Tuesday, June 12, 2012

Telluride Patient Safety Camp -- Day 1, Part 2

#TPSER8 We continue the saga of the first full day of the Telluride Patient Safety Resident Summer Camp program.  The first activity after lunch was my session on strategic negotiation, focusing on key concepts of negotiation theory.  There was plenty of time for interaction, as I used some classic simulation exercises to demonstrate the ideas of BATNA (best alternative to a negotiated agreement); interest-based rather than positional bargaining; and trading on differences.  The final simulation, entitled "Win as Much as You Can," (seen in progress above) demonstrates the importance of considering the structure, people, and context of negotiations and the need for compliance, enforcement, and re-opener provisions in many agreements.  These principles will come into play in sessions tomorrow in topics as diverse as the meaning of true informed consent and working within teams to infuse patient quality and safety into clinical practices.

But next, we turned to eggs. These poor unsuspecting specimens were put to use in a team-building exercise.  Dave explained the rules.  A long plank was balanced on a cinder block, and each team was given ten minutes to get six people to stand on the plank without see-sawing and crushing the eggs placed on the ground underneath each end of the plank.  The catch was that all players had to step on to the plank at its midpoint, and then all had to exit the plank in the same way.  This is tricky and requires excellent teamwork and execution.

Tragedy befell the first patient, er, egg, as the team did not coordinate its communication and work flows sufficiently well.  One player took the blame for this failure, but the team and faculty reminded her that a just culture was in place.  Her error could have happened to anybody, especially given the lack of a standardized work flow among the team members.  The high degree of variation in each person's assent was clearly at fault.

The second team, perhaps learning from the first, in addition to designing its own process flow and communications mechanisms, succeeded on its first try, with several minutes to spare.

Not to be outdone, team #1 came back for a rematch and also succeeded, proving to be "the best at getting better."

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