Taking Healthcare by Storm: Industry Insights with Holly Estel

In this captivating episode of Taking Healthcare by Storm, delve into the world of expert insights as Quality Insights Medical Director Dr. Jean Storm engages in a thought-provoking and informative discussion with Holly Estel, RN, Clinical Advisor for Genesis Healthcare.

Holly discusses long-term care nursing, covering topics such as the nursing workforce shortage, the essential role of nurse leadership, and the impact of COVID-19. They highlight challenges in staff recruitment, regulatory compliance, and innovations like infusion therapy and AI in patient care.

If you have any topics or guests you'd like to see on future episodes, reach out to us on our website.

Publication number QI-053025-GK

Transcript

Welcome to "Taking Healthcare by Storm: Industry Insights," the podcast that delves into the captivating intersection of innovation, science, compassion, and care. 

In each episode, Quality Insights’ Medical Director Dr. Jean Storm will have the privilege of engaging with leading experts across diverse fields, including dieticians, pharmacists, and brave patients navigating their own healthcare journeys. 

Our mission is to bring you the best healthcare insights, drawing from the expertise of professionals across West Virginia, Pennsylvania and the nation.

Subscribe now, and together, we can take healthcare by storm.

Hello, everyone, and welcome to another episode of Taking Healthcare by Storm. I am Dr. Jean Storm, the Medical Director of Quality Insights, and today I am excited to be joined by Holly Estill, RN. If you have done anything in longterm care in West Virginia, you definitely know the name Holly Estill. Holly is a seasoned leader in the longterm care industry with over two decades of experience in clinical operations, currently serving as the lead clinical advisor for 31 centers in West Virginia.

She oversees a large network of skilled nursing facilities, ensuring quality care, financial health. and compliance with industry standards with a rich background that spans from managing 41 centers of West Virginia to leading national teams and infusion therapy. Her career is focused on operational excellence, survey management and the professional development of nursing leadership, which is what one of the focuses that we're going to be talking about today.

Again, we'll be discussing the current state of the nursing workforce in long term care, something that is a very challenging problem right now, the crucial role of nurse leadership in driving education and innovation. And how the COVID 19 pandemic has influenced the development of nurse leaders. So this is going to be an insightful conversation on the future of long term care, challenges, opportunities facing nursing professionals in the sector.

I am excited. I've known Holly for a long time. So thank you very much for joining us, Holly. Thank you for having me. And thank you for the kind words in the introduction. Well, they were all valid. So can you tell us how you came to do what you do now and have you always lived in West Virginia? I certainly can.

I am born and raised in West Virginia. I've been here my whole entire all the years that I've been alive, and that's been a very long time, as you know, Jane, so I won't give people my age, but yes, I grew up in a very small, tiny town in Marshall County called Cameron, West Virginia, and I moved to Oregon town about 30 years ago and raised my family here.

How did I get here? That's quite an interesting story, actually.  As a very young, recent graduate nurse, Way back in, I won't tell you maybe when dinosaurs roamed the earth as my grandchildren would say, I was renting a piece of property and my landlord owned a nursing home and he says to me one day, would you consider  I'm really looking for a nurse, and I need a nurse a couple of days a week.

I know you work in, at the hospital. I was working in acute care at the time, just like most graduate nurses do. But  would you come and just like take a walk through the building and tell me what you think, and would you be willing to give me a day or two a week? And  you know, just like young, hungry nurses the thought was, you know, there was a stigma around nursing homes and nurses going to work in nursing homes at that time.

 But, I really liked my landlord and I really liked his family, had known them for a long time. So I went, immediately fell in love and that's exactly where I stayed and have been all of these years. That's fantastic. And you're definitely in the place you're supposed to be. So the pandemic, right? We had a pandemic, the COVID pandemic, it placed, right?

Everyone knows about that one. And it placed immense pressure on the nursing workforce. Can you talk about the current state of the nursing workforce in longterm care? And have you seen any successful efforts to support retention and recruitment in this field? Well, it's interesting that you asked that question because I just, about three or four days ago, I just read an article from ACCA, the American Healthcare Association, that said that 99 percent of the SNF environment or the SNF nursing homes, not in West Virginia, but across the United States, are looking for nursing workforce.

 I thought that was, Really interesting. 99%. That's everybody, right? I will say that we had a nursing shortage prior to the pandemic, and I think we have a nursing crisis post pandemic. Everybody is fighting for that RN, that LPN, and even the CNA in the workforce today. I will say probably in West Virginia, I'm probably luckier than most states.

 We don't have amount of competition here that I did when I worked in other parts of the industry across the country. But I will say that  we do vie for the same nurse. We do vie for the same CNA. We're lucky enough to have our own CNA programs and many of the centers that I oversee today.

What I fear though is the lack of Educators that are available to really educate our RNs and our LPNs. And really when I talk about this, I'm thinking about, you know, I live, you know, in a big university city, and I know that even at WVU that, that they struggle with how many students that they can get through Their four year programs and how quickly they can make that happen.

So, the workforce shortage is obviously something that I think everybody in the SNF environment is worried about. We're not going to be able to keep up with the way that  the nursing shortage is going to hit us in the future. With knowing that the baby boomer generation is just around the corner, if not already upon us, right?

And we know that there's going to be a big influx of and a big need for long term care. What have I seen is recruitment and retention. We partner very closely with a lot of affiliation agreements with nursing programs. Like I said before, we do a lot of our own CNA classes in our buildings, which has been extremely helpful to supply us with, you know, that.

Frontline workforce retention and recruitment. We're working on that constantly.  You have to look at what your competition is doing and do it better. I think we do a really good job with being creative and innovative. And by that, I mean, listening to our lines about what really works. Why do you stay if I'm a 20 year employee and I've been on the front line for 20 years.

That's the person I should be asking what makes you stay with us and what do we do right and then how do we get to that information out to our public to get us, you know, there's folks through the door, our interview process is really tight. I think we have really good strengths and how we plan and we do our orientation on our onboarding.

 Do we work on it every single day? I think we have to, and I think it's the face of what I'll say the face of Genesis while I'm in the community. I am constantly recruiting people, you know, stand in line at the grocery store, and you hear a young person talking about what their career path may be. You get the opportunity to talk to people about what you do and why you do it.

Yeah, I would agree. It's really important. And I think, agree, you have to kind of take every opportunity you have to kind of upsell. I totally agree with that. I mean, you know, if you have somebody like, I just, I have this. An event that I had when I went to a local restaurant and the wait staff was so good.

I remember saying to my waiter at the time, you know, have you ever thought about going into healthcare? You have such a people personality and that's really what we look for, you know, at that starting point. And, you know, and healthcare is so diverse these days that. There are so many things you can do from being a nurse or a clinician  or like you as a physician, that  we need to talk about those things and we don't often take those opportunities.

Yeah. Yes. So shifting to nursing leadership in nursing homes post pandemic, what new skills or strategies have emerged as critical for managing teams currently?

Oh, that's a big, that's a big question. Yeah.  I think from. Pre pandemic to post pandemic we just had to learn how to do business a little bit differently. Not that there was a critical shift in how you led a team, but maybe how you build a team.  And I'll talk about my own personal experience, you know, I Had a very large team prior to the pandemic and then the industry sort of began to shrink a little bit because you needed to look at the financial viability of, you know, all companies, not just the company I work for now, but every company that I've worked for in the past, but we really had to take a look at how do you.

How do you do the essential things to build a team? How do you get the right people in the right spots, sort of, on the bus? Do they come with the commitment that you need? And then how do you teach and train, mentor, guide, and then really Just focus on what's doing the right thing at the bedside. Now, the skill set, I don't  what I'm going to say to you, I think every skill set that any nurse or any practitioner brings to the table is a skill set I'm going to embrace, right?

If you're a CCU nurse, you're going to bring that talent to me. If you're an infusion nurse, like I am by trade, I'm going to bring that talent to the table. I want to give away my knowledge, and I think that team building is about giving away knowledge. And I, I also think very. I think strongly that when you get the right players in the right seats, that's when your center is really shining.

And we've got to take the time to do that. You don't want to, I don't like to, I like to think sometimes that we get into this mentality of the first person that comes through the door is the first person I should hire. And we have really gotten away from that and really focused on the right person for the right job.

And I think that's what strengthens teams, I think it's what will continue to strengthen teams in the future. I do believe this skill set can be taught.  I've hired many new nurses that don't know a thing about, you know, the skilled environment. But when they get here, you have the ability to, like I said, to mentor, to guide, to teach, and to train, and to mold that young nurse into the nurse that she needs to be just to be successful in the skilled environment.

Yeah, I agree. So, as the lead clinical advisor for Genesis for 31 centers in West Virginia, you must face unique challenges across, I mean, that's a huge number of facilities. I know as I once practiced in West Virginia and it, like, that's a lot of buildings. Can you walk us through a specific example where you successfully improved clinical capabilities or addressed a critical operational challenge in one of those facilities?

Sure.  Well, you know that, you know, I left. Genesis for a couple of years and I went out to New York City, and then I came back in May of this year rejoined the Genesis family, which I think when you leave a company and you go to see what other companies do that brings you a different perspective, but I will tell you that coming back to the 31 buildings is.

Is a challenge on itself. You have to learn all the players, but I will say one of the things that we really focused. I have two market presidents. I have a North market and South market in West Virginia, and I worked very closely with the market presidents on what their priorities were, and then I looked at what the clinical team had been doing prior to my returning to Genesis, and then I did Prioritize what that was going to look like.

So one of probably the very first things I did is we looked at foundational structure and in my world, and I'm sure you would agree with me, Jean. If you don't have a good foundation, you're not going to be able to build, you know, a successful company without it. Good solid foundation. So we looked at and lined up all the foundational things that we felt every nurse should be able to do and every clinician should be able to do.

And then we build our clinical capabilities around that. So  We just recently really focused on our clinical meeting and how the importance of the clinical meeting and what that did and set the foundation for everything you're absolutely going to do as your day progresses as you know the nurse leader as a unit manager as line staff nurse as the CNA.

And we put back a very structured clinical meeting that every center must have and must complete every single day. And we're talking five days a week and then really working on implementing that to a seven day a week process. And the other thing that I, you know, I'm an infusion nurse by trade. So I never stopped thinking about infusion therapy, but really focusing on in many of our major markets.

bringing  a skill set of being able to deliver a total parental nutrition, which is one of the skillsets that I found very lacking in the West Virginia market. So we're focusing on that currently. That's really exciting. I'm going to say for someone that tried to fight to get It's total parenteral nutrition for everyone out there.

That's if somebody obviously cannot eat, a resident or a patient cannot eat with their mouth or if they can't have a feeding tube due to any number of reasons, medical reasons, that they can't tolerate feedings into their GI tract, then they have to have those feedings into their vein. It is very Unusual to have that in the skilled nursing facility and I actually tried to do that with one of my residents, in pennsylvania and it was like It was a ridiculous amount of steps that I had to go through and I never actually got it.

Done What's a lot of it's a lot of education a lot of training but I think over you know I will say back when I first became a registered nurse, it was a much more complicated process than what it is today. So I think that we've got a, we've got a lot of opportunity.  I would say that if I had my way, I would really like the next big thing that I would like to be able to do is be able to offer, you know, blood transfusions at the bedside.

I did that and uh, when I was here before, not in West Virginia, but we had it in one of my other states and It was a process that really affected patient outcomes, and it didn't require the patient to go to an outpatient setting to have it done, and they could have it done in the comfort of their home, which is with us, and I'd really like to see West Virginia be able to be convinced that's a safe process to do at the bedside.

Yeah I would agree. I don't want to kind of derail us, but I was talking with an occupational therapist on the podcast yesterday. We did a recording and he's doing research on the effects of microtransitions on nursing home residents. And you know, those microtransitions are not only like room changes in the facility, but like outpatient appointments and going to dialysis and going for a blood transfusion and going for an iron transfusion.

So all of those things do have impact and some of them are negative. So offering things in the facility is. hugely beneficial. So I totally agree. Yes. So talking about that infusion therapy I'm sure you've had to collaborate with so many different departments, marketing, business development.

And so how do you navigate the balance between clinical excellence and financial health of the organization? Like when it comes to new practices like that, because I mean, TPN is. It's expensive. You know, just the, you know, the infusion itself and all the labs. So how does, how do you balance that?

Well, I don't think I call it balance. I think what I've been able to do over the, in the course of my career is being able to really look at priorities. And when I work with my market presidents it's funny that you asked this question because I wrote Like my focus list for the next couple of months and I have 21 areas of focus that I need to be working on right for my 31 centers.

And then someone said, well, how do you do that? And I'm like, well, I've got to prioritize and then I get to work with my market presidents or say what's the thing that we think we could get the best outcome?  What are the things that we can implement? That seemed financially feasible that would give me some of the biggest bang for my dollar, and for the education and training that I have to think about that's going to impact the resident and it's always for me it's always about the best thing to do for the resident and my bed, right, we all, it's all for me but it's always been about resident care, and if I can implement a program That isn't available except for an outpatient clinic or for an acute care, and I'm quite capable of doing that I can learn it I can safely implement it I can make it financially feasible.

Those are the kind of things that I look at and those are the kind of things that I prioritize. Then from the market standpoint, like you said I every discipline touches the clinical world. So I have to look at how do I. How do I balance what HR needs me to do? How do I balance what the market president wants?

How do I balance what the business opportunities might be? And I do the same thing. I outline each of those in my role. I outline each of those and I talk to my team and I also talk to each of the disciplines and we're very fortunate. As you know, here in West Virginia, we're a really tight knit family.

We meet routinely. We meet Usually  each market president has a meeting every single week, and we're given the autonomy, at least I am from the clinical side, given a lot of autonomy to the side, you know, once we have those initial discussions, then I can prioritize what needs to happen in each market, and that's been working for us, I think  really well over the last few years, and even in the time that I've Wasn't with Genesis those kind of things continue to happen even when I wasn't in the role.

So I do think it's been embraced By us by just, you know, listening and then determining what's going to be the best kind of business process that we can use to determine whether it's going to have a really good patient outcome and then really deciding over time when you look at your trends in your data analysis was it the right thing to do?

I mean, we've made mistakes just like every company has, but we do really try to do it in a priority talk kind of way. Yeah, putting the patient first. That's right. Always. Yes. So nursing leaders play a significant role in addressing vaccine hesitancy, misinformation and long term care, something maybe we're having some challenges with right now.

So what steps can nurse leaders take to ensure that their teams, their residents and families feel informed and confident in making vaccination decisions? Well, this is a great question, because I do think it's something that  since COVID, you know, came, and there was so much disinformation on the internet, and everybody has access to the internet, and everybody reads stories, and, you know, CNN says this, and somebody else says that, and so on and thus, but anyways  the disinformation and we fought that all for it all during the pandemic, as you're well aware, but what we've done is we really focus  on admission and at least quarterly, we talk to the patients and their families and our residents and talk to them about Risk and the benefits of, you know, vaccination.

And I'm not just talking about COVID vaccination, but flu vaccine, RSV, shingles, all the vaccinations that are available as a SNF that, you know, we're supposed to offer up and what I've found with, at least with my team and with teaching the DONs is, you know, coming to the table unbiased, right? You know, I think every person comes a little bit biased about their own personal experience with vaccines, but we really have to focus on the risk and benefits and I use COVID because COVID, you know, in the beginning, there were, like I said, the disinformation put out there was really sort of alarming.

And the questions that families and residents would ask you after they read an article on the internet and all the things that, that, you know, they began to believe, you really had to do an in depth discussion about. you know, what the vaccine was meant to be doing. It wasn't going to always prevent you from getting covid, but what it could prevent was a rehospitalization or a possible intubation or somebody from, the risk of death and really talking to them about what vaccination means and what's the benefit of taking a vaccination and then really giving them all the details that they need to be able to make an informed consent or a declination.

Yeah, super important. I think patient centered care, making sure really they understand all the risks, benefits. Yes. So, regulatory compliance, long term care facilities are the most regulated industry, healthcare environment. Nurse leaders play a key role in making sure standards are met. So, can you share how Nurse leaders can effectively balance regulatory requirements with providing high quality patient care because sometimes maybe they seem like they maybe not go together and what strategies could they use to foster a culture of compliance within their teams?

Yeah  this is a big question, right? I think that for me, it's doing the right thing every single day. You practice 24 7 what you preach, and understanding the rules and regulation is, as you probably are quite aware, CMS is getting ready to implement  some significant rule changes on March the 24th, and we've been really digging into what that's going to mean for us.

Regulation, as we are. As you said, we are highly regulated industry and as we probably should be, and I've always in my world I think I've always really thought if I can do the right thing every single day for all the right reasons, then everything else follows. And if you can And really find that balance between regulatory compliance and patient outcomes.

I think you're doing the best that you can do. Now, what do we do to try to support that? We do a lot of things. I think we do many things. Obviously, education and training. I think that we talk routinely on my DN calls. We talk about the regulations that are changing, what is going to impact their lives.

We do what's called FTAG rounding, and that might be a little different for some people on the call, but we'll take a specific, like I'll use infection control, and we'll take the critical element pathway and infection control. We built A rounding tool around that. And then we teach our nurses and our line staff what to look for when they are in patient rooms every single day.

They have the autonomy to build their own teams and to talk about  their. Challenges with their shortcomings, and then we talk about inequality improvement and hopefully see our changes in our infection control rates. We look at hand washing, we look at, how they carry their linen, we talk about, what's the transport of food, how we're washing our hands between meal delivery, those kind of things.

So I think that regulatory balance and patient care go hand in hand. The industry is complicated, as you know  very complicated. The rules changed, not frequently, but this is a big rule change for us. It's coming at the end of March.  They're going to really do a big focus on the use of antipsychotics, which I feel like it's been a long time coming.

 Or I should say the overuse of antipsychotics in the industry. But I do really feel like the balance is always Trying to understand and interpret the rules. Sometimes the rules are very subjective, but if you really understand the critical element pathways, CMS is giving you all the tools that they use, and all the tools that we should be using to understand the rules and understand how you implement those rules to give the best patient care.

Yeah I would agree with you and just making sure like sometimes it just breaks like maybe one, one little step, but of course, but it seems like you have a wonderful team approach to making sure everybody is on board, which is so which is crucial. That's critical, right? Everybody has to own the survey process, right?

But if you practice Yes. That every single day, 24 hours a day, seven days a week, then you never have to worry about what a survey is going to bring. Because your team is always well prepared and they're able to speak to whatever a surveyor may ask them or the observations that surveyors make while you're giving care.

So what advice would you give to someone who's considering pursuing a career in nursing leadership, particularly in long term care? What would you tell them their, what skills and experiences are the most valuable for success?

I'm not sure I know what the skills are.  I, for me particularly, it's always just been, you know, learning and growing. And as a clinician, you never stop learning and growing, right?  You know this as well as I do. In healthcare, there's something changing every single day. But I think new leaders, they have to be prepared to lead by example.

It's not an easy job. It's never going to be an easy job. It's not a nine to five job.  You know, I remind people every day that, you know  I'm responsible for clinical outcomes for 31 centers. My phone has never shut off. And, you know, there are things that happen and you have to pick up your phone at 4 a.

m.  I think you, you have to build a team that understands  your vision. You have to have a vision.  I'm probably not going to always be able to give you a vision. I can give you a hint of what my vision is for, you know, my 30 percent or anywhere I'd like to see us be.

But I think leadership comes from this internal mechanism that each of us with leadership abilities comes with it. You are driven. You're driven and you're passionate about what you want to do and what you accomplish. And for me, I would say my team, if I looked at every member of the other, the six women that work my team is we get up every day with that same passion to go to work and to accomplish and to really make somebody's life.

Different every single day, and that if I can get the best clinical care at the bedside, if that means I'm going to be in stumps today and I'm going to help you, that's what I'm going to do. If it means I'm going to sit in an office today and I'm going to plan what our future is going to look like, that's what I'm going to do.

I think leadership is just so diverse. You can make the Director of Nursing job anything you want it to be, but you have to work within the guidelines that CMS sets for you. You have to build a team that understands what those guidelines are, and you have to practice practice, And it's always an ever changing environment, and it's very challenging, it's very exciting, and it's very I think it's been very rewarding, and I think if they can see the reward that comes with the leadership that we can give to you, then you would be very successful.

I mean, you can hear that you are passionate about it in your voice. Thank you. I do. I love what I do. I've always loved what I do. I think you, you hit the nail on the head when you said I found where I belong. And I think that many new leaders if you've been in the industry for a long time, and like I have, , from Oprah 87 to our current challenges, we're always going to have challenges.

I think that we can meet those challenges. I think you have to be creative and innovative, and The sky's the limit is the way that I look at it. When I look at the industry, we don't do anything like we did, you know, 30 years ago when I came into the industry, it's just always something very exciting.

At least I find it exciting. And I like to think that I can give that excitement of how I feel and how I perceive the industry  to young readers. At least I hope I can. Yeah, you do. So, looking ahead  to the next five years, where do you see the future of long term care evolving, both in West Virginia and across the country, and what changes or innovations do you anticipate that could reshape healthcare, how's, how it's delivered and managed in these facilities?

I think the biggest focus for me, probably for the next five years, and even though this is a, it's an old tradition, but I think it's really imperative now because the acute care side is going to start to feel a little bit of the growing pains around re hospitalizations and the money that they'll have to pay back when, you know, you've got your accountable care organization or whatever you might be from the acute care side and you've really got to manage a patient from the time of hospitalization until they come through a sniff or they go to home health or wherever they're going to go downstream.

For me, I think it's really working on controlling rehospitalization.  I know in 2026 some of the major health organizations in West Virginia are going to be going into a program that's going to really. tell them this is the amount of dollars that you get for this patient and what you do with them in the acute care setting and how you partner with your downstream people are really going to be really how you're going to control your finances.

So I do think that we've got to find a way to control rehospitalizations. One of the things that I think that At least the genesis is done and done very well is that we have our medical directors are in our buildings many days of the week, not just one day a week or one day a month where they used to be.

We have advanced practice nurses in each of our buildings, you know, we've had that for quite some time I think we're improving on that every building has an APP. So we do that we have after hours call. Of internal actually, we're looking at a program now where we're bringing specialists into the building.

And I think  that's that for me is really innovative and not something that I don't think that I've seen a lot in West Virginia. I'm very excited about that. I think the more things that we can internalize from the sniff side to partner with our acute care partners. The more that we will be successful in the industry in five years, 10 years from now, but we have to be innovative and we have to be creative about how we do it.

But there are a plethora of opportunities. And I think that you've got to really look at each of those opportunities and decide what's really good for each of your buildings individually, and then what's really good for your company as a whole. Yeah, I would agree with, your, you know, looking at  your partners and other healthcare environments like hospitals, like we're not siloed.

We never were. Maybe we thought we were in long term care, but yeah  I think that innovation  with different healthcare environments is really exciting. Well, I think that too, Jean, and I'll just say this and then we can move on, but I think that what we saw, what we're really starting to see is that shift where, hospital systems were always,  this giant where they didn't really have to depend on their downstream.

providers. And with the change and the payment structure and the things that are coming in the future, they really, those partnerships are going to become invaluable. Yeah, most definitely. So if you were in charge of long term care in the United States, you were the RFK junior of long term care. What is the first thing you would do?

What is on your wishlist for long term care?

Well, I have a really long wish list  but I think the one priority would to ensure that our regulations match the care that we deliver. And by that I mean  we're not just long term care anymore, so many of our centers I have a short stay units. We, you know, we're really do a great job with that. Really critically ill patient.

I toward someone through a building, several months ago that said, when we think of skilled nursing, we think of nursing homes and that's really not what you do. You're like a little mini hospital. They're absolutely right. I'd like to be able to say that. CMS would take a look at that and decide that,   they really should stratify the rules and regulations because we do have long term care responsibilities, but we also have short stay responsibilities and they don't always match.

So that would probably be one of the things I would look at. I think the other things I would really embrace is technology. There's so many things coming that I find really exciting. I'm not a technology geek, but I do believe that technology can really help us to be more efficient. I think it can make us more productive.

I think it can really help us to learn and improve our critical thinking skills. I think about AI and some of the things I'm seeing out there that I find exciting where, for example, we have a package that we're looking at that like reads a discharge summary or reads a medical record and picks out keywords that then helps us to determine very, very quickly if that person is going to be, you know, a really good fit for maybe Building A that not building B.

So I think that technology and the use of artificial intelligence is something I find extremely exciting and how it can really impact the healthcare industry as a whole. Yeah, AI is really exciting. It is very, very exciting. Yes. Well, Holly Estill, I could talk for a long time with you. You've seen a lot and you are one of a kind in the long term care world.

So I feel lucky to have worked with you and to continue to collaborate on some level. So thank you very much for joining us today and sharing your insights. Thank you, Jen, for having me. 

Thank you for tuning in to Taking Healthcare by Storm: Industry Insights with Quality Insights Medical Director Dr. Jean Storm. We hope that you enjoyed this episode. If you found value in what you heard, please consider subscribing to our podcast on your favorite platform.

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