Learning Put Into Practice Through Relationship Building: One Student’s Reflection

By Kristin Morrison

Kristin Morrison is a Telluride Patient Safety Student and Resident Summer Camp Alumni, an MD candidate at the University of Missouri School of Medicine and an MPH candidate at the University of Missouri. See additional reflections by Kristin on patient safety & quality efforts through the eyes of a medical student at the Transparent Health blog: M2-Metaphors and Mindfulness and Why Not Put Adverse Events Right In Patient Charts?

Being a patient safety and medical education site, ETY is delighted to share student and resident research and reflections with you, as they represent the next generation of caregivers. Additionally, the issues discussed and educational materials shared by students on ETY are aspects of healthcare infrequently included in today’s medical curricula. Sharing them with other students and residents will help future caregivers better understand the issues and challenges facing healthcare in the years ahead.

When I think of Telluride, I think of one thing: a catalyst.

I went to Telluride with some experience in patient education and health literacy, and I believed that the topics of patient safety and quality improvement would fit nicely with my other interests. I was pleased to discover that these elements weave together beautifully, and that they’ve expanded my views on patient care while inspiring me to look at medical school as the perfect time to explore what entering this profession means to me.

Telluride was incredible because it provided me with a nurturing environment to discover both the fundamentals and nuances of patient safety and quality improvement. Armed with a stack of books by Pronovost and Levy and Gawande, a bunch of new contacts in my iPhone, and a flashdrive of more information than I originally realized, I left Telluride invigorated to do something to improve both patient safety and the experience of medical education at my school. One thing I noticed while there was that the human connection makes all the difference: whether it was talking in small group sessions, jamming to classic rock on a hike or listening to a mom who lost a daughter talk about how much she wished someone cared about her–building relationships seemed like the foundation to improving health care to me.

So, when I returned, I set out to build new relationships. I spoke with our Associate Dean of Education to tell her about Telluride and ask for ideas about who to talk to next. Then I met with our Patient Safety Coordinator to learn about what our hospital is doing in regards to patient safety, and I was so pleased to discover that we are actually doing quite a lot. I noticed she had Sorrel King’s “Josie’s Story” on her bookshelf, so I asked to borrow it; I offered her Pronovost’s “Safe Patients, Smart Hospitals” in exchange, and she has since ordered more copies for her department. I recently talked to the doc who coordinates our interprofessional curriculum, and will provide student input for future curriculum development meetings. In October, I’m attending a Crew Resource Management training at our new orthopaedic hospital and meeting with the medical director of our Office of Clinical Effectiveness. Given the human nature of medicine and patient safety, I thought it made the most sense to start by forming new relationships.

I also recently had a chance to work on building relationships with other med, nursing, and pharmacy students. We had an interprofessional session (based on one done at another university) about disclosure that involved a talk by our CMO followed by small-group breakout sessions. In the small-group sessions, teams of med, nursing, and pharm students practiced disclosing an error to a patient’s family member (portrayed by a standardized patient). The patient’s family member was aware that something had happened but not of the details, so the first question I asked her was “Can you tell me what you understand about what happened to your grandfather?” It gave my group a frame of reference for building the rest of the conversation because we had a better understanding of where she stood. One of our follow-up questions was, “What are you most worried about for your grandfather?” and we were surprised to discover that her worries were not the same as ours. We quickly shifted gears to address her concerns, and during the debrief she mentioned how glad she was that we were able to “meet her where she was” during the conversation.

One common thread I’ve noticed through working in health literacy, going to Telluride, meeting with folks at my school/hospital, and participating in that interdisciplinary session was that even though patient-centered care seems obviously correct and intuitive, it is still challenging to achieve. I can tell that providing safe, effective, patient-centered care will require diligence, flexibility, and teamwork from a variety of health professionals–and in doing so, I believe we can honor patients for the giving us the privilege of being a part of their lives.

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