Post Telluride Reflection by Matt Starr #TPSER8

I finally was able to get my burrito, but not without trouble. We showed up to town after a long afternoon of biking down the mountain around 5 pm. The problem with that is the taco stand closes at 5 pm. So I raced over to the stand only to find it closed, but the back door, which also served as the entrance, was still open. I ran up to it and asked the man inside if he would make me anything that he hadn’t put away for the day or ran out of. He agreed and made me a burrito and I had no idea what was in it, but I loved every bite. I cannot wait until I get to come back to Telluride again, this place is by far one of my favorite places to visit in the world; the people, the food, the atmosphere, it is truly an amazing place.

My ‘aha moment’ happened when Tim pointed out to me the obvious distinction between the airline industry and medicine. Yes, hospitals should be more like the cockpit, but every time a pilot makes a mistake, it is most likely going to cost that pilot his/her life. However, if a physician makes a mistake, it will most likely cost that patient his/her life. That is why the airline industry has always been faster at implementing change, they major stakeholders in the decision making process are risking their livers with each error being made.

Dr. Angood had been hinting to me all week the problems associated with this kind of standardization in medicine. Medicine and aviation are very similar, but also very different. Every medical case is different in some aspect than the previous. It can be very beneficial to streamline the major processes, but the doctors can’t be afraid to deviate from the standardization because it is very hard to categorize each patient that comes into the hospital into distinct groups.

This past week was a great opportunity to meet some really great people while learning about patient safety. I can’t speak for everyone, but I think most of us really made some great friends here and created a network that will allow us to transform our medical schools and hospitals into safer institutions. I learned a great deal about the current problems the field of medicine faces in terms of patient safety. It seems that every field can improve greatly and every allied health profession (nurses, PTs, OTs, PAs, etc.) can greatly improve…that’s a lot of room for improvement. But I think this conference was the first step in creating the network that we can all build on in the future as we seek to improve patient safety in all of our respected fields.

-Matt