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 challenges as providers in any other specialty of medicine.  The exercise about shared decision-making showed me how we communicate with patients using the same models as physicians in other specialties, however we also have to consider the challenges of stigma, significant medication side effects, ambivalence or lack of insight that is a feature of the disease state we are trying to treat, and medications that sometimes do not help patients.  It can be very difficult to talk to patients about the importance of following treatment and the rates of noncompliance are much higher.  The approach to take toward discussion of treatment options is the same – be honest with the patient, acknowledge the risks and side effects of treatment openly, present options to the patient, and ultimately respect their decision-making and try to meet them where they are.

– Other issues psychiatrists are concerned about include physical safety of our patients, managing behavior and protecting patients and staff from aggression.  We have an important role in caring for other caregivers.  We have an example to set when it comes to team-based care because we work very closely with social work, various kinds of therapy providers, as well as nursing.

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