A Burning Platform

While I am spending a week surrounded by some of the most gorgeous mountains, the Hide Park wildfires continue to ravage northern Colorado. Despite some of the best efforts of firefighters, the wildfires have consumed more than 58,7000 acres, have forced thousands to evacuate, and have destroyed more than 180 homes in nine days. With continued hot weather and winds, the goal is to contain the fire and minimize as much damage as possible.

With news about the fire on a nearly continuous feed on local news channels, I am reminded of Dr. Don Berwick’s famous 1999 National Forum Speech, “Escape Fire.” In the speech, he describes the 1949 wildfire that broke out on a Montana hillside and how it changed the way firefighting was managed in the United States through the use of an “escape fire.” Dr. Berwick draws the powerful analogy that our health care system is in a similar state of impending fiery disaster in great need of innovative solutions like an “escape fire.”

On our first day of programming at Telluride, we spent little time discussing the obvious that our health care system is sitting on a burning platform. After watching a video about the tragedy of Lewis Blackman, we jumped right into a presentation by Dr. Kim Oates (Fun Fact: Dr. Oates was Dr. Berwick’s Senior Resident at Children’s in Boston) on the qualities of the new clinical leader. Here are some essential tasks of a new clinical leader outlined in Dr. Oates’ presentation:

  • Lead reform in putting the patient first
  • Be a motivator, mentor, and facilitator
  • Be a communicator
  • Be a team leader and team player
  • Demonstrate high level clinical skills and research
  • Manage finances
  • Think critically
  • Monitor one’s own performance
  • Behave in an honest, open and ethical manner
  • Display integrity
  • See the big picture
  • Be able to learn from experience
  • MOST IMPORTANT: put the patient rather than one’s self at center stageThe task that resonated most with me was a reminder to keep the patient at the center. While not a tangible innovative solution, like an “escape fire,” perhaps the concept of patient-centeredness will be the compass towards those solutions.

    I look forward to continuing our discussions as we explore innovative communication strategies tomorrow that we can not only employ, but also share with our fellow students to work together and extinguish our burning platform.

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One Response to A Burning Platform

  1. Carey says:

    Thanks for this post. I was in Telluride last week and really love that your incorporated Berwick and the escape fire, which is so relevant and useful for the work we are doing. I especially like the part of Berwick’s speech describing how the fire crew so identified with their Pulaskis, a heavy combination of axe and pick, while trying to outrun the fire up the mountain. The tools slowed them down and were useless. However, the few who dropped their Pulaskis (dropped their tools) were unharmed in the escape fire. The metaphor of the escape fire can remind colleagues that we need to be trained to understand how new practices work. And old, useless tools need to be discarded. Communication was stress in virtually every one of Berwick’s addresses. So drop the Pulaskis. 🙂

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