Telluride Day 1 Reflections

Dave Mayer and Tim McDonald opened the 8th Annual Telluride Patient Safety Educational Roundtable and Summer Camp. This being the eighth year the pair have taken time away from busy academic appointments, clinical responsibilities and family to continue to push forward in educating new physicians along with faculty on the just culture they know will make healthcare safe for all of us.

The residents and faculty were introduced to one another, and then we quickly moved into the week’s agenda starting with all viewing From Tears to Transparency: The Story of Lewis Blackman — a striking example of why we are all here and why there is still so much work to be done.

The residents kicked off the week sharing how some of their current environments were aware of the need for open and honest communication, yet failed to provide the support when an opportunity to have that conversation with a patient actually arose. Another mentioned the mainstay Morbidity & Mortality (M &M) conferences failing to address the real story, or even address the cases that could have been true teaching moments. In response, another resident shared that their institution had moved from the traditional M & M to a Quality Improvement conference. This is just touching the surface of the type of conversations Telluride engenders in a roomful of people intent on changing the medical culture for the good of the patient and those who work within in it.

The afternoon was filled with an excellent workshop on Negotiation, led by special guest faculty, Paul Levy, who broke new ground in transparency in healthcare while CEO at Beth Israel Deaconess Medical Center when he started a blog, Running A Hospital, and posted quality metrics online for the world to see. A wonderful summary of Day One in Telluride can be found on his blog as well.

Key take aways on negotiation from Paul’s workshop include:

  1. Understand your BATNA (Best Alternative To A Negotiated Agreement).
  2. Both parties can be made better through effective negotiation.
  3. Solving their problem is part of your problem.
  4. Create value in negotiation.
  5. Never threaten in negotiation but degrading the other side’s BATNA is fair game.
  6. Invent options–Learn about the other side’s interests.
  7. There are commodities, things, decisions with different value to parties in a negotiation–you can trade on those differences.

And finally, the day ended with a team building game that required new colleagues to work together through communication and system design in the best interest of our egg-headed patient.