Safety is more than preventing physical harm

I have to admit, I was skeptical when I was first asked to attend this conference. As a psychiatry resident in my last year of training I have been confronted on a daily basis by patients placing themselves and others in unsafe environments and situations. Between seeing patients who heavily abuse substances and then get into arguments with loved ones or god forbid get into a car, to patients who shun the comforts of home because of profound paranoia about their home environment, I have always thought of the hospital as a safe place for psychiatric patients.

However, on a daily basis we are faced with a patient population who all to often cannot advocate for themselves or when they attempt to do so are written off or unfortunately flat out ignored. In a bigger way, patient safety is integral to good patient care because by allowing our patients to be their best advocate and placing these patients in a system that actively protects them and encourages wellness we are hopefully encouraging them to adapt these behaviors into their daily life. Psychiatric patients are frequently isolated and have few if any supports in their life. Placing these patients in a system where providers, nurses, pharmacists and social workers have a vested interest in their wellbeing and improvement can help these patients to develop social skills to advocate for themselves and their needs, it can also instill trust in patients who frequently believe the healthcare system is against them rather than working for them.

Attending the Telluride Experience is important to me because I want to learn how to make our unit a place where patient’s fears and suspicious are transformed by a culture of transparency. While we frequently talk about every healthcare provider on the unit as an integral part of the team, we too often find that each member of the team is in their own silo and only interested in their own tasks and duties to the detriment of knowing the struggles and joys of other members of the team. For too long we have believed that patients are not aware of this disharmony but our patients are more savvy than that deserve healthcare in a system where accidents and errors are not seen as a failing but as a way to improve not only that patient’s care but the care of other patients in the future.

For a long time we have only thought of patient safety as preventing medication errors, surgical site mistakes or preventing hospital acquired infections. I hope to learn more about how a culture of safety in healthcare can help promote psychological and spiritual wellbeing in the patients who entrust their care in us everyday.

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