Tribes and Hierarchies

Today was a great opening session of the Telluride Experience in Turf Valley.  I really enjoyed the opportunity to openly and honestly discuss patient safety with people of multiple perspectives.  It was a reminder to me that my understanding of the hospital landscape is one sculpted only by my experiences inside the hospital, which has been cultivated over years.  These are experiences that most people don’t have, thus hospitals remain a strange foreign place to them.

In discussing the tragic death of Lewis Blackman, I often found myself thinking, “I’ve seen that happen in the hospital.”  I’ve seen a group of highly educated and well intentioned individuals disbelieve a blood pressure reading, and reach for a new cuff multiple times.  I’ve seen a surgical patient bed on a medicine floor. And, I’ve seen families and patients who were scared, lost and suffering.  In the film, Lewis Blackman’s mother described not really knowing who everyone caring for her son was.

I realized that the same hospital I choose to go to work is a mysterious and scary place to my patients and their families.  It truly is a place of “tribes and hierarchies” which few patients understand. This reminded me of my own sister’s experience in a hospital earlier this year, and has inspired me to try to help. I want to design a simple one page drawing that will depict who is who in regards to that patient’s care. It will have the patient at the epicenter, with family/friends, a nurse and tech, attending/residents/medical students, consulting services, phlebotomy, dining services, housekeeping and other staff on the periphery.  Providers can use this tool to describe their individual role to the patient. That way the patient and family may better understand who is who, and know how to effectively direct their questions among the “tribes and hierarchies”.

If anyone already knows about a tool like this, please share it! I welcome any and all feedback and would love to collaborate with others on this.  Today has been great, and I can’t wait to hear more great ideas and get to know the group even better over the next three days.

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