Shattering the Wall: Imagine Healthcare without Preventable Medical Harm

By Anne Gunderson Ed.D, MS, GNP

Since the official creation of The Academy for Emerging Leaders in Patient Safety: The Telluride Experience in 2009, over 800 health science students and residents have attended one of our immersive sessions.  The program is intended to fill gaps in health sciences education where formal, systematic patient safety and quality curriculum is lacking. Learners leave with the tools, knowledge, support, and enthusiasm to make a difference at their institution or school, and a commitment to make patient safety a focus of their medical careers.  While in attendance, each learner is asked to blog nightly to provide an outlet for their reflections and the impact of its curriculum in their own words.  These powerful glimpses into their thoughts and experiences formed the inspiration for our new book, Shattering the Wall: Imagine Healthcare without Preventable Medical Harm.

Shattering the Wall is a collection of works created by these young healthcare learners and the faculty members who taught them.  Each chapter is deeply rooted in the healthcare domains of safety, quality, and leadership. No matter what type of reader you may be—healthcare professional, health science educator, or a patient who uses health services—this book will hopefully open your eyes to many of the intricacies of our current healthcare system, as well as the challenges faced by all of us in delivering safe, high-quality care. In this book, you will be exposed to first-hand accounts of real-life situations involving learners, professionals, patients, and their families, which reflect the historical background, current state, and lessons learned of each prevalent topic in healthcare practice.  The chapters do not have to be read in order. Feel free to pick a chapter on a topic that intrigues you, or start from the beginning and immerse yourself in a learning experience similar to what our learners experience while attending The Telluride Experience.

The future is limitless for these young leaders. The leaders of tomorrow have the opportunity to create a culture that is safe, and, most importantly, patient-focused. By stretching the boundaries of traditional thinking and acting, learners and professionals can deliver higher-quality care to patients and their families, thus transforming and improving healthcare culture and practices for future generations.

We hope you will accept this work in the spirit in which it was intended: to give a larger platform to the voices of our future healthcare leaders—voices that will carry the much-needed healthcare culture change forward. Our faculty strongly believes in the “Educate the Young” premise – providing the future generation of health care leaders the knowledge, tools, techniques, and behaviors associated with high-quality, safe care.

Whether you are a healthcare learner, a healthcare professional, or a patient or family member interested in learning more about our current healthcare culture, you will appreciate Shattering because we all have one thing in common - we are all affected by the health of our current healthcare system, and we will all, one day be patients.

Please note: Any and all proceeds from book sales will go directly to support future Telluride Scholars in their quest to become the safest, most patient-centered caregivers they can be. We are, in turn, grateful for your support.

Purchase book here: amazon.com

Clinician Education, Mentorship, and Teamwork: Building Tomorrow’s Leaders

By Melanie Powell, MD, MPH

Hello! I am the inaugural fellow in Quality and Safety at the MedStar Institute for Quality and Safety. Over the next year, I’ll provide monthly insights and document my transition from Family Medicine chief resident at one of MedStar’s community-based hospitals to the administrative fellow at MIQS, an institute housed within one of the largest hospital systems in the Northeast United States.

As residents settle into the new academic year, the most common question upper levels face is: “What’s next?” My former co-residents, having figured this out and starting their new positions, now ask, “How did that go by so fast?”

Times of transition are both challenging and incredibly exciting. Trainees across the healthcare spectrum transitioning to independent practice may feel high levels of anxiety, stress, and concerns about inadequacy, isolation, confusion, and fear. This can lead to underperformance, burnout and ultimately compromise the delivery of safe, high-quality care. In response, organizations such as the American College of Surgeons and residency programs like University of Iowa Health Care Anesthesiology developed Transition to Independent Practice Programs to help fill perceived gaps in training. The National Council of State Boards of Nursing recently completed a national study to transition new nursing graduates into clinical practice. Initial results show that nursing clinical competence significantly increased after 9-12 months of participation.

What these programs have in common is mentorship. Mentorship is critical to the development of confident and clinically competent healthcare providers. Typically, it is implied and assumed by residency programs but actualized with varying degrees of value to residents and faculty. Reviewing the ACGME Milestones for Family Medicine Residents, mentorship is mentioned only once (within the description of a Level 5 achievement for professionalism) and in the context of a resident becoming a successful mentor herself. While it’s expected and vital that residents become effective mentors so they may train the next generation of leaders and support their colleagues, all health care providers require guidance to do so.

I am excited to be part of a health system that recognizes the value of mentorship and feel privileged to have been mentored by two very strong women during my Family Medicine residency at MedStar Franklin Square Medical Center. In addition to the research mentorship provided through the MedStar Health Research Institute, the MedStar Institute for Quality and Safety is generating a network of quality and safety mentors to pair with young trainees. Further, the Academy for Emerging Leaders in Patient Safety (AELPS) continues to educate an interdisciplinary group of young trainees in the US and abroad that includes medical and nursing students, connected with each other through a shared love of patient safety and dedication to culture change.

The question we must always ask ourselves going forward is: “How can we improve?” There are abundant opportunities to add to the curricula of nursing/medical schools and residency programs so that future clinicians can start building their skills as early as possible. To do this, we must identify ways to make mentorship, quality improvement, patient safety, and leadership a part of trainees’ everyday experiences. I think this includes encouraging interdisciplinary collaboration whenever possible. We grow professionally and make our patients safer when each front-line voice is heard and connected.

I hope those of you reading this post reply with your insights and share the innovative changes happening at your medical schools, nursing schools, hospitals, and elsewhere.