Additional Day 3 reflections from faculty and residents follow:


By Patrick Smith MD

Day two of this conference was another amazing experience. I continue to be constantly surprised and impressed by all of the participants at this conference. It is very humbling to be in the presence of people of such outstanding quality with firm convictions to make the health care they give the best and safest it can be. I commend everyone on their character, heart and innovation. These people are inspiring in every sense of the word.

By Ann Lambrecht, RN, JD, FASHRM

Today was again very enjoyable.  Each component served as a foundation and building block for the next session.  The team building exercise was a profound learning experience.  The films raise real issues and the residents were so responsive in developing solutions. I am thoroughly impressed with these future leaders and the faculty so willing to assist them.

By Joan Lowery

Today was a touching and challenging day as the residents grappled with the seriousness of their work. Dealing with life and death on a daily basis and doing one’s best to help patients is challenging enough. But, it is compounded by old hierarchical structures defining who can say what to whom and when. It would be so much less stressful and safer if transparent and clear communication were the rule and not the exception.

The Lewis Blackman story told in the video, “From Tears to Transparency” was a catalyst for so much rich discussion. Assumptions, habits, lack of communication and poor diagnoses led to the unnecessary tragic death of this 15-year-old who had so much to live for and to give. As Lewis’ mother Helen said, she knew so much more about what was going on with Lewis as she was right there in his hospital room the entire time. But, no one seemed the least bit interested in hearing what she had to say.

Dealing with the aftermath of a death caused by medical error is so crucial on so many levels. Yet so often it’s not addressed in any comprehensive way by the care giving team and the hospital administration. It leaves big scars for everyone.

Honest, clear, respectful communication, team work and systems thinking are key to patient safety. Thank goodness this group of dedicated, idealistic and passionate medical residents is committed to doing what’s necessary to make healthcare delivery a much safer and more satisfying experience for patients, their families and their profession.