JKF Journal

Thursday, February 26, 2009

IHI On Call: Talking with Nursing and Medical Students

The first time that I ever spoke to a room full of medical students was a few years ago at Johns Hopkins. I told them Josie's story and at the end of the talk I asked them if they had ever head of the Institute of Medicine's report "To Err is Human". No one raised their hand. I remember feeling shocked that these students- who were taught how to cure diseases, deliver babies and mend broken bones- were not being told about one of the leading causes of death in our country- medical errors. The more medical and nursing students to whom I talked, the more I realized that it was indeed a rarely discussed topic. I found this frustrating and confusing. Since then I have tried to talk to as many medical and nursing students as I can. These young minds are the next generation, and if I could make a tiny difference in how they would care for their patients by sharing Josie's story then I was going to do it.

I am grateful to the Institute for Healthcare Improvement (IHI) for creating the Open School (www.ihi.org/openschool). The Open School is a great resource for medical and nursing students to round out their patient safety education. They offer free courses in patient safety and quality improvement, sponsor essay contests, and host safety conferences for students of the health professions. Each month the Open School offers an On Call teleconference lecture, in which a guest speaking talks about a topic related to patient safety. Students from all over the country listen in and learn. I don't believe anything can take the place of a classroom with a professor, however this may be the next best thing.

On Tuesday- with the help of modern technology- I sat at my desk in my home in Baltimore and had the honor of talking to a few hundred students from around the country. The session was called "Channeling Grief into Action". Simon Mathews, a medical student at Johns Hopkins, moderated the hour-long session. I shared Josie's story. I explained that Josie didn't die because of one misplaced decimal point, because of one doctor or nurse. She died because of a lack of communication. After I spoke, Simon opened the lines to take questions from callers. I loved hearing from the students and I could tell that they had been moved.

For me it had been an hour well spent. It was my chance to make an impression on these brilliant minds that will take healthcare into the future. It was my chance to remind them of the importance of good communication and the need to create a culture in which reporting errors is considered heroic; a culture where doctors and nurses work as a team to prevent medical errors; a culture where the patient is heard and when a mother says, "Something is not right..." she is listened to. I hope I succeeded in delivering that message.

Thank you to IHI for realizing the importance of getting this information to students. Thank you Deepa Ranganathan for pulling the program together, and thank you Simon Mathews for being a great moderator.

For more information, check out the links below:

-An audio recording and a transcript of the session will be available at www.ihi.org/openschool at the end of the month. This link is also the gateway to all of the information about IHI's Open School.

-IHI's Open School blog (www.ihiopenschool.blogspot.com) has an open conversation about the session where you can post comments/questions. I'll be checking in on the comments and responding to them.

-Want to take IHI's educational programming wherever you go for free? You can subscribe to their informative podcasts at the Apple iTunes Store. Just go to the iTunes Store, search for "Institute for Healthcare Improvement" and click "Subscribe" to download IHI's podcasts.

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Friday, October 12, 2007

With the Medical Students

A few nights ago I spent the evening with 27 Post-Baccalaureate students from Johns Hopkins University. I had been asked by the director to join the students for dinner and then speak to them for an hour or so. I was to be joined by Rick Kidwell, who had been the lead attorney at Hopkins when Josie died and was now at UPMC, University of Pittsburgh Medical Center.

The Hopkins Post-Baccalaureate program is a year long program that prepares students for medical school. Hundreds of students from all over the country apply to this program, with only 42 acceptances for 27 positions. These students have earned their undergraduate degrees with an average of a 3.7 or above. More impressive than their high academic standings are the things they have done after college on the humanitarian level. Each one had an amazing story to tell. Some had spent time teaching in impoverished areas overseas. One spent a year with Dr. Paul Farmer, who is known throughout the world for his work and dedication in the poor towns of Haiti. Another student worked with the world renowned Dr. Benjamin Carson, a Hopkins pediatric neurosurgeon. One student worked as a teacher in the Mississippi Delta and then went on to teach children with AIDS in Africa. These life experiences shaped their young minds and led them to discover what it was that they truly wanted to become. Doctors. It is this dedication to public service, this humility and this selflessness that set these students apart from all others and landed them in the prestigious Hopkins Post-Bac program.

I always find it invigorating to be with medical students. They are so young and eager with bright minds that can be shaped. I can see the future in their eyes, and as I sat at my computer the day before and read all that they had accomplished and all that they had contributed to society and at such a young age, I knew that it was going to be a memorable evening.

Rick and I sat on folding chairs on stage and began our presentation. I started by sharing Josie's story. I broke it down as if it were a case study and watched them as they began to put the pieces together, realizing that a little girl had died at one of the best hospitals in the world, not because of a misdiagnosis or a medication error. It was something far simpler: communicaton, or rather, a lack of communication. I continued to talk about the importance of disclosure, and what it means to a family to be told the truth, to have questions answered and to know that the problem will be fixed. Rick shared the hospital's side of the story. He talked about how doctors and nurses are affected by medical errors. He told the students that when they become doctors, and if they make a mistake always to tell the family. "Don't worry about a potential lawsuit," he said. "That is the job of the risk manager." The discussion led to error reporting systems, family involved root-cause analysis and more. They asked interesting questions, and they shared their thoughts.

Soon these students will be in medical school. They will be inundated with Biology, Chemistry, Physiology. The importance of communication might not be woven into their curriculum. This was my chance to sink a story into their hearts and hope that when they become doctors that they will remember how to listen and communicate. These students are going places. These are the ones who are going to win Nobel prizes and find cures for our diseases. They are going to save lives. I am sure of it. I was honored to be with them I wish them all luck, and I thank them for listening.

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