We have just finished up the first day of the Resident Physician Transforming Mindsets Workshop in Telluride, CO. There has been much discussion on several issues in patient safety today. The issue that sticks with me most in the need for widespread cultural change within an institution if patient safety is to improve.
Cultural change within large institutions, such as hospitals, medical schools and medical specialities, can be a top-down or bottom-up phenomenon, but broad support across the entire institution must be in place for the cultural change to occur. My perception of the first day of our activities is that folks generally thought of being on the bottom can in fact be the agents of change. Grass roots efforts by residents, medical students, and other health care workers generally thought of being at the bottom of the power pyramid can make genuine differences in patient care through their individual and collective efforts. Residents and students trained with the proper knowledge, skills, and attitudes early in their training can not only advocate for their patients during their schooling and residencies but also champion broad based cultural changes throughout their medical careers.