Telluride Breck – pre-arrival

I chose to attend the Telluride Experience because the farther I get into medical training, the more interested I become in patient safety initiatives. As I get closer to becoming an attending, the reality becomes clearer that I will have to decide for myself how I will practice medicine. Being a proceduralist, I have acquired a huge fund of knowledge from many different people who use different techniques and have different thought processes about similar disease processes and patients. At some point, I will need to distill this information down and decide how I will approach these same problems. Wrapped up in this decision is how to approach procedures in the safest most efficacious way for each and every patient. This becomes difficult in that while data exists for many basic principles, there are many patients who fall outside of prior randomized trial data. Face-to-face discussion with these patients is crucial to mutual decision making and assessment of risk/benefit.

Patient safety is integral to good patient care because patients trust health care workers to keep them safe and help them get better. There are so many things we do nowadays in health care to keep patients safe (e.g., checklists, time outs, double checks on blood, barcodes on medications, automatic alerts in EMR’s for allergies or drug dosages, etc) and once these things are part of a functioning system, they frankly aren’t very difficult to carry out. By not adhering to protocols known to work to keep patients safe, we head toward negligence. Safety is the basis of everything we do. In a procedural specialty, there will inevitably be complications, some of which may cause harm to the patient. However, the frequency of these complications will be directly related to the set point a team creates for itself. If you have a high functioning team focused on error and how to prevent it, the overall rate of complications resulting in harm to patients will be less.