It was only a matter of time before the Telluride Experience, which began as a labor of love by healthcare leader, Dave Mayer MD, almost twelve years ago came to Sydney, Australia. Kim Oates, MD, a local healthcare leader, Telluride faculty member and another who leads with love in the healthcare workplace, championed the experience for young healthcare professionals on the third continent this year.
Dave and Kim are two healthcare leaders who know what it means to put the patient first, what patient centered care really means, and they put that knowledge to the test in real life practice. Another gift both leaders possess is the ability to gently teach and guide, without sacrificing principles. They understand how hard it is for healthcare learners to rise above the medical culture because they have lived it. Today, Kim shared that the three hardest words in medicine are, “I don’t know,” and “Please help me.” Dave openly shares his own experience of being on the wrong side of medical harm when he was a resident physician. They both care deeply about patients. They also care deeply about educating young healthcare professionals to not only protect patients, but to also ensure these well-meaning nurses and doctors stay safe as well.
Healthcare needs more leaders like Kim and Dave, who lead with love. They never have to question the right and the wrong of a situation. Their hearts are their true north.
For more information on how to learn alongside healthcare leaders like Dave and Kim, as well as take home the lessons of the Telluride Experience, go to www.telluridesummercamp.com.
Today marks the first time our Academy for Emerging Leaders in Patient Safety (#AELPS16) goes global with our “Telluride Experience” Patient Safety Summer Camp curriculum kicking off in Doha, Qatar from March 23rd – 26th. A number of our faculty traveled from Washington, DC, Chicago and Denver to Doha yesterday to collaborate with health science leaders from Qatar in bringing our four-day Telluride Experience curriculum to many of the country’s current and future healthcare leaders.
In addition to our four-day safety camp, we will also be leading a faculty development program so healthcare leaders from Qatar can continue offering their own “Doha Experience” patient safety curriculum to future healthcare leaders on an annual basis. The collaboration is being sponsored by WISH – the World Innovation Healthcare Summit and the Qatar Foundation for Education, Science and Community Development.
The Telluride Experience team is very excited about being in Qatar, and are looking forward to the growing number of international collaborations ahead of us, with those who also believe ensuring the highest quality, lowest risk healthcare to the communities we serve requires Educating the Young – our future healthcare leaders.
Our final session of the 2015 Telluride Experience kicks off in Napa, CA this week. Once again, the learning began by sharing the Lewis Blackman story, and we were fortunate to have Helen Haskell as part of the faculty to lead discussion after the film, along with Dave Mayer. Having been part of the team who created the film, and having viewed it more times than I can count, I am always in awe of the new ideas each viewing inspires. A large part of that inspiration arises from the conversations and stories that are shared by attendees after they hear the story.
Today, there were many excellent comments but it was something Natalie B, a nurse practitioner and educator, mentioned about the fear junior healthcare professionals hold of getting chewed out by healthcare leaders that often prevents them from speaking up when they are unsure. (See her post Transparency and Vulnerability=Scary! on the Telluride Blog). The second inspirational comment came from our newest faculty member, Kathleen Bartholomew, also a nurse, who pointed out the need for a greater sense of urgency around adopting a culture of safety above all else. She continued by pointing out that 900 similar case like Lewis’ occurred in the single day and a half since our group arrived at this meeting.
This begs the question that, shouldn’t delivery of care always be about putting the patient first versus the care provider’s ego or fear of jeopardizing a career? This phenomenon is far from limited to trainees too, which is of even greater interest. Perhaps an interesting model to consider would be to have medical and nursing schools recruit, train and accept only the most courageous students versus those with the best MCATs or test scores. It would be nice to weed out those who would/could put their own professional well-being before that of their patient at any level.
The reminder of the need for a greater sense of urgency was both valuable and validating. There have been times when it has been hard to watch Lewis’ story yet again, knowing errors related to healthcare hierarchy and culture continue to occur again and again. Helen shared that on November 6th, it will be 15 years since Lewis died–was killed–if we’re being honest. She pointed out that all too soon he will have been gone from her life longer than he was alive. This is a hard fact for all of us to hold.
One of the greatest values to the Telluride Experience is infusion of the mindfulness and ire into the minds of young healthcare trainees that comes from hearing these stories. It is both that will be needed for real change. We need providers at all levels of training who are more afraid of harming a patient than of being chewed out by a dysfunctional healthcare mentor. I would challenge those going into healthcare, as well as those already in healthcare, to be prepared to put the patient first, always. Those who are unsure this is something they can do might want to consider a different career path.
Whether or not Tiger Woods is deserving of being called a role model, the body of work he has accumulated is worthy of admiration, especially by younger players like Rory McIlroy. What caught my attention about yet another inspiring Nike commercial, wasn’t so much the role model himself, but the reminder that others are watching and learning from the actions of those put into a leadership position–regardless of how deserving.
In healthcare, as in sport, skills and technical acumen are only part of the equation, though often they can take many onto a stage and into the spotlight exposing behavior and character far less developed. Like McIlroy, those with talent coming up the ranks in sport can often drive their own destiny with dedication and committment. Athletes can stay a safer distance from those who have gone before them than young learners and junior healthcare professionals. But these young professionals too can drive their own destiny, and shape a new set of expectations for what success looks like in healthcare. Here’s a shout out to our Telluride Alum on this Friday!
*In the event the video is pulled, you can find it on YouTube — Nike Golf, Ripple
Over the last few years, we have written about the vital importance of Care-for-the-Caregiver programs when unintended patient harm occurs from a medical error. As caregivers, the willingness to admit our humanness, as well as our ability to make an error, helps us reframe the recovery and learning process when these events tragically occur. All too often, we have turned away from our fellow colleagues, or worse, blamed them at a time when they needed our support the most. We all know of stories where good, caring healthcare professionals have taken their own lives after unintentionally harming a patient. As a profession, we need to do better.
I encourage everyone to read an outstanding two-page opinion piece in JAMA titled “What I Learned About Adverse Events From Captain Sully – It’s Not What You Think”. Written by Marjorie Podraza Steigler, a fellow anesthesiologist, the article should cause all of us to stop and rethink this important question. An emotional toll on physicians and nurses may occur even when no error was made, and the care team responded with precision during a major patient care crisis. As a cardiac anesthesiologist, I think of emergent, high-risk cases that went for hours, and while the outcome may have been good, the team was physically and emotionally drained afterwards. All of us, however, were usually expected to immediately return to the operating room for the next case often without time to process what had just occurred.
As Dr. Steigler correctly points out:
The contrast between the immediate removal from duty for those involved in the Miracle on the Hudson and the expectation that permeates our hospitals is stark. In both cases, the safe care of the next “customers,” whether they be travelers or patients, is at stake.
We have to do better for ourselves if we ever expect to do better for our patients.
“If transparency were a medication, it would be a blockbuster, with billions of dollars in sales and accolades the world over. While it is crucial to be mindful of the obstacles to transparency and the tensions—and the fact that many stakeholders benefit from our current largely nontransparent system—our review convinces us that a health care system that embraces transparency across the four domains will be one that produces safer care, better outcomes, and more trust among all of the involved parties. Notwithstanding the potential rewards, making this happen will depend on powerful, courageous leadership and an underlying culture of safety.”
The previous paragraph comes from the fifth and final National Patient Safety Foundation’s Lucian Leape Institute (LLI) White Paper entitled, “Shining a Light: Safer Health Care through Transparency”. Each of the five white papers address key issues that healthcare stakeholders will need to successfully manage if healthcare is to achieve zero preventable harm. I was honored to be part of the panel that helped create this paper and the 39 recommendations for greater transparency throughout healthcare.
Defining transparency as “the free, uninhibited flow of information that is open to the scrutiny of others”, the paper provides recommendations in four different domains of transparency:
- Transparency between clinicians and patients (illustrated by disclosure after medical errors)
- Transparency among clinicians themselves (illustrated by peer review and other mechanisms to share information within health care delivery organizations)
- Transparency of health care organizations with one another (illustrated by regional or national collaboratives)
- Transparency of both clinicians and organizations with the public (illustrated by public reporting of quality and safety data)
I encourage everyone to visit the LLI website and download the White Paper (click here for a copy). Increased transparency is critical to any Patient Safety mission. Greater transparency throughout the system is not only ethically correct, but will lead to improved outcomes, fewer errors, more satisfied patients, and lower costs.
Leadership is not so much about technique and methods as it is about opening the heart…about inspiration–of oneself and of others. Great leadership is about human experiences, not processes…it is not a formula or a program, it is a human activity that comes from the heart and considers the hearts of others. It is an attitude, not a routine.
Secretan’s teachings are based on the core principle of connecting the soul with what we consider as “work”– the two becoming intertwined in a way that redefines our “work-life” balance, making both truly fulfilling. It combines our inner passion to make a difference in someone’s life with our reason to get up each morning and go to “work”.
Each day in healthcare we are given the opportunity to make the world a better place—for our patients, our colleagues and our communities. As healthcare providers, we entered into our profession to care for others–to keep our patients safe at all costs while under our care. Think of the healing power that could occur not only in our healthcare workforce, but also in our patients, if leaders created care environments that were truly places that nurtured the soul.
Rosemary Gibson said it best when she paraphrased Gandhi, reminding us: “A patient is the most important visitor on our premises. They are not dependent on us – we are dependent on them. They are not an interruption in our work – they are the purpose of it. We are not doing our patients a favor by serving them, they are doing us a favor by allowing us to serve them.”
Can healthcare leaders create a work environment that reflects and honors the creative spaces of the soul and brings passion back into our daily work? Can healthcare leaders inspire caregivers to connect with their own inner values in helping health systems achieve the highest quality, safest care possible for both patients and caregivers?
As we move into the New Year, I am hopeful we can all “lead from the heart” in ways that inspire ourselves and others to achieve the highest quality, safest care possible for our patients and our caregivers.
Wishing everyone a healthy and happy new year.
After a brief hiatus for the #IHI26Forum, and in preparation for launch of Using Stories to Influence Change in Healthcare as an Amazon eBook, we are back online! With all the repeat hits to our ETY storytelling posts, it seemed of value to put them in a collection along with some of the ‘how and why’ storytelling has become of even greater value in healthcare. Here is the link if interested in having all of the storytelling posts in one place along with new commentary. From the description:
…as long as there are patients who fall victim to preventable harm in healthcare, there are healthcare professionals who also have a story rich in learning material from the other side of the bedrail. Both sides of the patient harm story will need to be embraced by healthcare leadership in order to achieve the delivery of reliable, high-quality, safe care everyone desires. Because the numbers harmed by healthcare have at the very best plateaued, an urgent need to pick up the pace for change remains. Sharing the stories of patients and healthcare professionals on a larger and more strategic scale throughout the industry will allow others to learn vicariously from mistakes as well as successes, building upon the positive momentum found when utilizing storytelling as a medium for change. Once again, our stories can provide the guiding light leading us into a new world for healthcare—where the patient voice is welcomed, and healthcare professionals are allowed to speak their truth.
And finally, our healthcare stories also serve many masters. When patients share their story of illness, they heal. When families tell stories of loss, they grieve. When healthcare professionals relate stories of guilt or near misses, they unburden their souls and can fix what is broken in health systems, enabling them to once again care for others as intended. Freedom to tell our story has always been a way to health and happiness. Using Stories to Influence Change in Healthcare is a jumping off place for those interested in learning more about how stories are being used in healthcare, and why they hold the power over us that they do. Tips from expert storytellers on how to craft good stories, as well as a glimpse into the science of story round out this introductory collection on using stories in healthcare…
Over the course of history, many young entrepreneurs have changed the world. Be it in the technology arena like Bill Gates, the social media world like Mark Zuckerberg or the newest Nobel Peace Prize co-winner, Malala Yousafzai–real change has been created by young leaders who envisioned a better way. These creative thinking young entrepreneurs are also leading change in healthcare. While their vision and action as patient safety advocates and role models may not send financial ripples across Wall Street, or redefine how we communicate with one another just yet, their efforts will save patient lives.
Over the last two years, ETY followers have read many stories about quality and safety projects being led by resident physician and health science student entrepreneurs, many Telluride Patient Safety Scholars and alumni. The attached video highlights another example of these young leaders in action, role-modeling the use of resilience tools that will make care safer for our patients. Daliha Aqbal, Telluride alumna and a medical student at the Georgetown School of Medicine, role models two resilience tools to over 300 faculty caregivers–the use of Safety Moments, and an example of “Stopping the Line” to validate and verify information when something doesn’t feel right. While many of these young leaders may not win a Nobel Peace Prize, they are truly helping change our safety culture as they lead by example.
No introduction necessary, though I did have to watch it twice to get the entire message because I was too taken in by the sad yellow lab.