Martin Luther King Jr. Day: Socioculturalism in Medicine

When you are born with yellow skin and black hair into a multicolored country, socioculturalism is a daily reality. Although my parents label me as an ABC (American Born Chinese) with amusement, unbeknownst to them, every day is a continuous combination of integration, negotiation, and assessment of how my decisions and actions define who I am. For example, if I choose Peking duck over sirloin steak for dinner, does that make me more Chinese? Where did this preference for a northern Chinese delicacy even stem from? My parents are from Shanghai, so my preferred protein should really be freshwater shrimp. Of the dance styles that I enjoy the most, my decision is straddled between Chinese and hip hop. When I’m seeking symptomatic relief from colds, I instinctually reach for Acetaminophen, Ibuprofen, and Phenylephrine. But, for sore throat relief specifically, my first line treatment of choice is Nin Jiom herbal lozenges and syrup. Asian Americans are predisposed to specific cancers and there is an overwhelming prevalence of Hepatitis B in the Asian American community. Because my diet is probably closer to the average American diet, what disease risk factors and predispositions do I actually have?

As illustrated above, I am socioculturally stochastic. Even the best statisticians would not be able to make any sense of this variability and extract a reliable pattern to predict my future actions. While I have never felt intimately tied to my ancestral culture, my physical appearance is a daily reminder that there is no escaping it. Despite my inability to lean one way or the other, whether I like it or not, I am American, Asian, and Chinese. Although I have traveled extensively around the world and have lived in several microcultures within the US, it wasn’t until I traveled to Ghana that I began to understand the significance and potential consequences of my blended identities within a broader context....

Go to the IHI Open School Blog to read the full post!

Morning Report: 3rd Annual Patient Safety and Quality Leadership Institute

Last week, I had the privilege of participating in AMSA’s third annual Patient Safety and Quality Leadership Institute at Thomas Jefferson University in Philadelphia. Nearly 40 participants from various backgrounds converged to learn about and discuss issues surrounding patient safety. The diversity of the students ranged in years from pre-meds to residents, but also in fields from nursing through pharmacy, and of course medicine. Our host was Dr. David Nash, the Dean of the Jefferson School of Population Health, and a preeminent expert in outcomes management, medical staff development and quality-of-care improvement. Over the intensive course of three days, senior leaders of hospital systems and experts in patient safety exchanged ideas with our group on two main domains: how to structure undergraduate medical curriculum to incorporate patient safety and quality into training, and how to implement our own ideas for projects into hospital systems. Though the days were packed with lectures, discussions, and project work-shopping, the evenings were left open for socialization with my fellow students. I walked away from the weekend feeling a sense of re-invigoration, purpose and the belief that the future of medicine without considerations for patient safety and quality is a future that cannot exist at all. I’ll briefly expound on three of my takeaways for the weekend:

• Patient safety is here to stay: perhaps I’m singing to the choir as the readers of this blog most likely have similar beliefs, but to those of you who may have stumbled here accidentally, the patient safety movement is here to stay. With the work laid out by various organizations such as IHI, and leaders like Don Berwick at CMS, there is no longer the feeling that patient safety is a fad. Hospitals and hospital systems are taking a careful eye to their own operations and taking legitimate issue with these topics. The leadership at these institutions, whether they are early adopters or late-comers, will inevitably arrive at the conclusion that if they will survive as organizations, they must prioritize quality initiatives, lest punishment by government or third-party insurers. This changing environment will allow ample opportunity for any student of medicine or related fields to access leadership for traction in his or her own project.

• Grass-roots AND top-down: as Dr. David Longnecker, the Director of Health Affairs for the Association of American Colleges Medical Colleges illustrated, the movement to incorporate patient safety into medical school and residency will no longer be a matter of “if,” but of “when.” Pervasive throughout the governing bodies of GME is the impetus of change; curricular activities will have some form of training requirement for residency related to patient safety. At the University of Pennsylvania, Dr. Jennifer Myers told our institute about a specialized patient-safety longitudinal track for interested residents. Elite programs around the country, as well as the world, have adopted such a model for resident education. But this may not be enough. While curricular changes in residency may indeed force some perspectives to widen, there is an on-going need for medical schools at the undergraduate level to continue on in this mold. Models of patient safety should be integrated into medical schools throughout the country, not merely as an hour-long “special topics” lecture, but an extended module incorporating didactics and projects for practice. The essential inter-disciplinary nature of patient safety necessitates that these models should not be learned in isolation, but shared with colleagues throughout the patient care realm (i.e. nursing, public health, pharmacy).

• Take action: the best way to get involved is to... surprise! Get involved! This can range from having coffee chats with your classmates to joining your local IHI chapter to implementing your own projects at your hospital. All of the participants at this leadership institute came in with project ideas that we hoped could benefit from the exchange of ideas that this forum affords us. Having experts working with us one-on-one to define and refine our project scope and implementation plan was invaluable. Even more impressive was the ability to view the range of patient safety improvement projects around the country; the enthusiasm was palpable to say the least, with 40 minds humming away offering suggestions to each other.

I cannot express enough gratitude to Dr. Nash for enabling and providing us with such a fantastic weekend of programming. The slides for the various presenters are open to the public, should one feel like perusing through the excellent material. Future leaders of healthcare, take note: patient safety is inextricably linked to the success of your institution, start learning and practicing today!

Slides from presenters:

http://www.amsa.org/AMSA/Homepage/EducationCareerDevelopment/AMSAAcademy/PSQLI.aspx

AMSA Patient Safety Webinar:

http://www.amsa.org/AMSA/Libraries/Initiative_Docs/AMSApatientsafetywebinar.sflb.ashx