paper to describe why taxpayer return on investment is not appropriate for a VR type of program. And they submitted it to, I think it was three, maybe four different econ journals, and some of them didn't even send it out for review. They said, this is already settled. It's not appropriate for this kind of program. So the issue is another workforce programs or human capital development. And the purpose of a human capital development type of program is to in our case, find people employment and look at that probability of employment. And then conditional on that earnings, if you've got people in your system and they're entry level, a lot of them are not going to be at the level where they pay any kind of taxes at all for several years. So you really don't have a lot to show when you do taxpayer return on investment in terms of that. Also, one of the things that we noticed when one of the studies that was done is that in some cases, and this is with a particular type of one of the particular disabilities, is the only one they looked at this with when we had some Social Security earnings available data available to us for a short while. Not only do we get people off of Social Security benefits, but we also find people that go on to Social Security benefits from being involved with VR, and that often makes them more stable. So then they can then participate in a VR type of program and be successful. But it's a long, long term process to do that. So in the short term, you're not going to show anything but about as many come on as go off. So you're really not showing that. But if you're doing what the authorizing legislation says you're supposed to do, which is get people employed, let's just take it down to a simple level and then the question becomes, are you efficient and effective in that process? And that's what this particular return on investment model is about. And that is what the economists would say is the appropriate way to look at this. Now they would call this a social welfare type of program is the category they put it in. And then human capital development. But there's other kinds of benefits that accrue to the individual. Because this model, this type of approach looks at it benefits to the individual and to the society in general, which is the individual being employed. And in this case, there are other benefits that we can't observe. Self-confidence would be a good example. Quality of life would be a good example. So in our case, what we're able to observe is how they're interacting in the workplace. And that's really the piece that we can measure. And that's where we're going with this. And the others might be important, but very few places have really figured out how to measure that.   Carol: Well, Joe, I actually I was telling Bob before we hopped on, I said, you know, I threw something in ChatGPT because I was like, all right, VR return on investment. Explain it to me. And ChatGPT it spit out. It talked about financial return on investment, you know, with employment earnings, cost savings. But it was talking about social return on investment, improve quality of life, community contributions. You know people experiencing that enhanced self-esteem, independence, all those things. And then personal return on investment with skill development, career advancement, those kind of things. It was just kind of fun to run it through and go, hey, yeah, because I know you guys have wrestled with like, what are you going to call the thing? Did you come up with like the name, The Thing??   Joe: Yes, it's interesting. I think what we came down with is that we think the vocational rehabilitation return on investment is the name we're going to stick with. And then say, you know, what we have is a human capital development project, and that's how we're measuring it or return on investment. But what we're going to have to do this is so ingrained in the culture of VR that you've got to return taxpayer dollars. Well, that's really not what VR says it's supposed to do. And so how do you get people to understand that that's not the appropriate way to look at the VR program. So we're going to have to do some education. I think about what return on investment is. And I may use your ChatGPT story...   Carol: Yeah.   Joe: To ...tell it.   Carol: Bob, I see you have something you want to jump in with.   Bob: Yes, and I think well, I have several things. One is I think the reason it's so ingrained, I think I might be wrong. Joe can correct me is because agency directors have to testify before the state legislature to get the money they want from the state legislature, right? And say the legislature, at least for a while. I don't know if they're still doing it. They're saying, yeah, but what's the return to the taxpayer on this? Why are we funding this if it's a money losing proposition Well, that's the thought process. But the problem with that is the state legislatures are kind of going against the odds. The federal authorizing legislation, you know, VR dates back to again, Joe can correct me. After World War One, when veterans came back from war and they had some severe physical injuries, and the federal government said, well, let's try to get them services to help them vocationally help them get back to work, get a job, and keep it so that they're effective in the workplace. Well, that thing was incredibly successful. So over time they said, well, this works so well. Can we expand it to other disabilities? Maybe states want to get involved in this as well. So what's happened over time is every one of the 50 states has this kind of co-funded arrangement with the federal government. And the Rehabilitation Services Administration oversees it, where they jointly sponsor these things, and it now covers many disabilities. Some states have more than one agency, one for the blind and visually impaired and one for the general. Other disabilities. So it goes back that far. And the authorizing legislation says is specifically provide services to help the individual gain and maintain competitive employment. And we're back down to the individual with that. It doesn't say to pay for itself to the fed, to repay the state or federal government for those services. So that's one thing. It's not what the metric to do it by. A second thing is, I mean, I never did like the social welfare. I'm an economist who would never call this a social welfare program. First of all, welfare has a negative connotation, even if its denotation is not negative. It's social improvement or anything. But it's really less a social more. As I said, the human capital development, that's what it's all about. And he also mentioned the issue that a lot of some things just aren't measurable. So when you mentioned financial return on investment, that's what we're talking about. Is the agency doing its job of getting people back to competitive employment and leading a better life, and maybe freeing up some of their family work to do other things. There might also be a multiplier effect in the sense that they earn more money, they spend the money. Other people, as a result, earn more money. And economists call that a multiplier effect. So that dollar has more on it. But it wouldn't get measured in this taxpayer return on investment at all.   Carol: Okay, cool. So I know you guys have made some interesting observations in reviewing the data and looking at some of the longitudinal data. What kind of things are you guys seeing?   Joe: My observation is that it concerns me that some people we've  learned recently that some of the states aren't capturing data after the fourth quarter after exit in terms of UI data. I know one state that is capturing going for that after the fourth quarter for their Social Security cases, because it helps them obtain more resources through cost reimbursement. But I think that we're underselling the value of VR when you only do the fourth quarter up to four quarters after exit. And I realize that's a lot more than we used to do. But on the other hand, it's probably not the best way to tell the VR story, because you just don't capture everything. And younger population exacerbates this. You just don't capture it with all the impact of VR can be for an individual over time. So I think that's one of the things I have seen. We had a study we did from a long time ago, from the first since I did with David, Dean and Bob, where we had a program, that transition program, and the students that participated in it were focused on post-secondary opportunities, and they were measured against the counterpart group that went in the VR system of youth. And the other kids typically went to work faster than the participants in this program. But at year six, after application, the perk students took off in terms of their employment, and the other kids just they were still employed and they were doing well. But the perk kids took off with this post-secondary approach, which is what we're being asked to do now. And you really wouldn't have told the story if you only went for five years after application. So those are the kinds of things that I'm concerned about with the longitudinal data.   Carol: Joe, so what about this to with it. You know, like especially blind agencies tend to provide a lot of the services themselves. What kind of problems are there with that and not sort of capturing the data?   Joe: We have seen that as an issue with the 2007 data set. We have in the 2012 data set, we had and our colleagues in the blind agencies were very clear that there were services that they were providing that were critical to successful employment and adjustment, but we didn't have any way to capture it. And so you're, again, you're undervaluing the impact of those agency provided services by not capturing them. And I think that's going to be critical. I think there's some requirements now that they have to be reporting some of this information, but it's a question of whether it's getting into that case management system and it becomes readily available administrative data that can be used to help tell the story of the impact of the great work that these counselors and other kinds of specialists are providing to help people become employed and adjust into their settings. Bob, you want to talk a little bit about what you're seeing in the data?   Bob: Well, yes. And now with the new data set, RSA 911, that quarterly report that all agencies have to provide and again for four quarters after closure that thing now they've made some changes and it's now required whereby types by 32 different service types they report. Did you provide purchase services during the quarter. If so how much did you provide it in-house or was it provided through a comparable benefit, some other external agency and that might have a dollar value attached to it? So we're going to use that data and see what we have. Now of course with any data set. Now I'll tell you purchase service data that's pretty reliable because they need to get their money back, right? They need to get reimbursed. They need to pay the bills. And so they track that through their accounting system very well. But the other things are and had entered often by counselors who are harried and busy and have a lot of other things to do, rather than this bureaucratic kind of form filling out, so it's only as good as the data that are put into it, and we won't know how good that is, but we'll see how much we learn. this way, hopefully we'll learn some things we didn't know.   Joe: What we have been told is that the data is not there for us to capture, and that it undervalues the kind of work that's being done. So we're hoping we can find a way to tell that story, because it sounds pretty important. And then from my personal experience in managing some of these services, I know how hard these folks work and how valuable these services are. But if you can't capture it, you're not able to tell the story.   Carol: Yep. If it isn't documented, it didn't happen.   Joe: Yeah.   Bob: That's right.   Carol: So what are the next steps on the grant and how can we get folks involved? Are you needing people to help with anything, any states or anything we've got?   Joe: North Carolina is, we're working very closely with them and they've been really good to work with. We will be once we get the prototype, I don't know what to call it. The economists are putting together the data system information so that they can begin to apply the new model and that'll be happening hopefully within a couple of months. And then once we've run the model a couple of times, we'll be asking some other people to come in sort of a national audience to take a look and hear what the model is, what it offers to get their feedback on. Yes, that would be useful or that doesn't seem to work for me much. Could you do this other thing? And then we'll also be asking them about. We'll be showing them what we've come up with for the simplified model to see if that version is going to work or if we need to be developing maybe a template RFP for them to use with a local institution that they work with, then they would be able to get the data set. So we're going to be looking at that. We may be asking folks to work with us a little bit on the capacity survey, where it talks about the training that states might be wanting to say, who can provide this kind of service, and would this be valuable to do to increase people's ability capacity? Because there's a lot of data needs out there. And I think if it would help our project, it would probably help a lot of other projects as well.   Carol: So, Joe, are you thinking about that for fall, possibly at CSAVR or something?   Joe: That's November. That should be a time when we would have an opportunity to gather some information. Yeah, because we might be ready for it by then. Of course, that might put a little pressure on the economists, but I don't mind doing that.   Carol: Yeah. Bob's looking like, oh well okay.   Bob: You love doing that, Joe. I mean, one of the things my major professor in graduate school always said, I love working on a research project where I learn something and what Joe said is exactly right. So we would take and vet our results to various agents. We may make a trip to the agency before Covid. We go and we sit down. We go through everything, explain what we're trying to do when we sell. And then they would say, that looks a little wonky or something, or did you do this? And you say, no, we didn't do that. Yeah, we could do that. Let's do it. And then we would revise the model or no, unfortunately we don't have enough information to do it. Could you collect it? You know, that kind of thing. So yeah, we keep learning things and that's what these groups are intended. That's what they're for. For our selfish purposes. That's what we like about them.   Carol: That's excellent, you guys.   Joe: So November would be good, Bob.   Bob: So you say.   Carol: Well, I'm definitely looking forward to seeing what comes out of all of this. And you were saying that the end of the grant then is in 2025.   Joe: August 31st of 25.   Bob: Right.   Carol: All right. That's coming up quick you guys, really quick.   Joe: Oh it is.   Carol: Well, awesome I appreciate you both being on today. I cannot wait to hear more as this unfolds. So thanks for joining me.   Joe: We really appreciate the opportunity.   Bob: Yes we do.   {Music}   Outro Voice: Conversations powered by VR, one manager at a time, one minute at a time, brought to you by the VR TAC for Quality Management. Catch all of our podcast episodes by subscribing on Apple Podcasts, Google Podcasts or wherever you listen to podcasts. Thanks for listening!

Join us with guest Dr. Rolland Carlson, CEO of Immunexpress to talk about the transformative work happening in sepsis diagnosis. Dr. Carlson discusses the importance of rapid sepsis diagnosis. The episode covers challenges faced during product development, regulatory achievements, and future plans for sepsis diagnostics. Dr. Carlson also shares advice on ensuring product quality and navigating FDA clearances.00:00 Introduction to From Lab to Launch00:25 Meet Dr. Rolland Carlson, CEO of Immunexpress01:31 Challenges and Innovations in Sepsis Diagnosis03:01 Impact of COVID-19 on Clinical Trials04:17 The Vision Behind Septicite Rapid05:17 Technical Insights into Sepsis Diagnosis14:00 Regulatory Achievements and Quality Management16:58 Integrating Septicite Rapid in Clinical Workflows24:00 Future Innovations in Sepsis Diagnostics25:34 A Personal Note from Dr. Carlson26:29 Conclusion and Farewellhttps://immunexpress.com/ https://www.linkedin.com/in/rollie-carlson-ph-d-059074a/  Qualio website:https://www.qualio.com/ Previous episodes:https://www.qualio.com/from-lab-to-launch-podcast Apply to be on the show:https://forms.gle/uUH2YtCFxJHrVGeL8 Music by keldez

Explore the essential role of quality management in small medical device companies with Vernon Baker, a seasoned engineer. Learn about core QMS activities, regulatory intelligence, effective communication with top management, and key skills for aspiring quality managers. Gain valuable insights on supplier management, risk assessment, and regulatory compliance for startups and growing medical device firms.

What if your organization could lead a quality management revolution? Join us as we explore AASHTO re:source's roadmap for 2024 to 2027 with Bob Lutz, the Director of AASHTO re:source. Bob shares the inspiration and process behind this ambitious strategy, which aims to transform the construction materials, testing, and inspection industry. Learn how identifying key stakeholders and understanding their needs laid the foundation for a bold vision and mission that promises to shift the paradigm from compliance to excellence.In our conversation, Bob delves into the collaborative approach that defined AASHTO re:source's mission, vision, and values. We discuss the strategic objectives that prioritize leading by example, building trust, and fostering continual improvement, all while holding safety, integrity, and inclusivity at the core. Discover exciting plans for educational content and innovative use of proficiency testing data to better serve customers. This episode provides insights into how this dynamic roadmap can propel AASHTO re:source and its stakeholders toward unparalleled success. Don't miss it!Related Information: https://aashtoresource.org/qualitySend us a Text Message.Have questions, comments, or want to be a guest on an upcoming episode? Email podcast@aashtoresource.org. Related information on this and other episodes can be found at aashtoresource.org.

In this episode we bring David Suhy, co-founder and Chief Scientific Officer at Earli back to the podcast. David shares the heartfelt founding story of Earli, the company's mission to make cancer a benign experience by catching it early, and their unique approach utilizing synthetic promoters for early cancer detection and treatment. He discusses challenges faced in clinical trials, the importance of quality and safety in research, and provides advice for other startups in life sciences. David also talks about the recent advancements at Earli, their funding journey, and offers valuable insights on navigating the dynamic field of scientific innovation. The episode concludes with a light-hearted discussion about David's passion for making pizzas in his backyard wood-fired oven.00:00 Introduction and Podcast Overview00:37 Guest Introduction: David Suhy from Earli01:19 The Founding Story of Earli04:24 Earli's Unique Approach to Cancer Detection06:33 Challenges and Innovations in Cancer Treatment10:06 Clinical Trials and Lessons Learned15:30 Funding and Financial Strategies18:56 Future Plans and Developments21:14 Quality and Safety in Research23:43 Advice for Entrepreneurs and Scientists25:27 Fun Facts and Closing Remarkshttps://www.earli.com https://www.linkedin.com/in/davidsuhy/  Qualio website:https://www.qualio.com/ Previous episodes:https://www.qualio.com/from-lab-to-launch-podcast Apply to be on the show:https://forms.gle/uUH2YtCFxJHrVGeL8 Music by keldez

Go behind the curtain at the National Clearinghouse of Rehabilitation Training Materials (NCRTM) with Heather Servais, Project Manager. Join us as we delve into the vast resources available to vocational rehabilitation counselors, supervisors, and VR professionals. From employment navigation to disability-specific resources and cutting-edge training, Heather reveals how the revamped NCRTM website is a treasure trove of information and tools to enhance your practices and improve services. Tune in to explore these new features and see how the NCRTM can support you in your vital work. Don't miss this opportunity to unlock the full potential of this dynamic platform!   Listen Here   Full Transcript:   {Music}   Heather: This is made by people that have done the work, like it's just so relevant and timely to what's happening in the field. We have resources on a Microsoft Word and PDF, PowerPoints. There's a whole bunch of information on the NCRTM page, which is a great starting point for when you're thinking about how can I make this information accessible for everyone? If you have a customer who's thinking about work, or you want to have some reputable job-seeking tools, it's a great tool for those counselors to be able to give to their customers. If you want help locating some resources, just email us NCRTM at New Editions dot Net.   Intro Voice: Manager Minute brought to you by the VRTAC for Quality Management, Conversations powered by VR, one manager at a time, one minute at a time. Here is your host Carol Pankow.   Carol: Welcome to the manager minute, Heather Servais project manager with the National Clearinghouse of Rehabilitation Training Materials, or the NCRTM, will join me in the studio today. So, Heather, how are things going?   Heather: It's so good to be here. I'm great. I'm so excited to be on Manager Minute.   Carol: I love it, I love it. We've been doing lots of fun stuff lately, so it's kind of fun to do this collaboration. I want to give our listeners a little bit of a background. So the NCRTM is a central clearinghouse for vocational rehabilitation information for individuals with disabilities, and it offers VR and education communities an opportunity to contribute new knowledge to their specific fields and gain visibility for their work. Now, I remember Heather, when I was still with Minnesota Blind, and I stumbled across this website and it was full of information, I was like, what is this? I had no idea it existed. And back then we had this internal like a little intranet. And I remember linking up staff to different materials because back in the day, and I know you went through a big refresh of the website back in the day, it was a little complicated to get through. I was linking folks to some really specific things that existed out there, and I thought that was so cool. Now, I know since you've been on, you've been working really hard on promoting the website and everything that NCRTM does, and we wanted to just take our listeners behind the curtain at the NCRTM. I also wanted our listeners to know, too, that Heather and I have been collaborating for the past few years on a lot of different items, and she has been fabulous in promoting our podcasts and all our materials for the VRTAC for Quality Management. So with that, let's dig in. So, Heather, would you tell our listeners a little bit about yourself and your journey into VR? You didn't just like land at the NCRTM out of nowhere. You came through kind of a fun journey.   Heather: Yeah. I'd love to tell you a little bit about my journey in VR. Well, if you would have asked me when I was growing up if I would be a VR counselor or know what the field of rehabilitation counseling was, I would have told you no. I actually landed in this field by happy accident when I went to college. I was majoring in history and was considering being a teacher, or maybe pre-law, and I was looking for ways to get involved on campus. And I came across a club called Best Buddies that pairs college students into 1 to 1 friendships with individuals with disabilities. And I just loved being a part of the club. I loved my buddy that I was able to be paired with. And then while I was volunteering, I got asked by one of my co volunteers to consider working with this new company in town that worked with individuals with disabilities on independent living skills and non-residential support services. So I started doing that when I was in college, absolutely fell in love with it. And then when I graduated, I moved on to work for a community rehabilitation provider, where I started as a job coach, moved up to an employment specialist. I dabbled in vocational evaluation and then eventually became the employment services manager. And while I was there and working in the field, I absolutely just fell in love and I knew that this is what I wanted to do with the rest of my life. So I actually went back to school for my master's while I was working full time.   I was really lucky to be the recipient of an RSA scholarship. That helped me be able to go back to school to get my master's in rehabilitation counseling, and I was able to do that, which I really felt like helped my career and was really able to be beneficial to me. When I made the jump from community rehabilitation provider to the state VR side, it was like there was all these names and terms and theories behind the work that I was actually doing. So it really kind of tied it all together in a nice little bow. I worked for that community rehabilitation provider for about seven years, and then I decided to make the jump to state VR to be a counselor. And for a long time I had a general caseload. I also worked in a rural county, and then towards the end of my time in the field, I worked with youth. And then I made the jump over to VR headquarters, where I took a supervisory job as the supervisor of at the time was a new unit called the Field and Provider Relations Unit, and this unit did training and technical assistance with both VR staff and with the community rehabilitation providers that were providing those employment services. So I really enjoyed it because it got to pull together the field experience that I had and then also the provider experience. And then my last stop at Florida VR was as the assistant chief of Field Services, where I oversaw a lot of the programming. So I oversaw learning and development, Ticket to Work, the employment programs team and the deaf hard of hearing deaf blind team and business relations team. I worked there and I loved building programs and loved being part of state VR. Towards 2020, I started to study for my Project Management Professional, or PMP certification. We were managing a lot of projects and building a lot of programs, and I felt like the PMP kind of helped me have a better understanding of some different methodologies to be able to do that. So it really helped pull the programmatic experience with the project management experience. And that's what really landed me here at NTM. So in my role, I get to work with a lot of technical assistance centers and training centers, and I'm able to have both the VR program knowledge and then also the project management knowledge to be able to understand the terms of the project and the contracts and the business aspect of this too. So it's been a long journey, but I'm so happy to be here because this role I get to work with so many different stakeholders. I love working with the VR agencies, the counselors, the rehabilitation counseling students, the parents, the families. I get to see it all, and not just from a local perspective. I'm getting to work with state and nationwide programs, and I think that's just a really big joy.   Carol: And it's so cool. What a great fit for you. This explains a lot. You crack me up, though, because I was considering being in pre-law like back in my undergrad as well. I feel like we have kind of similar journeys. I was a job coach. I'm like, we both come from those humble beginnings, kind of fall into VR, and we find a lot of our guests on the show have been from different backgrounds and sort of stumbled into VR different ways. So that is so cool to know about you. Thanks for sharing that. Now, I know sometimes people are maybe confused a little bit about the NCRTM can you ground us in like how all this works, how you're connected with RSA? Like who do you actually work for? Because people are like, is this an RSA thing? What is this thing? So give us the skinny.   Heather: Yeah, sure. So the NCRTM has actually been around for more than 40 years. When I found that out, you know, I was a little history nerd. So I did some digging and I was shocked. I was like 40 years. I mean, I think I've, you know, been around in the field for a long time and I didn't even know about the NCRTM until I was working at headquarters as a manager. So I think about the first basically half of my career, I didn't even know about it. And that's one of the things about this job is like, I want people to know. And so when NCRTM originated, it was a paper based repository that was basically where RSA grantees would submit their products at the end, and they would be stored and used and to what it is today, which is this really dynamic and engaging platform that has a website and a YouTube and social media and lots of connections. And so it's kind of continuing to grow and evolve. And the driver of NCRTM, where it actually originates is section 15 of the Rehabilitation Act. We are in there. And what section 15 says is that it creates a clearinghouse, and it says that we have to deliver three things. One is information about the location, provision and availability of services and programs for individuals with disabilities. We also need to have information and research related to recent medical and scientific developments bearing on disabilities. And we have to have information about the current numbers of individuals with disabilities and their needs. And so when we look at NCRTM, that's our driver. That's what we're trying to do. We're trying to share that information, the NCRTM itself and how it relates to RSA. Right now, NCRTM is funded by a contract through RSA and is operated by New Editions Consulting. So technically I work for New Editions Consulting, which is a fantastic company to work for. We just won one of the top places to work for the Washington Post, so they take wonderful care of us. It's been one of my favorite teams I've ever had the pleasure of being a part of. It's just been a really fun place to work. So we work very, very closely with RSA. We have a coordination team, so there are a big group of folks from RSA and the different units there that add and contribute to the content and the planning and the strategic direction for NCRTM. And then we also work really, really closely with the Technical Assistance Centers with other RSA grantees and federal partners to build out the content to deliver to our users through the NCRTM website and our platforms.   Carol: I had no clue that that had been around for 40 years. Holy cow. I had no idea. That is amazing. And I can imagine, you know, when you think about the paper based, you know, products in the day.   Heather: How do you get that out into the hands of the field? So we live in a great time,  you know, we have this technology and we can use it because the products that are coming out of the technical assistance centers and some other RSA grantees, you know, this is made by people that have done the work. Like that's one of the things that I love so much about the clearinghouse is it's just so relevant and timely to what's happening in the field.   Carol: Yeah, I love it. That advent of social media, too, has helped so much with us all being able to kind of cross plug and promote each other's tools and activities and things that are going on that has been so great. Now, I know since you arrived there, I feel like, no, I'm not disparaging anybody from the past, but I feel like you've brought this just fresh, different look at things and you've been really doing a lot of cool stuff. So would you  talk about some of that cool stuff that you've been doing and kind of where are you getting your ideas from? Because it's been really fun to watch.   Heather: Yeah, I came onto the scene with NTM in late 2021, and there was a lot of this stuff that was already in progress, and we launched a new version of the website in 2022. So not only do we have, you know, pretty robust content, NCRTM has mostly been known for the library. When you say NCRTM, people think library, library, library, and that is a big part of what we do. We have more than 3600 items in our library. When you think of a library, it can be anything from podcast episodes, research papers, blogs, toolkits, guides, trainings. There's such a diverse array of materials in that library. So that's one of the things we were most known for. We started with some of those library enhancements, so we had an enhanced filtering. So now our users are able to locate by topic area, disability type, audience type. There's a ton of filters that you can select to really zero in on materials of interest. We also added some recently viewed features. So if you go to the NCRTM and you're poking around looking for some things and you look at it, you can go back and you'll see some of the items that you recently viewed. We now have the ability to share the information from the website so you can email it to yourself. You can share it directly on social media. Also, as part of that big website launch, we updated our training and events page. This is one of those plugs that if you are new to the website, I love directing people to the training and events page because I know time is of the essence and there's so much training and information available, and NCRTM collects training and events and post them from the Technical Assistance Center. So if there's something happening from those, those are going to be on our site, from federal partners, from grantees. So a grantee could be a university, could be a nonprofit. There's lots of different types of events that are out there on our site. You can sort by live, which means these are like live upcoming events. So you're going to want to log into those or on demand. So that could be either a training module that was made to be an asynchronous learning experience, or it could be a recorded event from one of the previously featured live and upcoming events that we had hosted prior. You can also sort on that training events page by CRC Credit Availability. So for those of you that are counselors or administrators or managers that are looking to get those CRC credits, this is a great way where you can zero in on finding those trainings that are of interest to you, that offer that CRC credit for free. It's a great resource. We also added some new pages to the platform so that we're really the result of user feedback. I think that's one of the things that I'm most proud of with NCRTM team that we do is we are serious about user feedback. So we are collecting feedback from surveys. We run user advisory groups a few times a year. We also are really out in the community talking to VR counselors, talking to rehabilitation counseling students. We're talking to grantees about their needs and what they're doing, really wanting to get the feedback so that we can curate content or we can build content that's meaningful for folks. So in the spirit of section 15, one of the new items that we launched on NCRTM was a programs and services page. And this page focuses on job seeking resources. So for individuals with disabilities. So all processes from when you're considering employment. So maybe you need to do some assessments. Or maybe you're just thinking about going to work all the way through the hiring and retention and career advancement phases of your career. So this is a really great starting point. If you have a customer who's thinking about work or you want to have some reputable job seeking tools right at your fingertips, you can use it there. It's a great tool for those counselors to be able to give to their customers as a starting point. And we do update that page regularly. So if you would like to see like a national level resource on there that you found, that's not, email us. We're here. We want to add things to that page. We are constantly growing the page. We are adding new information to the library and to the website regularly.   Carol: I actually have your site up right now. I love it really did change with that refresh that you guys did in 22 I remember having. Well, I'll say it, I tried to search in the library before and it would bring up like either 50,000 things or no things. When you put in word search or something, it just seems like your capabilities on here are so much more robust than they used to be.   Heather: Yeah, we've definitely added a lot of enhancements to make it a lot more user friendly. We were trying to make it more streamlined. We wanted things to be easier to find, easier to get to material. And then we're also trying to be a little bit plainer in our language. Some of our users felt the language was way too academic, and we wanted this site to be something that's useful for all. So we're trying to do better with using plainer language and getting straight to the point of what the document is or what that material is, so that it's easy for people to digest when they're reading it. We also added a business engagement page. So for those counselors or even those folks who work for VR agencies that are on the business relations or business consulting team, this is a great resource to kind of help you understand the business needs and how to work with employers. When you're thinking about things like job placement and job retention and accommodations and the process for hiring, that's another great tool that you can use and share in your work. But you can use it as a counselor to educate yourself. It's also helpful when you're engaging with businesses so that you're using their business language.   Carol: Excellent   Heather:  One other thing for counselors to consider. I know sometimes when we're VR counselors, I always say it was the hardest job I ever had. There's so much that you have to balance. There's so much to learn, and it always feels like there's things on your plate that you need to do. And sometimes we're so focused on our individual customers, our individual caseload, that we can forget that we're part of something so much bigger. It's not just our caseload or our office or even our state. We're part of a national VR program. Every state has a VR program. There's programs and the territories. There are so many others that are in this field along with you. And I think that's one of the great things about NCTRM is it can kind of help connect the dots so that you get to see the bigger picture. You can find materials that are created by other folks that are doing this work. You're able to see what innovative practices are working on caseloads that may be similar to yours. It may give you strategies that you can better know how to work with your customers. So I think that's one takeaway for NCRTM is just it's a different perspective. You can find things from your peers to help improve your work, and it just connects you better to the VR community around the country.   Carol: Do you guys agree with that page at all with like CSAVR and the NET?   Heather: We did. We were very happy that CSAVR and Kathy West Evans was helpful with us when formulating that content and reviewing that content. So yes, absolutely. We partnered with them to help put that together.   Carol: Excellent.   Heather: We also have I know you mentioned the Disability Innovation Fund and I'm a Manager Minute podcast listener. So I know, I know you've done some episodes with some DIF grantees, and we have a whole page that's dedicated to the Disability Innovation Fund grants. And so this is one of those pages that we're working on. It's definitely still a work in progress. So if you're interested in learning more about those Disability Innovation fund programs, we have each iteration of the grants there so that you can see kind of a little bit about what the purpose is and what those grants are doing. And then as those grantees are submitting products, we're going to be linking those products in the library right to that page. So you can kind of start to see some of the outcomes from those grant programs. So that's a really exciting page that we added. We're looking forward to being able to continue to update that pretty regularly, as we're starting to get some of those products in from those grantees.   Carol: I love that. Those Disability Innovation fund, let me tell you, since we started doing podcasts, you know, featuring the different years and the States and what they're doing, I had no clue, you know, you'd hear about them. But unless you're really, like, talking to the people and finding out what's going on, man, there's some awesome stuff happening across the country that is going to be so helpful to the rest of the VR. People put out their products. It's good to know you're going to have a page dedicated to all of that, because I just envision these really amazing things coming from that, that are going to be so useful to VR as a whole for years to come.   Heather: Absolutely. And there really is a lot of innovation coming out of the agencies that have these grants. And that's exactly what we want. We want others to be able to access those materials so they can think about how that could work in their state, and how that could work in their program, and be able to connect to resources that can help them on their journey to implementing and improving and streamlining their services.   Carol: For sure. 100%.   Heather: And then lastly, I have to plug here for the Accessibility Resources page. So accessibility is such a huge part of what we do. And coming from the field of VR and coming from a provider background, I knew about accessibility in theory, but it really wasn't until I got to working at the clearinghouse when I realized all I didn't know about accessibility. And this is definitely an area where I've had a lot of personal growth and a lot of personal learning to do since I came on board here. But the NCRTM has a page for accessibility resources. So if you are with a VR program or you're a VR counselor, or if you're an RSA grantee and you're looking to make your products accessible. So if you're thinking about having a PowerPoint, how can you make that accessible so that the information is accessible to all users? We have resources on a Microsoft word and PDF and PowerPoints. We have guides, we have video tutorials. There's a whole bunch of information on the NCRTM page, which is a great starting point for when you're thinking about how can I make this information accessible for everyone? And so we encourage folks to check that out too, because it's a really great starting point.   Carol: Yeah, I think that's been an area that maybe VR has not done as well with. You would think we'd know better and do better and be better with that. But I've been amazed over time, different places I've gone or, you know, folks I've talked to and people still struggling with accessibility. So your having those resources out there is super timely and really important.   Heather: Yeah, absolutely. And it really is one of those you don't know what you don't know until you kind of get into the thick of it. And I'm thankful now that I know better and I'm starting to do better. But it's definitely a journey and there's a lot to learn. And I would encourage folks not to be intimidated because you can start small and just learn a little at a time. And over time, that makes a really, really big difference in what you can do with your materials.   Carol: Absolutely. Now, I know we have a lot of counselors that listen in, and you and I had talked about this a little bit. What advice would you have for counselors who may be exploring your website for the first time? I know you and I talked about you felt like you'd be a whole different counselor had you known about the cool materials that are out there for them.   Heather: Yeah, man, I do. I feel like I would have been totally a much better counselor than what I was. When I think about going back to being a VR counselor, it can be overwhelming. I always say the hardest job I ever had was a VR counselor. Just because there's so much to learn. You have a lot of cases. I had to travel a lot for mine because I was in a rural county. You have a lot on your plate and it can be kind of overwhelming and you kind of start spinning your wheels sometimes because you're like, well, I don't even know if I have time to find out this information to help me do better. And I think, you know, what I would tell counselors is NCRTM is here and you can plug in. And so whether you're a new counselor and you're coming into VR kind of cold, maybe your background is in something different. You know, maybe you came with a social work background or a business background, and you may be kind of struggling to learn the VR part of counseling. Or if you're a seasoned counselor, you know, you may feel like you've been doing this a long time and you know a lot. But if you're not learning, you're not growing, and there's really always something more you can learn. And so we have resources for you in every stage of your career. And even as you continue to grow and transition, we have a lot of resources for those who move into management or supervision and program administration. So it's a really great resource to be able to support you when you are out there in the field looking to do, I think about like motivational interviewing and how much I really wanted to do that and use that technique. And I went through some trainings and it was like, okay, But the trainings, I always felt like they were just kind of never really got to the nuts and bolts like it was overviews. And one of my favorite resources in the NCRTM was actually this motivational training series that was created by Oregon VR and it's, you know, several years old now, but it's nuts and bolts. It's how to do motivational interviewing in a VR setting. Like it's amazing. And I wish I would have had that when I was a counselor. And there's also all kinds of different toolkits and guides. There's so much available. There's also another place on the NCRTM team where you can kind of as a starting point. We produce these things, which is a fancy word. We call it a curated list, but basically we have more than 20 curated lists on various topics, and most of the topics that we have selected these curated lists on were user driven. These were given to us. Ideas came from the field, came from our users. And these curated lists usually have, you know, 10 to 25 different resources on them about various topics. So for instance, we did one on VR 101. So for those folks, it can be counselors, it could be parents. All of the curated lists are segmented by audience. So if you're a counselor and you're looking for resources for yourself, you can check out these lists and it'll say for VR professionals. Or if you're looking for resources that you can share with your customers, you'll see for individuals with disabilities and families for general audiences, some of them are for specific disability types, like we have a list on autism and employment. We have a list on mental health. We have curated lists on work incentives, financial incentives, labor market information. So there's more than 20 of them out there. We add new lists pretty regularly. Right now we're in the process of updating some existing lists. So these lists change and they grow. But that's a really great starting point. If you're not really sure where to go or what to look at, I'd also highly recommend plugging into those training and events pages. So I know with the variety of information and training topics that are available, sometimes you really don't want to sit down and do a training, but you can look and a lot of the trainings are available on demand, so you can do it at a time that's convenient for you. As nerdy as it sounds, I like to listen to trainings in the background sometimes, so most of the trainings that are on the site I've listened to, I've taken myself and there's some really good stuff out there. So I'd encourage you to not be intimidated. But I'd also like to offer is just support. There's a team behind the team behind this curtain that's there to help you. So if you want to get acquainted with the site or you want help locating some resources, just email us. Our email address is NRTM@NewEditions.net, and one of our team members will be able to help you right away. So don't feel like you're in this alone. Like we can help you navigate and help you learn how to explore and show you what's available on the site and how it can benefit your work.   Carol: All excellent advice that you've given that is super cool. I know that curated list. When I found that, I'm like, oh my gosh, that literally is what I felt like I did back in the day when I was at Minnesota, was create a curated list from your website. It was like linking counselors to these different really awesome materials on particular topics. So it's so awesome that you guys have done that. I feel like this is advanced so much and I know your team can do other cool stuff for VR agencies. So I heard you say, you know, obviously people can email you and you can do some support, but what are kind of trainings you could do for a VR agency on supporting using the website and such?   Heather: Yeah, absolutely. So we are happy to do in-service trainings and system demonstrations for VR agencies. In the past we've had agencies where we've done executive leadership, where we've shown the executive leadership how to use the site. Not only do we show you how to use it, we talk to you about it. We tell you about it, and then we show you it. So you get to see a live system demo and then, you know, we can take requests. So if it is of interest or particular parts of the website where you want to learn a little bit more information, we can focus on those areas. We've also done it with teams or units. So we can do any type of training like a 1 to 1 setting or like small group setting for your teams. If you're interested in learning more about NCRTM and how you can use it in your work, we also help agencies with locating materials. Well, not just VR agencies. We help individuals so we get emails all the time about people. I just had one last week from a parent who has a child that's transitioning into the workforce, and they're really interested in learning more information about customized employment. And so the parent reached out to us because they really weren't sure where to go. And we were able to pull together a list, kind of walk the parent through what was on the list and was able to share that with them. So if you've got a topic that you're interested in, or maybe you're looking to compile a curriculum of trainings that are available to support you, there's a ton of great resources out there for the training. So those on demand training modules are very common. So if you're an agency and you're looking to build out a training curriculum without like basically rebuilding and restarting and rebuilding the wheel, let's take a look and see what's already out there. You know, this stuff that's coming out of the Technical Assistance Centers and RSA grantees. It's really relevant to what's happening and what's needed in the field right now. And we really want folks to be able to connect to that so we can help you locate those. I had an agency that was asking about financial literacy training, and I was able to send them, Carol, to the financial literacy training from QM, you know, so it was really great. So we have these kind of resources and these requests coming in all the time, and we welcome that. We want to be able to help you navigate resources that's out there. It's up to us to know where to point you and we're happy to do that. And then another thing that we do. So for those agencies that want to submit products to NCRTM, or maybe they're a DIF grantee or another RSA program grantee, we do accessibility technical assistance. So the team behind the team is we have a 508 team here at New Additions, and they help us a lot with accessibility work and making sure that the products that go onto the NCRTM are accessible so we can help provide technical assistance. We do accessibility reviews on materials, especially if they're the result of an RSA grant. And then we can offer if it's like remediations or complex accessibility work, we can provide technical assistance on that. So for instance, we had an RSA grantee who was really interested in doing some new video work, but they really weren't sure how to do audio descriptions. And so our 508 team was able to provide that technical assistance, to be able to kind of show them and walk them through how to do audio descriptions in work. We often do a lot of document remediation, so we're able to kind of review your PDF and word documents. If you're submitting it to the NCRTM, to let you know if it's accessible or not, and then what kind of steps need to be taken to make sure that it's accessible. So that's another service that we offer.   Carol: I had no clue about that. That is fabulous. I hope people take you up on that for sure. Oh my gosh. You've talked about the website and the materials posted there. So I know that the RSA grantees can put information out there. Are there other people that can put information on your website?   Heather: Yeah, technically anybody can submit materials to the NCRTM. It's a public website. So anybody can what we recommend if you're interested in submitting, we have an online library submission form. So when you go to the NCRTM website home page, if you navigate to the library using that top navigation bar on the far left hand side, it says library. When you go into the library, then you will come across a link on the right hand side of the page. And what that link says is submit materials to the NCRTM library. You can go ahead and click on that link. And there's a form that you can fill out. And you'll just have to put some very basic information about the material that you're submitting. So maybe this is something that your agency created, that you're very proud of and would like to be on the NCRTM website. Or maybe it's something from a federal partner that's publicly available, that's not in our library that you think should be. That's another thing you can do is you can submit it to NCRTM. Every material that's submitted is reviewed by our team to make sure that it's accessible, and then also that it's appropriate to be on the NCRTM, and then we can go ahead and publish it and make it available on the website. So anybody can yeah, anybody can submit, which I think is pretty cool. And we really encourage folks. So if you're a VR agency and you have tools and you have success stories or you have trainings you want to share and you want them to get the word out about it, send it our way, we will help you figure out a way to put it on the site and help you amplify that material. Like, we really want these products and these materials that you're working on that are really meaningful for the VR community. We want to get them out there.   Carol: Well, we're definitely better together. You know, everybody's creating all of this great stuff. We don't have to all reinvent the wheel. Like, let's use this so each other can get like all that great stuff. Everybody's producing. I think that's wonderful.   Heather:  Yeah. If you're afraid to use that form, you can always email us like we are small team, but we're very responsive. We take a lot of pride in making sure that we're responding to folks quickly. So if you have questions about submitting materials or you want to walk it through, you can email us at NCRTM@NewEditions.Net, and we'll walk you through that. For those RSA grantees we have a whole guide that's out there, the guide for product submission and websites about submitting products to the NCRTM. But that's more for RSA grantees. If you're an individual or you're a VR agency, definitely email us or use that library submission form and we're going to be happy to help you.   Carol: Very cool. So I know you have a lovely newsletter you guys put out. And then I saw recently kind of a little different format. You were doing like a news blast or something. Sort of groovy. How can folks, because we do have a lot of counselors that listen into and they don't always have access, you know, maybe the directors on your mailing list or something. But how do folks subscribe so they can get it quickly?   Heather: Yeah, we have a lot of ways that you can connect with us. Carol, you mentioned the newsletter. We do put out a monthly newsletter. We are trying some new things. So we are starting to do some news blasts. So if there's some really important announcement or might be an event reminder or something that NCRTM is doing, we're going to start sending some more regular communications to our subscribers. The best way to do that is to sign up for the NCRTM newsletter. And you can do that by using the web page. You use the top navigation bar and click on join the NTM network tab. That's going to take you to our page, where you can start to subscribe so you can subscribe for our newsletter. Like I said, it goes out once a month. We also have another subscription where if you're really interested in keeping up to date on what's new, what's happening with the library materials, you can subscribe for library updates. So once a month, you'll get a list of all of the new items that were added to the NCRTM library. And it really varies month to month. Sometimes we have a lot of folks that submit products, other times it's just our team out there looking and finding what's new and putting it onto the site. So some months you'll see a lot, some months you might not see as much. It just really depends if you're really interested in staying up to date, we encourage you to do that. We also have social media. You can find us on X which is formerly Twitter. Our handle is at RSA_NCRTM. So we encourage you to follow us on Twitter. We do a lot of amplifying new products. We talk about some of the events and trainings that are going on. And then we also have a YouTube. So whenever NCRTM hosts a training because we do host trainings ourselves too. Right now we're doing a series of lunch and learns. Carol, you were a big help with moderating what our first Lunch and Learn event last November with Doctor Herbert. We had a panel discussion about recruitment and retention. We also just did a really wonderful lunch and learn session that we did alive. And then we just released the publication earlier this month on managing counselor workload guilt. So for those of you counselors who are out there maybe struggling, feeling a little guilty because your workload is high, and this really looks at strategies to kind of find balance and prioritize wellbeing. It was a really fantastic event. And so that video is available on our YouTube channel. And then earlier this month we hosted a lunch and learn where we partnered with NRIC, the National Rehabilitation Information Centre, and really kind of zeroed in on research. And how can you navigate with NRIC and use research in your work. And so the video of that will be coming out very soon too. So if you're interested in looking at some of the trainings that NCRTM has done, definitely check out our YouTube channel.   Carol: Yeah, folks, definitely need to sign up because then you get everything. I love it because I must be signed up like three different ways. I get it, you know, from RSA, Joe Doney. And then I get from you guys, I get it all the time. So I make sure I have all the current information and the lunch and learns are fabulous. They're really fast paced. It's nice. There's just great guests that have been on there. I think they're really a good product that you've developed.   Heather: Yeah, so definitely the newsletter. I think you hit it. That's the best way. So if you're looking to connect, we have a lot of ways. But the newsletter you're going to see a lot of the new stuff that's coming out. You're going to be able to see any of the lunch and learns that we're hosting. You're going to get to see NCRTM materials. You'll also get to see all of our new library materials. We usually feature 3 to 4 new library materials on that newsletter, too, so you don't sign up for library updates. You can still see that in the newsletter. So yeah, the newsletter is really a great source to get the most information about what's happening at NCRTM.   Carol: Very cool. So is there any way our listeners can help you? I don't know if you had any particular ask for them. Or are there ways that our listeners can help you guys?   Heather: Yeah, absolutely. Like I mentioned, we are very serious about user feedback. So we want to hear from you. We want to be able to curate content that's meaningful and helpful for you. So we want you to share your ideas with us. So if there's library materials, if there's a webinar or training topic that would be helpful for you or idea for a new curated list, we want to hear from you. That's how we continue to build and grow the NCRTM to make sure that it's meaningful to our users. So really reach out to us, email us, NCRTM@NewEditions.Net. We also have a customer feedback survey so you can connect with us. That way you can fill it out if you have ideas for content or things that you would find helpful, and then also just connecting with the NCRTM team by signing up for the newsletter would be a really big help. It also helps keep you up to date on what's happening. Those are some of the bigger ways that your listeners could help us is really those connections. Tell us what you need, how we can help you, and then connect with us and stay up to date. Connect with us so that you know what's going on, because I guarantee you your work will benefit.   Carol: Awesome. Thanks for joining me today, Heather, I really appreciate you being on. This was great.   Heather: Yeah, thanks for having me. It was awesome I appreciate it.   {Music}   Outro Voice: Conversations powered by VR, one manager at a time, one minute at a time, brought to you by the VR TAC for Quality Management. Catch all of our podcast episodes by subscribing on Apple Podcasts, Google Podcasts or wherever you listen to podcasts. 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This episode we're joined by Dr. Joshua Lee, a clinician, researcher, and professor specializing in medication-assisted treatment (MAT) for alcohol and opioid use disorders. Dr. Lee discusses his extensive research on medications such as naltrexone and buprenorphine, their significance in treating substance use disorders, and the transformative potential of telemedicine platforms like Oar Health. He highlights the underutilization of effective medications in primary care, the barriers to accessibility, and the enduring stigma associated with addiction. The conversation also touches on emerging trends and the future of addiction treatment.Dr. Lee's BioJoshua specializes in medication-assisted treatment of alcohol and opioid use disorders. He conducts clinical trials and treats patients struggling with addiction as a primary care physician. As a Professor at NYU Grossman School of Medicine, he leads the Addiction Medicine Fellowship and conducts research focused on justice and community outcomes. https://www.oarhealth.com/https://med.nyu.edu/faculty/joshua-d-leehttps://x.com/drjoshuadlee00:00 Introduction and Podcast Overview00:38 Introducing Dr. Joshua Lee01:20 Clinical Trials and Medication Insights03:46 Challenges in Alcohol and Opioid Treatment08:50 Telemedicine and Its Impact11:59 Addressing Misconceptions and Barriers19:35 Success Rates and Future Trends30:14 Fun Personal Question Qualio website:https://www.qualio.com/ Previous episodes:https://www.qualio.com/from-lab-to-launch-podcast Apply to be on the show:https://forms.gle/uUH2YtCFxJHrVGeL8 Music by keldez

In this episode, Sandy Domingos-Shipley, a quality management consultant discusses the importance of leadership, communication, and technology in implementing ISO standards. Sandy shares her journey from struggles with dyslexia to building a successful career, emphasizing the value of small continuous improvements, better communication, and leadership's role in quality management. She also highlights the significance of storytelling and understanding individual learning styles for effective implementation of quality systems.   Episode Highlights: 04:27 Challenges and Triumphs with Dyslexia 05:54 Starting a Business and Finding a Niche 08:47 The Importance of Human Connection 10:39 Discovering ISO and Writing a Book 13:56 Implementing ISO and Overcoming Challenges 17:27 Leadership and Technology in Quality Management   Sandy Domingos-Shipley, born and raised in Toronto, Canada, is a certified ISO Lead Auditor, CQI Chartered Quality Professional, and ISO consultant. Her journey began with a knack for languages and music, transitioning into a career in translation and eventually venturing to England. After diverse roles in legal and educational sectors, she founded The Systems Link, driven by her experiences with dyslexia and a desire to empower her son. Sandy's innovative approach to ISO standards gained traction during the pandemic, leading to her acclaimed e-book and significant business growth. A sought-after trainer, she continues to redefine ISO's practical applications across industries globally.   Other ways to connect with Sandy: Website: www.thesystemslink.com Linkedin: https://www.linkedin.com/in/sandy-domingos-shipley/   For more insights: Follow me on my YouTube Channel: https://bit.ly/47GgMdn  Sign up for my Weekly Newsletter:  https://bit.ly/3T09kVc Sign up for my LinkedIn Newsletter: https://bit.ly/49SmRV3See omnystudio.com/listener for privacy information.

What does it truly mean for a team to feel a sense of ownership? How can leaders cultivate an environment where every team member is invested, engaged, and feels responsible for the success of the team? On this episode Dr. Shari Dade is joined by Kirsten Aghen as they dive deep into the nuances of these questions and more. Kirsten Aghen is the Director of the VHA National Improvement Office (NIO), within the Office of Quality Management, in the VHA Office of Quality and Patient Safety (QPS).   Get ready to join us as we explore an incredibly important topic to discuss; how leaders can inspire ownership within their teams. Whether you're leading a team or working on your own leadership development, this episode is packed with actionable insights that you can start implementing right away!   Closed Caption Transcript is available at: https://www.sharedfedtraining.org/Podcasts/TATF_S4E7.pdf ===============================Key Lessons:     By instilling ownership on a team, you move team members from simply doing what's in front of them and drive them to lead themselves and each other's for the good of the organization.When inspiring ownership, it's important to communicate the vision in ways the team can align with. When there's resistance, take a pause and ask what can be done to close the gap of understanding.   Interested in learning more about services offered by the National Center of Organization Development? Please check out additional services here: VHA National Center for Organization Development - Home (sharepoint.com)

Upskilling of oil and gas professionals in the digital era is a topic everywhere, including the Caribbean island economies. Upskilling means the acquisition of new knowledge and skills, and in digital, this means topics such as cloud computing, artificial intelligence, app development, and sensor technology. It's tough enough to acquire new capabilities and stay current in big metropolitan centers. Imagine the challenges in smaller oil and gas producing economies, such as those found in the Caribbean. On-line and distance learning help, but that's not enough. The formal education sector has to play its role, as does industy. But how does this happen? In this podcast, I'm in conversation with Hamlyn Holder, a sessional lecturer with the University of the West Indies and an employee of the oil and gas industry, based in Trinidad and Tobago, one such oil production nation in the Caribbean. Hamlyn has over 20 years of both upstream and downstream engineering experience with nearly a decade of this time dedicated to serving Methanex Trinidad Ltd. Methanex Corporation is the world's largest producer and supplier of methanol to major international markets in North and South America, Europe, and Asia Pacific. Methanol is a clear liquid chemical used in thousands of everyday products, including plastics, paints, cosmetics, and is a clean-burning, cost-effective alternative fuel. As the Site Reliability Engineer, he ensures the optimal functionality and performance of critical plant assets and is committed to continuous improvement and innovation in the asset management of their methanol plants and air separation units. He currently serves as a Lecturer at the University of the West Indies, Engineering Faculty and also at the Caribbean Institute for Quality training the Caribbean workforce in ASQ courses such as Six Sigma Black Belt, Quality Management and Reliability Engineering. He holds a Master's in Engineering and Asset Management from the University of the West Indies, is CAMA Certified and co-founded Cube Root Farms, a company that helps local farmers, schools and communities to adopt modern smart and sustainable agricultural techniques. He is also well versed in developing, enhancing and launching many enterprise management softwares and is a member of many industry bodies such as API, ASQ, PMI , IEEE, ASME and APETT.  Additional Tools & Resources:

Hadiya Nuridden is the CEO and founder of Duets Learning and author of the new release, Quality Management in Learning and Development. In this episode, Hadiya breaks down what quality management really is and the misconceptions around it. Go beyond the limited “review process” mentality of checking for typos and broken links and learn how to think bigger by developing a quality management system that works toward the success of an organization.    The conversation also covers the challenges L&D professionals face when it comes to collaborating on a quality management system across departments. Hadiya shares her expertise on incorporating evidence-based procedures, designing for accessibility, and user-generated content in quality management guidelines. Resources Hadiya on LinkedIn: https://www.linkedin.com/in/hadiyanuriddin   Book: https://www.td.org/book/quality-management-in-learning-and-development   Duets Learning Website: https://www.duetslearning.com/   Interlude Newsletter: https://www.linkedin.com/newsletters/interlude-7036192515565240321/     

Hadiya Nuriddin explains how to start or improve a quality management program in your organization.

Murat Aydin, a strategic advisor and consultant in Quality Management and Regulatory Affairs, joins the Legacy Leaders Show to share his insights on driving organizational excellence in the life sciences sector. With his extensive experience in enhancing ecosystems to create happier societies and increasing stakeholder and shareholder value through higher productivity and profitability, Murat delves into his philosophy on business excellence. He discusses the crucial role of talent, leadership, and societal satisfaction in achieving harmonious business success. Tune in to explore how Murat's strategic thinking and innovative approaches can inspire leadership and transform industries.Champions, Buckle Up For This Epic Episode!