Do Simple Better

This quote from Joe Maddon really stood out to me and really set the tone for Day 2 in my mind.  I feel that everything that we’ve discussed so far at this conference is stuff every medical student, resident, and attending knows in the back of their mind, just like how every baseball player knows how to field a ground ball.  But we forget sometimes that you cannot do something complex unless you successfully do the simple thing.  In keeping with the baseball theme, you cannot successfully turn a double play unless the shortstop gets his glove on the ground, squares up with ball, and cleanly gets it from his glove to his throwing hand.  Us doctors and nurses couldn’t even begin to deal with the whole complexity of the medical “system” until we can first do all the simple things.

I think that this conference… Continue reading


by Janice Park

This probably isn’t the normal sentiment to hearing John Nance speak. He gave us an incredible talk about patient safety and summarized many of the important points he made in his book, Why Hospitals Should Fly. He told us stories about hardened surgeons and flight disasters, explained why our system cannot function the way it does. But as he spoke to us today, I couldn’t help but experience this enormous wave of relief.

Why? Here is an experienced pilot explaining to a room full of residents, medical students, and nurses that the way we practice medicine is unsafe because it relies on every single one of us to act in individual perfection, which is humanly impossible. He asked us whether any one of us had ever been taught that we are allowed to be imperfect, and no one raised a hand. This entire model of… Continue reading

Day Two Reflections: Telluride Breckenridge

by Amy Abramowitz

A few thoughts from another full day:

– Finding joy and meaning in the workplace – This is so crucial to providing safe and high quality care.  Every team member must feel that their role is important and must be empowered to speak up when they are worried about a patient.  The past few days have made me think about how important it is for me as a physician to empower and listen to members of my team.

– Data should include attitude measures, what people think and feel about what you are trying to change – It is so critical when you are in a leadership position to understand the goals and concerns of people whose behavior you are trying to change.

– I have been thinking more about the role of psychiatry in quality and safety.  Psychiatrists face many of the same… Continue reading

Culture Change

by Luke Perkins

A lot of this week’s conference has been discussing how big of an issue patient safety is in our medical system. We are far from perfect and have even accepted that perfection is not achievable. This is certainly a dismal state of affairs in many respects. We have a culture where patients are in danger far too often.

Somehow, we are supposed to ignite a change. How does one do this? How do we make a new normal? We have no choice but to start at the grass roots. It can begin with educating our colleagues, in addition to our patients, regarding the very oath we take as medical professionals. “First, do no harm.” We must treat their diseases, while at the same time protecting them from ourselves.

We, each as individuals, cannot accept the patient safety risks, without seeking alternatives. We must push our departments. We… Continue reading

Reflections Telluride Breckenridge Day 1 and 2

by Ariel Finberg

There have been many pearls of knowledge shared with us during these last two days; all invaluable tools to help us as new leaders change the face of healthcare. My favorite bits of wisdom however came out of two of the games we played, the domino game yesterday and the teeter-totter game today. In the midst of the silliness, it was incredible to see how quickly and effective a quick debrief in between sessions was. 

We started the domino game and failed almost immediately. After our allotted time, we met up to discuss what was a strength and what could be improved on for the next session. This quick 2 minute debrief COMPLETELY changed the outcome of the next two rounds. We were able to effectively communicate and work together to successfully complete the puzzles. The same thing occurred with the teeter totter game. We had… Continue reading


Today was another thought provoking day in Breckenridge.  While I found pearls in all the of the sessions, I think my favorite two sessions were the talk by Shelly Dierkling on QI projects and the discussion led by John Nance.  As a graduate nursing student in the Health Care Systems Clinical Nurse Leader Track at UNC, I had been tasked with developing a QI project as part of my program prior to being selected for this camp.  Last semester I was given a model to follow, the Dartmouth Model, and tasked with discovering a clinical need that would improve the quality of care provided by the clinic I work in.  I completed the task and presented all the right deliverables, but at the end of the day I didn’t have a lot of confidence that the project I am hoping to implement will actually gain traction.… Continue reading

Consent to Learn

As a first-year medical student, I spent a lot of time trying things for the first time. Very few of these “first-time” events were procedures, but I anticipate a day in which it will be necessary for me to perform something more advanced like my first set of sutures or my first biopsy. While simulation is incredibly valuable, performing a procedure on a patient is irreplaceable; it’s a necessary part of the medical education process. However, entrusting a completely green medical student with a task that requires some level of skill is not without risks. As we discuss the importance of informed consent, I find myself wondering to what extent revolutionizing medical culture to improve our informed consent process will impact medical education. Will patients frequently dissent to procedures when told a medical student will be taking point, or will they be more inclined to allow medical students to perform… Continue reading

Telluride Day 1 Reflection

When I first applied for the Telluride Experience, I knew it would be an experience that would enhance they way I approach my future clinical years as a rising M2. However, after Day 1, the Telluride Experience has already truly transformed even my most basic assumptions regarding medicine.

I felt that the Lewis Blackman film was a true wakeup call for young students and residents. As a medical student, it often feels like the most important task as a future physician is to learn all the clinical manifestations of disease, their diagnostic criteria, and their treatments. However, the film evidenced that systems error may lead to a negative outcome regardless of all the knowledge accrued by health professionals. At first, this was disappointing to me–after so many years of education, the last thing you’d expect to cause the unnecessary death of a patient is a systems error. I… Continue reading


This has been a wonderful experience thus far. Over the last two days we’ve discussed leadership and the qualities that make a good leader. We discussed mentorship, experience, good listening skills, and good mediation skills as positive attributes. Qualities such as dominance/ego/overconfident, poor empathy/integrity, and poor communication describe a bad leader. Our residency program recently used the DISC personality test to assess our personality and how this affects our own leadership styles. The Disc personality test describes styles of dominance, influence, steadiness and conscientious. Our residency overall scored highest with steadiness. Steadiness in general describes a person who is motivated by cooperation, prioritizes giving support and fosters collaboration. Steady leaders are described as calm, patient, and stable. They may fear change, loss of stability and worry about offending others. One of our residents had previously attended a hospital leadership conference where most of the attendees rated highly in dominance. Dominant… Continue reading

Day 2 Podcast

Here James, Brian, Cari, Maryam, Kristen, Justin, Sus, Vidya discuss the idea of culture from today’s discussion.