Dr. Catherin Diskin ECHO Complex Care - In My Words: Meet the Leads title

In My Words: Meet the Leads – Dr. Catherine Diskin, Paediatrician | Complex Care

Dr. Catherine Diskin quote about Complex Care and collaboration.
Dr. Catherine Diskin quote about ECHO and learnings that apply to clinical practice

With her famous Irish lilt and her openness and passion, Dr. Catherine Diskin’s voice has been helping to guide the ECHO Complex Care program and the community that’s grown with it, since its inception five years ago.

Joining the program as a SickKids Fellow in Complex Care, Dr. Diskin’s story is a perfect witness to ECHO’s power as a continuing medical education program and a community of practice, where providers can journey and grow at all stages of learning – from foundational entry points to those of established medical experts.

Dr. Diskin is the Co-Educational Lead within the SickKids Complex Care program, and co-Chair of the special interest group in the American Pediatric Association focused on Complex Care and Disability. She is Medical Lead for the ECHO Complex Care program, along with her colleagues Dr. Julia Orkin, Dr. Eyal Cohen and Michelle Ho.

In 2021, Dr. Diskin completed her Academic Paediatric Fellowship at SickKids, focused on caring for children with medical complexity.  She completed her postgraduate training in General Paediatrics with a subspecialty interest in Neurodisability with the Royal College of Physicians, Ireland.

My passion for Paediatric Complex Care and how ECHO fits into my clinical practice?

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From SickKids Fellow, to Education Co-Lead and Medical Co-Lead of Project ECHO Complex Care, Dr. Catherine Diskin’s professional journey speaks to ECHO’s formative strengths at all stages of medical learning – from foundational entry points, to those of medical experts.

Dr. Catherine Diskin:

Complex care, caring for children with medical complexity, it’s kind of this unique spot where you get to care for children over a long period of time and you get to really know them. And relationships are really important. You generally aren’t a solo practitioner, and so I work with nurse practitioners, social workers and occupational therapists every day of the week.

And you also spend a lot of your time figuring out things with families.

And so complex care has that kind of unique melting pot of, you know, collaboration, shared decision making in an interprofessional environment.

Project Echo was actually formative in my own training. You know, the original and ECHO sessions on competencies. The idea of like listening to somebody provide a didactic and then have case discussions and see how the professional team could
and could work in a teaching environment to in ways that was like applicable to care was actually really important.

And so like Echo was a non-negotiable part of my, my fellowship when I became faculty of SickKids and U of T, I took on to be the medical lead because my area outside of children with medical complexity, my area of academic focus is education.

And so now I look on Project Echo, as always, an opportunity for learning.

There isn’t an ECHO Session that goes by when I don’t pick up some nugget that I can apply to my clinical practice that day or the next, but also as a way of building a community of practice.

And so what I think is phenomenal about ECHO is that you have a group of individuals
who work literally all over maybe North America, but oftentimes further afield, and they come to both learn but also share their own experience.

And I think that that’s the piece that’s really exciting for ECHO is, is that it’s a model through which people can develop their own expertise, but also develop connections
with other professionals caring for a similar population of children. And I think that that community of practice translates into an opportunity for support, which presenters are oftentimes surprised by.

But again, I guess it comes back to the point that, people are eager to share their stories, but also eager toto be part of a supportive community. A community of practice is never static, either in its knowledge, its members, or even for who’s part of it, where they are in their learning of children with medical complexity.

Something that I didn’t appreciate about Echo is that like it can address the learning needs of everyone from novice for new to complex care, right through to established experts. We’re motivated to provide sessions that are relevant to us and to our colleagues.

And so in general, the topics are, you know, like just last week it was about feeding assessment in children with medical complexity, something that crops up week in, week out, in the care of children with disability and medical complexity. It’s not about, you know, remote or, you know, theories of practice. It’s actually about what matters in clinical practice, what are that knowledge and skills that we need as health care providers to be able to care for children with medical complexity.

So I think that’s one of the things that, you know, gets people through the Zoom door to join us. But also it’s why like it’s why I go.

Three Key Points

A few key points that Dr. Diskin raises throughout her interview:

  • ECHO Complex Care is an excellent vehicle for demonstrating interdisciplinary care and its importance in caring for children with medical complexity.
  • ECHO addresses core medical expert topics at all levels of learning: for those new to Complex Care seeking foundational learning, right through to established medical experts.
  • ECHO is a model through which people can develop their own expertise but also develop connections with professionals caring for a similar population of children.

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“In My Words: Meet the Leads” is an ongoing series where we are profiling stories of the medical leads guiding the ECHO Paediatrics community of practice through their collaborative, CPD-accredited learning journey.

How does the ECHO ComplexCare community of practice support each other?

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And I think we’re definitely seeing where we’ve had speakers come and join us and people make relationships or make connections or I go to follow up with youafter this session and just last week,and I don’t know if this is answering your question,our occupational therapist for sharing. Well, we have a, you know, a practice guide or something similar. And now the chat was like, oh, I’d like to see it and oh, I’d like to see it.

And I think what it often times does is that it links people in a way so and I think that a lot of those connections don’t ultimately go through meas one of the leads, but actually people are able to make connections themselves.

Have I made connections? Yeah, absolutely.

How does ECHO fit within e-health services used by the Complex Care team?

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We often times talk about how we provide care and how, within Ontario and Complex Care kids in Ontario, we want to provide care to children close to their home and that in a way we want to de-emphasize that everything has to be through the tertiary children’s hospital, but actually how do we work with providers close to the child’s home so that their family can access care locally, recognizing that we can involve local community care providers, that you can reduce journey and travel times to bigger institutions that might be further away.

And so how do you do that?

One, one really important pieces is to build capacity among health care professionals.
And Project Echo is actually our vehicle for building capacity. You know, I think at the outset, our hope was to build a community of practice across Ontario.

And what we see now, and I think is, is that every month we get about fifty people joining our sessions on average. And so I think ECHO where it fits is it is building capacity.

And the other pieces is that it really does emphasize the multi-disciplinary team approach and the value that each health professional adds to the care of the child and their family.

Which teacher had a strong influence on you and what did you learn from them?

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I remember one teacher Sister Consuelo, who in the summertime, on days like today, our classroom was outside and she taught history by bringing us on local tours of the town where we all grew up, pointing out, this building is important for this and this building is here, they did this.

And, as I think about new learners coming to Complex Care [at SickKids] at the start of July. And I think we talk a lot about orientation to SickKids and to Fellowship and different pieces. But how do we orientate people to Toronto and how do we orientate people to the place where we live, but also where families and children live? That being the broader province of Ontario. I actually can’t think of a better idea than actually saying, out you go and explore all the communities of Toronto.

So I guess, that was what someone who influenced me. And a pediatrician, Dr. O’Neill – and any of the trainees who have the unfortunate experience of having to work with me know I always want to know why somebody is thinking something, because I think that if you can explain why you’re doing something, it’s really helpful being an investigation or something like this.

And so he really focused on like that critical reasoning and understanding why you’re making decisions.

And I think that that suited me as a learner, but it’s also something that I took away and probably has made me a better physician today.

How can we improve patient and family engagement in Continuing Medical Education and address it in ECHO Complex Care?

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As a clinician teacher family, there is no one more invested in the health care professional being the best that they can be than families and patients.

I think families can add a different perspective and it can enhance learning for health care professionals. I think we have to do it in a very deliberate way.

What would families like to add? How would they see themselves adding?

And then how do we make sure that we create a safe environment for families participating and retain what I hope is a safe environment for clinicians?

And you mentioned C6 (Conversations with Families to Advance the Clinical Care of Children with Medical Complexities and Disabilities) which was a seminar series which we co-led with families, supported by the ECHO team. You know, one of the key pieces is,is that preparation like actually, you know, true preparation of both ourselves as clinicians and families and very deliberatecommunication and very deliberate about what are we asking?

How do we go about this intentional communication about what’s involved and creating, shared understanding is actually probably what we have to do.

So baby steps, but very deliberate steps.

Dr. Eyal Cohen Tweet about Family Partnership in Continuing Medical Education: A Collaborative Experience

*Link to Dr. Eyal Cohen’s complete Twitter Thread about the C6 Webinar series and the AAP “Pediatrics” article published by Dr. Diskin.

American Academy of Pediatrics paper on "Family Partnership in Continuing Medical Education"

In 2022 Dr. Catherine Diskin and Dr. Eyal Cohen, medical co-lead of ECHO Complex Care, collaborated on a novel CME seminar series: Collaborative Conversations with Families to Advance the Clinical Care of Children with Medical Complexities and Disabilities (C6).

Led by the SickKids Learning Institute and Family Voices, the series focused on the “growing appreciation of the importance of patient/family partnership in clinical care & research. This project was an extension of this principle into continuing medical education”, as Dr. Cohen expressed on his Twitter profile. *Thread linked in the image above.

Describing the AAP publication, Dr. Cohen tweeted: “The paper reflects on a process in which an education series aimed at clinicians was co-designed, co-developed, and co-delivered together with family partners. This process was really eye-opening for those of us involved, and I would like to hope that others can also develop new and meaningful ways to engage with patients and families in co-producing educational programs aimed at learners in healthcare.”

About Complex Care at SickKids

Complex Care Program, inter-disciplinary team, collaboration

Complex Care at SickKids is an inter-disciplinary team comprised of – staff paediatricians, advanced practice nurses, clinical nurse specialists, social workers, pharmacists, dietitians, occupational therapists, physiotherapists, program coordinators and a clinical director – all collaborating in the care of children with medical complexity.

But how do they work together? What does this collaboration look like in practice.

*Coming Soon: In the coming months we will be publishing a webpage that provides insight into how each of these roles work together to provide patient care. Check back for more.

Learn more about the Complex Care program on the SickKids Hospital website link above.