Jeff Anderson — Reflecting on a Wonderful Week — #TPSER8

Sitting in the airport after a successful week in Telluride, it is difficult not to reflect on where to go from here with regard to taking what we learned during the Roundtable and applying it to our home institutions.  So many wonderful and innovative ideas for moving forward were shared on the last day, including ways to grow IHI chapters, methods of addressing patient safety and quality improvement with attending physicians, and developing student reporting tools, only to name a few.  It was great to see so many students excited about returning home to spread the word and improve their systems, and I certainly share in that enthusiasm.
A few things that especially struck me most during the week were students’ lack of knowledge about the role of their nursing counterparts in the care of patients as well as the lack of “just” reporting tools for medical students… Continue reading

John Wooden’s Spirit Alive and Well in Telluride–#TPSER8

“If they haven’t learned it, you haven’t taught it.” This was a Woodenism oft quoted at the Resident Summer Camp in Telluride by special guest faculty, Paul Levy. Wooden and Levy are both coaches and teachers in their respective fields–one hospital administration and the other NCAA Men’s Basketball. With that statement, they both take responsibility to the fullest extent for successfully transferring knowledge to those they themselves are charged with educating.  As I reflect on that week, this message rang especially true during the group’s conversation on informed consent and shared decision-making.

One of the residents had mentioned how surprised he was at an intelligent patient’s off-the-mark retelling of the information he had just conveyed. “It was like apples and orange,” he said, as John Wooden’s words rang loud and clear in my head. It was also becoming clear that as care providers, the role also encompasses educator… Continue reading

Write it down, read it back

One technique that striked me as a great idea was the check-back method. This involves listening to another medical professional tell you about the patient, preferably in the SBAR format, you jot down the important notes, and then you read the notes back to the dictator.

Previously I had known about teach-back method which involves the patient repeating and paraphrasing the information that you given them. However, I never really thought about writing the information down. The written aspect is so powerful because it helps you to remember better, and it’s a form of traceable documentation.

One anecdote that I thought was very powerful was the one in which the doctor asks the patient, may I record this conversation? The patient agrees, thinking that the doctor wants to make a record to cover his tracks legally. At the end of the meeting however, the doctor takes out the tape from… Continue reading

Final Thoughts #TPSE8

Its been a incredible experience – whether it was bonding while taking our 3 mile hike or bonding during the picnic or in casual get togethers amongst friends at picnics and barbecues;  we exchanged thoughts and imagined a system committed to bold, new ways of thinking of health care and the relationships between doctors and other care providers. Today we heard a touching story about a child that experienced an adverse outcome that highlighted the value of strong communication and truly understanding the environment/mood before making inappropriate diagnosis of patients especially kids who may try to naively consolidate multiple emotions and be more scared based on what they read/watched on TV. As I leave this round table – I think about what I can take back to my home institution and implement. Some of my thoughts include creating a difficult patient encounter in Clinical Skills where an individual has… Continue reading

Student Reflections: Test for Change at #TPSER8

Elliott Schottland, Medical Student, says:

The discussion about nursing and doctoring reminded me of conversations I had with fellow classmates at school. We were studying for the NBME Behavioral Sciences exam and joking about the ethical  dilemma practice questions we were working on. A common theme that we noticed is that any answer involving soliciting a nurse for help or consulting with a nurse would invariably be wrong. We agreed that answers involving nurses can be crossed off and it would be nice to get one on the test because we could narrow down the answers easier. Almost like how there used to  rarely be positive depictions of minorities in the cinema, early medical education is nearly void of positive depictions of nurses. The best way to effect change in medical school is to test students on the material. This should be applied to learning about hospital hierarchy… Continue reading

Student Reflections — Take Home Messages From #TPSER8

Michael Coplin, Emory University, MD/MBA 2016 says:

As we wrap up day 3 of the Patient Safety Roundtable, I am amazed by how quickly this week has gone by.  It has been a wonderful week of exploring critical questions during sessions guided by patient safety experts, engaging with and learning from students with a common interest, and enjoying the beauty of Telluride.  It has also been enlightening to learn from both American and Australian healthcare professionals and to recognize that we share common challenges despite being a world apart.  The days have been incredibly thought provoking, and I am certain that I will leave here with more questions than I had coming in.  I feel empowered and motivated to return to my home institution, Emory University School of Medicine, with the goal of sharing the lessons I have learned with fellow medical students, IHI Open School… Continue reading

Where is the Med Student Andon Cord?


LEAN in a nutshell–Dave LaHote’s masterful diagram

The theme of our second day at Telluride was about reporting, risk management and quality improvement. We learned about the great examples that UIC and the University of Michigan Health System have set in adopting a policy of transparency and timely open and honest communication with patients when it comes to medical errors. The systems not only have resulted in improving direct communication between providers and patients, but have also led to significant cost savings (click here to learn more). The most important aspect of the system is that it allows a health system to engage in continuous quality improvement and learn from its mistakes.

However, as the discussion continued, we realized that while events at these health systems will trigger a process of error analysis and patient communication, many systems are severely lacking in a mechanism for medical students and residents to… Continue reading

Reflections from the Roundtable

Reflecting on the first two days of the Patient Safety Summer Camp has made me realize how incredibly lucky and thankful I am to be here. Not only am I in spectacular Telluride, I am surrounded by students who share the same driving forces. I’m also gaining a network of faculty to help support the mission of patient centered care and to help translate that mission at medical centers across the country.
The main themes we’ve discussed so far center on the idea of open, honest, and clear communication. At first I was surprised to find this as the emphasis but now I fully understand how this basis of respectful and effective communication is vital to the mission of the Telluride camp. It allows us to converse with each other in meaningful ways and to think about our communication with members of the diverse heath care teams at home institutions.… Continue reading

Lightbulbs and Helpful Advice from Day 3 of Telluride Patient Safety Roundtable

A lightbulb: Today we discussed the importance of including patients at risk analysis meetings and as members of QI teams because they keep us honest.  I couldn’t agree more and also realized today that there are things that happen and are said within the health care setting that I would have found appalling prior to entering medical school.  But somewhere along the way (probably most profoundly during third year) I lost sense of this.  Things I should find egregious I don’t.  Here is where we absolutely need patients and members of the community to provide a reality check and put us back in touch with a perspective we can’t always access any more.

Helpful Advice from David Mayer as I begin applying to residency programs and want to find one in which I will continue to learn and be pushed around issues of patient safety and… Continue reading

Collusion

Collusion: When a person perpetuates the system of oppression by action, inaction or silence because she/he internalizes the false belief that the system is correct or fears repercussions or chooses to stay unaware, or refuses to take action.  [Definition from National Conference for Community and Justice’s Anytown Institute , Glossary of Terms]

Today at the Telluride Roundtable we discussed (among many things!) who should report and whose responsibility it is to take action when patient safety and effective communication are at risk.  This term “collusion” kept popping into my head.  I first came to know the term when challenged to think about oppression surrounding identities such as race, class, gender, sex and sexual orientation.  For example, collusion with racism is “[t]hinking and acting in ways that support the system of racism.  White people can actively collude by joining groups that advocate white supremacy.  All… Continue reading