Today has been an exceedingly informative and moving first day here in Napa! My hope in coming to this conference was to challenge myself to think critically about patient safety issues and garner the skills to create meaningful change when I head back to school in a few weeks. 

One of the most interesting realizations for me from today occurred during the domino game. For those who may not be aware of the domino game- there are three roles: the doctor, the nurse and an administrator. The doctor is looking at a picture of dominos oriented in a specific fashion and giving instructions to the nurse who is trying to replicate the image with an actual set of dominos. The administrator oversees the game and keeps track of the time. The game was repeated 3 times, each time rotating roles, and slightly changing the instructions. In the first round, only the doctor was allowed to talk; in the second round, the doctor and nurse were allowed to plan for 2 minutes before beginning; and in the final round, the doctor and nurse were able to communicate freely. 

What I found extremely interesting and highly applicable to medical practice was that on the final rotation in which the nurse was allowed to ask questions to the doctor, not only did accuracy increase to 100%, but efficiency increased significantly as well. I think this speaks volumes about the importance of creating a culture in which all members of the team are comfortable speaking up and asking questions. Oftentimes, members of the medical team may feel uncomfortable asking clarifying questions out of fear of “wasting valuable time” or being an annoyance. However, I feel the domino game was a great example of how taking the time to ask those questions actually results in a more efficient and effective process. Not only does this eliminate potential patient safety issues due to miscommunications, it creates a positive culture and confidence within the team. 

This was just one of the many activities and stories that have impacted my thinking thus far. I’m very much looking forward to the next few days!