The best advocate

By John Joseph, MS2 Wayne State School of Medicine

We completed the first day of the Telluride Patient Safety Summer Camp and I can say already that I am so glad I took the time to make the trip out. Telluride is a beautiful place and the enthusiasm and passion of the participants and leaders has reignited my interest. The lesson that stood out the most to me today was the video put together by Drs. Mayer and McDonald on the heartbreaking case of Lewis Blackman. His mother, Helen Haskell, fought tremendously for Lewis while he was in the hospital (and she continues to fight the system that killed him to this day) after a routine surgery. She trusted her instincts that something was wrong and repeatedly pushed for more senior physicians to examine Lewis, over and over and over. I was shocked that despite her insistence, that her requests were not honored. I was also horrified to think that if this type of cascade of errors can persist when the patient has a vocal advocate like Helen, what must happen to patients that are alone or do not have advocates that feel comfortable or able to question at all? How many children and adults have died because they did not have someone on their side? This hammered home the need for patient advocates and I look forward to learning more about their roles and implementation later in the week.

Lightbulbs and Helpful Advice from Day 3 of Telluride Patient Safety Roundtable

A lightbulb: Today we discussed the importance of including patients at risk analysis meetings and as members of QI teams because they keep us honest.  I couldn’t agree more and also realized today that there are things that happen and are said within the health care setting that I would have found appalling prior to entering medical school.  But somewhere along the way (probably most profoundly during third year) I lost sense of this.  Things I should find egregious I don’t.  Here is where we absolutely need patients and members of the community to provide a reality check and put us back in touch with a perspective we can’t always access any more.

Helpful Advice from David Mayer as I begin applying to residency programs and want to find one in which I will continue to learn and be pushed around issues of patient safety and QI:

A) Ask the residency program two specific questions

1) Do you have a simulation center?  [This will allow you to gain mastery of skills vs. just minimal competence.]
2) Can you show me your resident QI curriculum?

B) For the programs that are your most serious and realistic choices, arrange to spend a day before or after your actual interview rounding with a team.  This will truly allow you to assess how they communicate.

Thanks Dave!  Would very much appreciate additional advice from anyone else who has ideas on this topic!

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