3rd Annual PCC CSUSM Faculty Professional Conference Scholarship App

Third Annual San Diego Professional Palliative Care Conference | Friday, June 15, 2018

Welcome to the CSUSM Faculty Professional Development Scholarship Application for the Third Annual San Diego Professional Palliative Care Conference. Our 2018 theme is "Palliative Care: High Tech, High Touch." This conference will take place from 8:00 a.m.-5:00 p.m. on Friday, June 15, 2018 in the USU here at CSUSM. The CSU Institute for Palliative Care at CSUSM and the San Diego Coalition for Compassionate Care are very excited to be hosting this event, as it will provide an opportunity for local professional health care providers to come together and discuss palliative care in San Diego county. Last year we had a great slate of presenters from a variety of health care professions and this year's conference is shaping up nicely. Our Keynote Speaker is Dr. Michael Rabow, MD, FAAHPM, the Helen Diller Family Chair in Palliative Care at UC San Francisco, and we have a variety of excellent speakers and panels on technology and compassion in the delivery of palliative care to patients. Our end goal is to decrease suffering, improve quality of life and improve quality of care for all seriously ill patients and their loved ones.

CSUSM FACULTY APPLICATION DEADLINE: Monday, May 28, 2018 at 5:00 p.m.

AWARD NOTIFICATION: On or before Friday, June 1st, 2018

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* 1. Applicant Name:

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* 2. Title:

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* 3. CSUSM Office Phone:

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* 4. CSUSM E-Mail:

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* 5. Department:

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* 6. Department Chair Name:

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* 7. Department Phone Extension:

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* 8. Describe how attending this conference will contribute to your professional development and/or research in Palliative Care (200 word max).

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* 9. Which of the following conference topics are you most interested in exploring? (check all that apply) And Why?

Panel: Giving Voice to the Choice: Right Care at the Right Time

Utilizing Web Based Tools to Improve Safety: The County of San Diego’s Efforts
to Protect Older and Vulnerable Adults

Advance Care Planning with Diverse Populations

High Tech Tools in a High Touch World: Palliative Care Resources for Youth

Use of Caring Language Changes Everyone

Medical Cannabis: In Search of Hope

Surefire Safety and Quality Strategies: Being Present and Aware

Collaborating to Implement a Community-Based ePOLST Registry

Using Technology to Extend Compassionate Care

Panel: Hard Call – Ethical Issues in Palliative Care

Why did you select these topics? (100 words max)

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* 10. Would you like to receive CME/CE credit for this conference?

Yes

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* 11. Please type your first and last name below to acknowledge you understand the following information:

1. If awarded a Professional Development Scholarship you agree to attend the full day conference from 8 a.m. - 5 p.m. on Friday, June 15, 2018.

2. All CSUSM Faculty are eligible to apply (tenure, adjunct, lecturer, full or part-time). First priority will be given to applicants who have not yet received professional development funds from the CSU Institute for Palliative Care at CSUSM.

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* 12. Today's date:

Date

Thank you for your application! If you have any questions please contact Donna at dheard@csusm.edu or x 3550.