The Real Movie Stars of Patient Safety

By Michael Kantrowitz DO (Guest Author, and Chief Resident at Maimonides Medical Center)

It was exciting to be part of the filming of “Breaking the Wall of Silence” a few weeks ago as the filmmakers followed Dave Mayer up to New York where he met with leadership from the Committee of Interns and Residents (CIR).  The next day they came to Brooklyn and followed me around the hospital where I work, Maimonides Medical Center.  In a paradoxical way it was fun (albeit a little nerve-wracking) to be involved in the filming.  The documentary is casting light on some very serious issues regarding transparency and safety in healthcare and it was a privilege to be able to discuss some of the hurdles residents face in being part of the next generation of physicians who will need to address these issues.  There were a few residents who had “cameos” in the filming, who I also wanted to recognize: Drs. Steven Shamah, Nidhi Shah, and Prasun Shah.  They are three of the incredible residents I get to work with everyday, and are proof that there is a changing cultural tide in our cohort of physicians.  As we were filmed on rounds, we discussed safety issues such as the importance of accurate medication reconciliation and fall prevention.

After participating in the Telluride Patient Safety Roundtable last summer, I have tried to integrate what I learned into my role as chief resident.  As a result, I changed much of how I approach patient safety and care quality concerns involving residents from looking to find individual fault to identifying system failures.  That hasn’t happened overnight and I certainly have not perfected this approach, but not surprisingly I’ve found that it more effectively engages residents in the process, as opposed to putting them on the defensive.  In academic medical centers, residents are the front line physician staff.  They typically evaluate patients before the attending physician, and are often the first to respond to acute changes in a patient’s status.  I’ve always enjoyed the opportunity to beat the attending to the diagnosis or stabilize a patient before they arrive because I think it has led to my own growth and independence as a physician.  With such high stakes, however, it is really important to have a clinical environment in which to identify and learn from errors without fear of reprimand or ridicule.  I’ve been fortunate to train in such an environment alongside colleagues like Steven, Nidhi, and Prasun.

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