Resident Reflections: Day One at #TPSER9 2013

IMG_1635Following are reflections by resident scholars after a motivating and moving first day in Telluride, 2013! Thanks to all who have shared their thoughts so far. Keep the great ideas coming–

By Michelle Espinoza

Just finishing my first 24 hr call as “the” senior resident and Chief, I began my journey into Telluride completely exhausted.  I was fully aware of my limitations as a human being,  and my heart was still pounding thinking about the 18 patients whose lives had been entrusted to me overnight. However, I was joyful. I was not only going to a beautiful place that seemed to be the inspiration for all of  Bob Ross’s masterpiece paintings, but also a place where I had hoped to develop and mature as a doctor–“Doctor” as defined by its rudimentary latin origin, “to teach”.

However, today’s experience was life changing. Today it was reaffirmed to me why I had decided to make medicine my vocation. You see for me, Medicine is not just a career, it is a God anointed life calling. To be here in Telluride is truly a blessing, and to be surrounded by such knowledge, talent, wisdom and passion is AMAZING.

Today I learned that I am not alone in thinking our hospitals are one of the most dangerous places for patients. That my internal conflict regarding my concerns for residency training is not isolated to my hospital, and that there are people who not only believe this is wrong, but have dedicated their lives to making a change. It’s divinely inspiring and I can’t wait to see what the rest of the week brings.


By Heather Batchelor

After the first day at the Telluride Patient Safety Resident Summer Camp, the same word encompasses my awe as I was riding up the mountains to the gorgeous view that awaited us at Bear Creek Lodge yesterday: Wow.  Today was such an incredible experience of sharing and learning from other residents and leaders in quality and safety.  Already my expectations from this week have been surpassed.  Today’s most moving moment for me was watching the video of Lewis Blackman story.  The discussion that this emotional film triggered was truly remarkable and I appreciate my colleagues sharing their experiences without fear or hesitation.  The most striking thing I have found from discussions both inside and outside of the classroom, is that even though we are from all areas of the country with varying backgrounds, we all face very similar barriers when it comes to patient safety: hierarchical culture of medical training, honest communication, and implementing change.  Today set the tone for the rest of the week, and I am excited to learn from all of our differences and similarities in how we can all make positive changes for patients, families, and colleagues.

Sometimes the best conversations happen in a gondola

Day one in telluride proved to be educational and inspiring. The negotiations piece by Paul Levy was interesting because I have never thought about how apparent negotiations are in our day-to-day lives. I also was never aware of the components of negotiation skills or their application to medicine. What an important life skill that I can continue to practice. C.U.S. is a new acronym to me but something I can see being easily applied to our new intern orientation next week. There were so many passionate and inspiring comments in the room. After a full day at the intermediate school I think we were all excited to share our passion and our personal experiences with patient safety and quality improvement at our home institutions. I had a great gondola ride with my fellow residents and I can sense a spark lit within all of us. I am looking forward to the week ahead!

Conflict Resolution at #TPSER8

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Shelly Dierking is leading a workshop in conflict resolution today at the Telluride Patient Safety Educational Roundtable and Summer Camp. Residents are using role play of cases to highlight where conflict management breaks down and how best to build it back up.

What is coming to light is that there is variance that needs to be managed on a daily basis, and without teamwork and systems in place to manage and support those at the front lines, it’s only a matter of time before a tipping point is reached and the patient suffers. Not to mention the care providers who have the best of intentions, are human and who suffer along with their patients when an error occurs.

Telluride Day 1 Reflections

Dave Mayer and Tim McDonald opened the 8th Annual Telluride Patient Safety Educational Roundtable and Summer Camp. This being the eighth year the pair have taken time away from busy academic appointments, clinical responsibilities and family to continue to push forward in educating new physicians along with faculty on the just culture they know will make healthcare safe for all of us.

The residents and faculty were introduced to one another, and then we quickly moved into the week’s agenda starting with all viewing From Tears to Transparency: The Story of Lewis Blackman — a striking example of why we are all here and why there is still so much work to be done.

The residents kicked off the week sharing how some of their current environments were aware of the need for open and honest communication, yet failed to provide the support when an opportunity to have that conversation with a patient actually arose. Another mentioned the mainstay Morbidity & Mortality (M &M) conferences failing to address the real story, or even address the cases that could have been true teaching moments. In response, another resident shared that their institution had moved from the traditional M & M to a Quality Improvement conference. This is just touching the surface of the type of conversations Telluride engenders in a roomful of people intent on changing the medical culture for the good of the patient and those who work within in it.

The afternoon was filled with an excellent workshop on Negotiation, led by special guest faculty, Paul Levy, who broke new ground in transparency in healthcare while CEO at Beth Israel Deaconess Medical Center when he started a blog, Running A Hospital, and posted quality metrics online for the world to see. A wonderful summary of Day One in Telluride can be found on his blog as well.

Key take aways on negotiation from Paul’s workshop include:

  1. Understand your BATNA (Best Alternative To A Negotiated Agreement).
  2. Both parties can be made better through effective negotiation.
  3. Solving their problem is part of your problem.
  4. Create value in negotiation.
  5. Never threaten in negotiation but degrading the other side’s BATNA is fair game.
  6. Invent options–Learn about the other side’s interests.
  7. There are commodities, things, decisions with different value to parties in a negotiation–you can trade on those differences.

And finally, the day ended with a team building game that required new colleagues to work together through communication and system design in the best interest of our egg-headed patient.

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