I have often heard “volun-tourism” used as a derogative phrase, generally referring to those who expend significant cost and effort to do charity work abroad. While the criticism implicit in this term comments primarily upon the selfishness of the work’s motivation, even if conducted with the purest of intentions, it can seem silly to leave and work abroad when there is so much progress that needs to be made in our own communities.
When thinking about the problems still existing in areas of patient safety, a similar framework seems to apply. In the same way that it seems unconscionable to step over homeless neighbors on our way to donate to an Asian charity, it seems unacceptable to continue to pursue new therapies and cures without addressing the everyday problems already rampant in our system. Both– the local, and the global– are necessary parts to better our community and our world (which, for many in residency or medical school, may sometimes equate to the hospital).
Furthermore, the two perspectives are deeply interconnected. In order to innovate and develop new solutions to local problems, it is helpful to gain a larger viewpoint. This is what Telluride has done for us so far: it is taken our limited understanding of 1-2 medical systems and developed it into a more integrated healthcare view based upon the contributions of our peers in the program. Conversely, in order to effect global change, it must start at the local level. Big leaps in progress are supported by smaller first steps: in the context of QI, this can mean that in order for a new cancer cure to be effective, or for deep-brain stimulation to reverse Parkinson’s, patients cannot die from a central line or other hospital-acquired infection first.
The delicacy of this balance is why I am so excited to see what kind of projects my peers do for their QI initiative after this. I think that Telluride does an excellent job of inspiring us to act globally while encouraging us to act locally, and I am already enjoying thinking about how that balance might look. We hope to make one small step for providers, but much larger steps for patient safety.