Breaking down the barriers

The Telluride Conference ended this past Sunday, and within twenty-four hours, I was starting my second year of medical school. I am so thankful to have spent the four days preceding this year learning about patient safety with an incredible group of people committed to putting patients first and hoping to make a change in how we provide healthcare. As I reflect back on my Telluride experience, there is one thing that I keep coming back to. That is the way the barriers between who was a nurse, a resident, a fellow, and a medical student broke down almost instantly. Not only did we get to learn from each other, but we also enjoyed spending time with each other and built relationships with people we may not normally have sought to build relationships with. It was rather remarkable and as my classmates have asked me what the conference was like, I think this is one of the things that captures its essence the best.


During the Telluride sessions, we focused quite a bit on the culture change that needs to happen in healthcare. There is a hierarchy that gets in the way of communication, causes added stress and anxiety to our jobs, and prevents people from asking for help. It allows some people to think they can treat those under them with disrespect, and makes us fearful of admitting to making a mistake. It creates fractures in the health care team and reduces the quality of care we are able to provide that can—and does—harm our patients. It is something that desperately needs to change. We can make all the changes we want to the healthcare system to try to reduce errors, but if we don’t also change our culture then we won’t get very far.


One of my peers said early in the conference, “Everyone is part of the healthcare team until something bad happens.” I remember thinking that was spot on. We all like to say that the nurse, the doctor, the resident, the tech, the medical student, etc. is part of the healthcare team, but do we truly mean it? When that sentiment is tested, such as when a medical error happens, is that how we truly respond? In many instances, the answer is no. We and our institutions often still seek to blame someone rather than support each other in this crucial time. Sometimes when I think about this, it feels as if we have a far way to go in creating a just culture. But then I remember these past four days—how the barriers between us broke down and how we’ll all take what we learned to pass on to our institutions, and I know with small steps, we will continue the culture change.