Before I started medical school, I spent a year working at a free clinic in Moab, UT. If you aren’t familiar, Moab is a small town of about 5,000 people sandwiched between Canyonlands and Arches National Parks–some of the most stunning landscape in the world. At the Clinic, we serve the many people who work to keep this popular tourist town (it has over 2 million visitors per year) running. As a first year medical student, I don’t have a ton of experience working on the hospital floors, but in Moab I worked as part of a two person staff where I coordinated our clinical volunteers and was the main point of contact for most of our patients’ follow-up care.
At the time, we were a clinic run entirely by non-medical personnel, so we rarely used the vocabulary of quality improvement and patient safety that I’ve since learned in medical school and in the first few sessions of the Telluride Summer Camp. However, I’ve come to realize that we prioritized patients’ needs, primarily through open communication between volunteer providers, clinic staff, and patients about the plan of care. We didn’t necessarily have protocols–we all sat as a team and discussed each case and each team members’ responsibilities. Much of this was done on the fly, but we seemed to have a pretty good system for making sure folks didn’t fall through the cracks.
Our strength as a small clinic (we see about 1,500 patients per year in about 5,000 visits) is our flexibility with each case–the Clinic was started by folks who were unable to find affordable health care themselves. Because of this, patient care has been more than the buzzwords of “patient safety” and “effective communication”–it is ingrained in our history. As a board member at the Clinic, I’m excited to take back what I learned from the TSC. Especially as we continue to expand (we now have five staff members) and provide more services, we have more opportunities for mistakes and miscommunication. It also leaves a lot of room for innovation and improvement. For better or worse, I find it difficult to get too excited about change at a large institution like the University of Wisconsin, but I feel empowered to continue working with the Clinic so that we can continue to provide the best patient-centered care.