Telluride East Final Reflections: Never Stop Improving

When I began medical school, my academic mentor advised me to be cognizant of when the more experienced would drop pearls of wisdom.  Well during these past 4 days it’s been raining pearls.  After trying to absorb so much knowledge, my brain feels like an overfilled suitcase with a weak zipper; it’s about to burst.   And therein may actually lie a problem.  To those with less clinical and formal patient safety experience, Telluride covers too much information in too little time.  Many of the activities and discussions felt rushed.  Here I present an open, honest critique of the Telluride program and make suggestions for improvement.

I will focus on 3 observations: 1) The negotiations, listening and human factors lectures were some of the best received, 2) Group exercises/games are highly beneficial and are worth the time expense, 3) People felt that there was not enough time for discussion.

Telluride promotes discussion between those of vastly different disciplines and experience levels.  The benefit is the plethora of viewpoints from the resulting diversity.  However, the challenge is creating lectures that can be informative for such a diverse audience.  Many of the experienced nurses were already well-versed in tools and  concepts such as SBAR, TeamSTEPPS, Just Culture, etc.  Therefore, although I as a medical student was overwhelmed with information, this was just review for many others.  The lectures that garnered universal interest, due to their novelty to all parties, were the non-clinical lectures.  I heard both the inexperienced and the experienced alike wishing they could have heard more of or done more activities with the negotiations, listening and human factors lecture.  Going along with this, there was unanimous praise for the efficacy and utility of the exercises done in Telluride such as the dominoes and see-saw.  Although activities such as these are time expensive, they are fun, and more importantly, effectively get the message across.  There should be more of these exercises.  One suggestion for a listening and retention exercise would be to have one person explain a very abstract topic, such as computer algorithms, to another and see the amount of retention.  This would model the feelings of a health illiterate patient listening to medical jargon.  Finally, several felt that there was insufficient time given to discussion.  This may have been due to incorrect expectations of what is Telluride.  A couple students had voiced that they expected Telluride to be more of a think-tank and were excited to brainstorm and interact closely with such titans of patient safety.  Instead they felt that this was too focused on didactic lecture.

Based on these observations here are my suggestions for improvements.  First devote each morning to a single topic.  For example one morning for negotiations, the next for human factors and the next for listening.  With each didactic lecture include 2 – 3 activities/games for each topic (like a dominoes, see-saw, parker-gibson, etc.).  Then save the entire afternoon for small group (~7 people) discussions devoted to brainstorming solutions to a selected patient safety issue (informed consent, decreasing central line infections, patient call buttons, etc.). Ideally within each group would be at least one person not from healthcare that has suffered an adverse event.  Finally end the day with each group sharing their proposed solutions or progress with the rest of the groups and opening the floor to comments.  These problem specific discussions have several advantages: 1) Allows for close faculty, student interaction, 2) It gives something specific and concrete that people can take away from the conference and work on.  This is especially important for the students who need some guidance as to a specific area to focus on in the vast realm of patient safety.  3) Finally the research collaborations that stem from these discussion ensure continued communication between various Telluride scholars.

Telluride has been one of the best learning experiences I’ve ever had.  I just hope these comments will be able to further improve upon the awesomeness which is the Telluride experience.

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4 Responses to Telluride East Final Reflections: Never Stop Improving

  1. As a patient, I am sad and appalled that there is such need to teach the science of safety to the medical world. We naively assume that we need not worry about our own safety as we enter the hospital, or increasingly, go to some outpatient clinic, only too often to be put at risk of greater harm. As a nation, we are hearing the stories, and coming to distrust the very system we should be able to rely upon.

    Inevitably, it is due errors of communication between the parties, with the patient silenced or dismissed, that the disasters arise. When there is true respect for the patient, that respect will also flow between the medical parties, facilitating communication and the willingness to learn from one another. That will have greater impact on all the decisions, and no doubt improve the outcomes dramatically.

    • Tracy Granzyk MS says:

      Peggy,
      Thanks so much for taking the time to comment. The Telluride Patient Safety Roundtable is filling a gap in health sciences curricula that includes some of the very topics you mention. The group here is part of the choir to which you add your voice. I truly believe it is with the aid of the patient voice that we can move these ideas forward faster. Continue to share your thoughts and ideas here, or at http://www.EducatetheYoung.wordpress.com
      Warmest regards,
      Tracy

      • Tracy, I became a health care advocate after my own delayed diagnosis, which endangered my life. A desire to get cosmetic eye surgery led to a blood test, showing a hemoglobin of 6.6, explained away as due to a “Tiny scabbed-over ulcer”. Eight months later, after many iron pills, endoscopies, iron shots and more, an ultrasound showed a 9x10cm kidney tumor, and thereafter a CT scan showed my lungs to be full of tiny mets.
        Now nine years later, and healthy, I try to be the voice of the patient in educating others how to advocate for oneself. Education is empowering for all, and especially for the newly diagnosed cancer patient.

        But who knew that one’s basic safety was at risk from the hospitalization? Who knew that you had to protect yourself from you caregivers at a medical facility? Now only can earlier and accurate diagnoses impact countless patients and save live, so can the simple adherence to basic safety guidelines and communication. Do be aware as you go forward of the value of letting the patient help. The resource offered by the patient, entrusted to the system and the providers, is a resource for all. Let us help.

        My blog at http://www.peggyRCC.wordpress.com is my contribution to the kidney cancer patients, done in recognition of the help I received, and in memory of so many who passed too early in their lives

      • Tracy Granzyk MS says:

        Peggy,
        Thanks very much for your comments. You are definitely among like-minded healthcare advocates here. We have an amazing network and are trying to elevate the voice of the patient on a daily basis. You can also find us at http://www.educatetheyoung.wordpress.com! So glad you found us, and so glad you were able to successfully navigate the healthcare system. I know how it feels to want to empower others with that same knowledge —
        Tracy

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