Having spent the past year as a chief resident in quality improvement and patient safety, I’ve come to the conclusion that QI is at most times frustrating, at many times defeating, and, in sweet but rare moments, enriching. This has been my (limited) experience, at least. Working inside an institution that has been under intense scrutiny for its quality and safety issues, rarely a day passes in which I’m not pulled into a discussion about a recent safety event, near miss, or upcoming meeting with hospital leadership regarding a root cause analysis. Perhaps my sense of disappointment stems from the fact that meaningful, systemic solutions to the problems our institution faces are almost invariably faced with inertia and a lack of buy-in from involved parties.

I maintain hope for the future of quality and safety because it is still a relatively new phenomenon, at least in the field of healthcare. This means that culture shifts will very likely take a generation or more of physicians to pass to become a fully integrated part of medicine. It will most certainly occur during the course of my career.

Day one of Telluride is complete, and it is invigorating to be surrounded by like-minded individuals who believe in the principles that will one day be commonplace. It is heartwarming to hear the empathic and passionate voices of the senior faculty who have dedicated their careers to “fighting the good fight.” I hope to join their ranks as my career begins.