Sunday, May 05, 2013

The thoroughbreds were in MD, not KY

As I headed to BWI airport early Friday morning, my seatmate turned and asked if I was staying on the flight to connect to Louisville, to watch the Kentucky Derby.  "No," I replied, "I'm going to Maryland to watch the real thoroughbreds in action."  A quizzical look was the response.

I was headed to a meeting of MedStar Health's Patient and Family Advisory Council for Quality and Safety, convened by Dr. David Mayer, Vice President, Quality and Safety.  With strong suport from the system's CEO and Board, David is leading a system-wide effort to make the Medstar hospitals the best in the nation for quality, safety, and transparency.  He decided to enable a strong voice for the patients and has recruited the ultimate dream team for the PFAC.

Here's the list:
Michael Millenson (photo at right)
Patty Skolnik (photo at right, with Michael)
Rosemary Gibson (top photo)
Carol Hemmelgarn (top photo, with Rosemary)
Sorrel King (below, left)
Helen Haskell (bottom photo)

Those of you who have been following this field know that this is the Who's Who of internationally acknowledged experts in patient advocacy.  Sadly, many of the group came to this field because of family tragedies, loved ones killed by preventable medical errors.  They have channeled their grief into a commitment to help others avoid what they have been through.  In so doing, they have also become experts in process improvement, root cause analysis, behavior science, and the like.   

David put the group through their paces, with an extensive and intensive agenda.  They, in turn, did the same for David and his team, asking probing and difficult questions and making programmatic suggestions to enhance the MedStar effort.  This is no rubber-stamp body!


e-Patient Dave said...

What a stunning line-up! Can't wait to hear whatever they publish as a result!

I especially love that the voices you listed really do speak from the patient perspective. Good for them.

So why were you there?? (Seriously.)

Paul Levy said...

I was invited to participate for the day.

e-Patient Dave said...

Paul, that was my first genuine out-loud laugh of the day - I FIGURED you'd been INVITED. :) I just wondered what your role was, since I assume you weren't speaking as a patient. Was it your experience doing listen-to-patient things at BIDMC, or LEAN work, or...

It's not a biggie - just wondering.

Paul Levy said...


All of the above, Dave. It was such an honor to be in that company, though.

David Joyce MD said...

Paul, that is all well and good to have big conferences and grand pronouncements about how they will be the greatest. True change will not occur until every provider is given the education needed for them to deliver health care better. That is business education. Delivery is a business process, plain and simple. When will medical education, either in the medical school or GME, teach leadership, finance, clinical practice improvement and strategy planning. We teach clinical only and expect them to go out and practice safely and the fact that we hide the results is evidence of our failure. Once everyone has access to business (delivery) education, only then will we see change. Creating a bunch of physician leaders is only just scratching the surface.
I would expect everyone to run for information like this
not yet, maybe next year.

Unknown said...

It is a priviledge to work with this group of patient and medical leaders. We will tackle education in all realms as we do in Telluride. Also having guests like you join us with your wisdom is invluable.
Patty Skolnik
Citizens for Patient Safety

beverly said...

Dr. Joyce, I see hiding our mistakes as more a cultural problem than a business one. Exacerbated, of course, by legal issues. Shame, recriminations from colleagues and superiors, "guidance' from internal legal counsel, fear of punishment will not be changed without addressing us old hands as well as the new young ones. These patient advocates are unfortunately needed to hold in front of our faces why we have to change our culture, now. Very few have been speaking up from within.

Beverly Rogers, M.D.

David Joyce MD said...

Thanks Beverly, Corporate culture, recriminations from colleagues, fear of punishment, information and communication among young and more experienced physicians, customer/patient sensitivity and attention are all business process entities that have known solutions that are not intuitive. Does the Ritz Carlton, experts in customer engagement, need customer advocates?
The key is education of all physicians on the right way to deliver care/business of medicine.

beverly said...

Not to be argumentative, but the health care market does not have the same external incentives to improve service that Ritz and others do. Most patients cannot vote with their feet, and do not pay the bills. But we know that already.
Maybe I'm naive, but I continue to believe there needs to be an important role for internal conscience and moral duty in the delivery of health care not seen in other industries. These advocates help show us that. Too bad they are needed.

Beverly Rogers, M.D.

David Joyce MD said...

Number one, it is OK to be respectfully augmentative, actually good. Two, the overwhelming majority of health care providers are the most internally conscious and moral people I have ever met and look where that has gotten us in our ability to deliver high quality safe care. It is not the people, it is the process, as Charles Deming would say. Process is a business entity and has business solutions.

e-Patient Dave said...

Dr. Bev,

In a post last week I put it this way:

"Give us clear information about our options, their quality, and our prices,

and give us ability to choose, and to change our minds

and go elsewhere when we get mad.

Then we’ll see who’s a competent consumer."

(It's at the bottom of the post.)

Richard Corder said...

Paul - thanks for sharing the MedStar story, its a great one. Thoroughbreds for sure! They are modeling that convening folks that are typically not at the table and having conversations that we're not accustomed to (and hopefully uncomfortable about), is the only way we will learn and change.

I love the fact that they are simultaneously modeling transparency by inviting cameras in to document the journey.

What's different (it's not a big conference or a grand pronouncement) is that they are acknowledging that good work is being done, and that there are pockets of best practice that we can be learning from - from patients, families, nurses, doctors, everyone!

Kudos to all involved!

Richard Corder
CRICO Strategies