Transplanting Telluride

Trying daily to transplant all of the vital information that I learned in Telluride into my day-to-day interactions with other providers and patients.  It’s been a month since I was in Telluride and I still am so overwhelmed by the relevance and utility of what I learned there.  I am trying to get more involved where I can at my institution on quality and patient safety committees as well as being involved with various resident groups around the hospital to collaborate on safety and QI projects.  Just hoping I can find the time to do all the things I want to do now after being so inspired in Telluride!  Thank you to everyone involved for such a wonderful and educational experience!

 

#TPSER9 – Telluride Student Summer Camp Reflections on USA Today Article and more

By Aaron Cantor, BS, ENS, MC, USNR, MSII Pennsylvania State College of Medicine

On my way back home from Telluride, I happened to pick up a copy of USA Today from 20 June.  I was pleasantly surprised to see that the front page featured a special report, “When Health Care Makes You Sick: Under the knife for nothing.”

Although the article highlights medical errors, interviews Lucian Leape and Rosemary Gibson, and even mentions the story of Michael Skolnik, its tone perpetuates acceptance of medical errors and withholding of valuable information:  there is a way to know the total number of cases in which people got surgery that wasn’t needed if honest disclosure is practiced; hospitals are required to report infection and surgical errors to a governing body, but reporting to the patient and family (those who are most affected) may not be required.  The article… Continue reading

Changing Perspective

By Pat Bigaouette, Georgetown University School of Medicine

While riding in the plane from Dallas to Montrose I was reading the book “Collateral Damage”, which was suggested/required reading for Telluride. Immediately after the stewardess gave us our drinks, the man directly across the aisle from me leaned across and asked if I was going to Telluride. I looked and my book and then looked at him and replied “yes”. He introduced himself as Tim McDonald and I immediately recognized the name and remembered it being listed as of the four coordinators of the conference.

Knowing that the man I was speaking to would probably be giving several lectures, and that he was probably very important in the patient safety/quality community, I tried to keep a low profile while being polite as possible. I imagined 100s of people squished into a hotel conference room and I had a huge fear that… Continue reading

Just plain truth and humility go a long way

By Suresh Mohan, M4l, Warren Alpert Medical School of Brown University

After digesting for a few days, I’ve realized our experience at Telluride will stay with me. Discussing my week with peers back home, I was shocked to realize how little they knew (and, thus, cared) about the topic of safety. I received responses of- “well, I guess every field has its downsides” to “Whoa, I didn’t know you were, like, super into that primary care stuff”. It reaffirmed my decision to have attended, and the value of what we learned.

In my view, a lot of issues in patient safety could be solved through two simple things our parents taught us: honesty and humility. Honesty encompasses the obvious actions we ought to take when we’ve committed a mistake- apologize, and tell the truth. It builds trust in place of suspicion, and can potentially prevent “afterharm”. As we’ve been told,… Continue reading

Infection Rates: It’s not just transparency, it’s informed consent

One of the highlights of the Telluride Patient Safety Summer Camp was the in-depth discussion of the meaning of informed consent. It is not as straightforward as “here, sign this”. In fact the paper consent itself is in a sense the last and least component of informed consent. I was a bit surprised and secretly glad to hear some places have rid themselves of the informed consent form, which reinforces the notion that informed consent is some kind of administrative scut to be dished out to residents. Informed consent isn’t extra, it isn’t something for special procedures, it really should be an integrated part of every doctor-patient relationship. The heart of it is shared decision making and coming to the best course of action based on the patient’s preferences, values, needs, and goals. (“Preferences, values, needs, and goals” was in fact one of my takeaways – a mental checklist… Continue reading

Culture Change? Which One?

By Garrett Coyan, University of Kansas Medical School

The last week I spent at Telluride was very eye-opening for me. I was glad to be surrounded by so many other healthcare professionals that had the same desire to provide the safe and high-quality patient care experiences as I do. Reinvigorated with ideas for improving communication and decreasing risk to my patients, I couldn’t wait to get back to my institution and start implementing change. However, as I returned to the hospital today, I was quickly reminded of the main reason why this goal will be so difficult. Not only does cultural change need to occur in the hospital, but I would argue that even more importantly, cultural change needs to occur in the education of health professions students. This was made evidently clear by a conversation I had with one of my recently graduated colleagues who is staring his internship… Continue reading

Getting to 50

By Nicole T. Jiam, Johns Hopkins University School of Medicine

About a month ago, I was sitting in on a clinical correlation led by an aneurysm neurosurgeon and his patient at the Johns Hopkins Hospital. These clinical correlations are incredible opportunities for medical school students to learn directly from the patients themselves by hearing their story and then asking them questions.

During this particular clinical correlation, the neurosurgeon discussed the importance of informed consent and the decision making process that stretches over several weeks. The decision to undergo a surgery and which neurosurgeon requires deliberation and time.

At one of the meetings prior to the operation, the Johns Hopkins neurosurgeon candidly told his patient: “One of the most important ways of evaluating physician competency is case volume. You want to pick a surgeon that has a huge wealth of experience doing this procedure.”

To which the patient… Continue reading

We Can Do Better: Telluride Reflections by Madeline Rovira #TPSER9

Wow.  I’m not even sure how to reflect on the amazing day we had today.  From the horrors of the Michael Skolnik case video, to the excitement of being the first group ever to save Stewie (our egg ‘patient’),  to the heartbreaking story that Carole courageously shared with the class, today has been emotional and eye-opening.

So many moments today, as we listened to and became engrossed in the narratives being shared, I found my face scrunched up or my mouth falling open wondering how we could possibly treat our patients and families in some of the ways that we do.  I like to believe that people are good and generally do the best they can.  And yet, hearing about health care providers who ignore and belittle a mother worried about her child, or administrators who threaten a mother who just lost her child to… Continue reading

Reflections on Going Home

I have been interested in quality and safety since being personally harmed during a hospitalization many years ago. However, during medical school I’ve had some trouble finding students, faculty, and administrators that share my interest. Here at Telluride, I feel lucky to finally be surrounded by the faculty and colleagues that have such passion for patient safety.
While feeling lucky to attend this conference, I spend most of my reflective time wondering how to bring the education, ideas, and enthusiasm back to my home school to make meaningful change. Too often we attend an excellent meeting and come away with new concepts and empowering memories, but when we return home it is difficult to transform these into concrete change.  I look forward to designing/implementing my project this year and seeing other people do theirs. That way I know that stories like Carole’s or Helen’s will not only have had… Continue reading

Informed Consent and Transparency

So much has been covered in the last three days at The Telluride Research Experience #TPSER9 that I hardly know where to begin…I have thoughts on communication, patient safety, interdisciplinary interactions, and transparency with my patients and coworkers…I think as I process through all of these I will create multiple posts. For now I would like to focus on transparency in care.

In thinking about informed consent and transparency in medical and nursing care, I wonder what that looks like on a daily level, particularly on the floor. Obviously there needs to be informed consent for major surgical procedures and tests. I feel most people understand that. But what about the daily things? Starting a new antibiotic, initiating an indwelling foley catheter, starting an IV…each of these have risks associated with them. The antibiotic could cause some GI upset or increase risk of C. diff., the catheter will increase chances… Continue reading