Galvanize

There’s a fire brewin’ in my belly and it’s growing stronger with every demonstration of how healthcare should be, but sadly isn’t. St. Michael’s, Lewis Blackman, countless stories from other residents–all highlighting the failures in my own practice and in my home institution. I’m compelled to spread the word of risk reporting, transparency, and teamwork. These lessons learned at the Telluride patient safety conference have changed me permanently.

I am Not Alone

CIR_Dinner_BestI have only just begun my journey here at Telluride, but one thing is clear: I am not alone. As the first day unfolded, I have been given the opportunity to meet an amazing cast of future leaders. All of whom have patient safety as a main priority. Some of us are on the front end of our patient safety journey while others are more accomplished. Some beginning residency while others are soon to graduate and take their Telluride experiences with them into their future careers. As the first and sole participant from my residency program, where our patient safety revolution is still in its infancy, it gives me great pride and pleasure to know that I am not alone. Each one of us here at Telluride Patient Safety Resident Summer Camp is not alone. When we leave Telluride  and head back to our home institutions, we will have… Continue reading

to new friends and new ideas

Even though one of my good friends attended Telluride last year and came back to my institution brimming with ideas, I still wasn’t sure what to expect. Despite the airport delays and bad weather, Telluride has been as spectacular as promised. The natural beauty of the surroundings seems to spark discussion and the fresh air is a welcome change from the musty, odd-smelling corridors of the hospitals we all work in. The thing I’ve enjoyed the most so far? Meeting like minded young physicians from around the country and getting to know one another. Looking forward to a week full of interesting conversations and new ideas!

Telluride Resident Summer Camp Class of 2014 Introductions

Dave_Leads_ClassMeet this year’s Telluride Patient Safety Summer Camp class of resident physician alumni, poised to change the world of patient safety and patient care!

This year’s residents are working in: Rehab medicine, pediatrics, emergency and internal medicine, anesthesia, radiology and looking to gain acceptance to fellowships in pulmonary critical care, hem/onc, GI, hepatobiliary surgery, nephrology, interventional radiology, health administration, robotic surgery and pediatric anesthesia.

Members of this year’s group were born as far away as India, Taiwan and Germany, have attended medical school in Iowa, Missouri, California, Georgia, Texas, Utah, New York and Poland, and are doing their residencies across the country with a large contingent attending from the MedStar Health system in the Washington DC/Baltimore area, from New York and California hospitals and sponsored by the Committee of Interns and Residents in New York, and by COPIC in Colorado, representing a respectable cross section of the… Continue reading

Patient safety and quality is paramount

Telluride patient safety roundtable Day #1
Today was a very powerful day and I anticipate more is to come throughout the week. I was moved by a lot of the stories, and ideas. Something that resonated with me was the idea of mindfulness. I thought this is very crucial to constantly be aware of your own biases, mental processes and judgment in evaluating situations. I think this idea, in addition to building a more collegial medical team and including the patient’s family in medical rounds and discussion could potentially have saved the life of Lewis Blackman.
General thoughts on the day: It is safe to conclude that patient safety and quality is paramount in health care. Just as we invest in medical research, and technological innovation we should invest in learning and implementing tools and systems to ensure quality care and a safe environment. After all, you will think it… Continue reading

Daily blog

Learned a lot today such a great experience. I wanted to share some advice I tell all my junior residents that seem to help me throughout the years: 1. Never be the last person to know something..ie always bump up knowledge up the chain. 2. The most important question I ask a patient in the morning for daily rounds is how are you feeling this morning…we always get concerned as surgeons whether the patient ate, pass gas, pain is controlled, etc but I feel like patients own self assessment especially in comparison to other days is very informative 3. Never be afraid to ask a question…this advice came from my mom who always said what’s the worse that can happen from asking a question and usually the answer was nothing…

Day 1

Learned a lot today such a great experience. I wanted to share some advice I tell all my junior residents that seem to help me throughout the years: 1. Never be the last person to know something..ie always bump up knowledge up the chain. 2. The most important question I ask a patient in the morning for daily rounds is how are you feeling this morning…we always get concerned as surgeons whether the patient ate, pass gas, pain is controlled, etc but I feel like patients own self assessment especially in comparison to other days is very informative 3. Never be afraid to ask a question…this advice came from my mom who always said what’s the worse that can happen from asking a question and usually the answer was nothing…

Transparency – How much do you weigh?

It was a great first day at Patient Safety Camp!  It is a privilege to learn from leaders in quality and safety from around the country and internationally (thanks for coming back, Kim!!).  The bigger privilege, and the one I didn’t anticipate prior to arriving, was the privilege of meeting fellow residents from around the country.  At first it was a little intimidating to be surrounded by residents who had accomplished so much as leaders in the IHI, leaders in CIR, radio talk show hosts, and pharmacists… the list went on and on.  But as the day progressed I realized that I was lucky to be surrounded by such great people that I can hopefully learn from for years to come.  We have already learned so much from each other by discussing ways to improve transparency and communication with patients, how to increase physician reporting… Continue reading

Reflection day one

After hearing about the LB story, it brought back numerous experiences with similar breaches in communication. One potential remedy which was not discussed today was the importance of a read back. Applying it to today’s discussions…what if a formal read back from an attending was expected by the culture of that hospital community?….
Attending: So you’re telling me this 15 year old patient is tachycardic, has a rigid abdomen, and has new onset severe abdominal pain, and you attributed some of his abnormal vital signs to blood pressure cuff size??

I’m sure that after repeating those words out loud, the story would’ve had a different ending.

1st Day Thoughts

Telluride is beautiful – leaving me breathless. First day of programming was packed with goodies. Lots of great discussion – respect for everyone who shared their thoughts – fellow residents, teachers, and patient families. For me, it was my intro to twitter – which I’d signed up for but never used. Check out @edcountydoc which I took to throughout the day with thoughts. Some are shared here.

One tweet that received no love was my tweet on handoffs. We are always so focused on the number of handoffs that we point fingers at the number and poor quality of handoffs as a major reason that errors and patient safety have not improved since work hour restrictions. However, I think this is a correlation and not causation. The thing that never comes up is that handoffs are not usually 1:1. During the day, there are multiple teams on duty. For… Continue reading