A note from one of our senior faculty members in the department of surgery:
As I am sure you are aware, we are in the process of recruiting the PGY-I class for 2009. Many of the candidates schedule their interviews so that they can visit all three Boston hospitals on their “swing through town”. During one interview with a spectacular candidate -- AOA, top of the class, and solid research experience -- was the following question: “BI has gotten a lot of bad press lately, could you tell me about it?”
At first she seemed surprised when the reply was, "I would be delighted." She was told that, I as an individual practitioner, and we as a health care organization realize that, as long as medicine is practiced by humans on humans, there will always be the likelihood for errors. She was told that although we all have a zero tolerance policy for errors, when they occur our obligation to the patient, and to the health care organization, is to learn all we can to decrease the likelihood the same error would be repeated. I then gave her several examples from my own practice over the years.
She admitted that the first step in understanding the factors leading up to an error was the admission of same. She then said that she understood the transparency focus. We left this portion of the interview with the following question: “Do you think errors are occurring in other hospitals, perhaps your own, and perhaps even other Boston hospitals? Perhaps they have chosen a different path to resolution?” The question did not require an answer.
I thought you may find the discussion interesting. Thanks.
To which I add the following open letter:
Dear prospective interns and residents,
Please consider coming to our hospital if you would like to join in our quality improvement adventure. We promise a blame-free environment in which all participants (including trainees) are treated respectfully and as part of a team devoted to eliminating preventable medical errors. For reference, please see the post immediately below, as well as this one and this one.
In short, we teach the science of medical care delivery here, as well as the science of disease. We believe that this has become an essential component of graduate medical education and will serve you well in your career. We hope you agree and will find BIDMC an attractive opportunity for the next phase of your training.