Sep 3, 2008

No more pencils no more books…

I took 22 credits one term, survived four terms of Biostatistics, and thought I was learning the essentials of public health. So I was a little dismayed when I started my first job in a large health care organization and realized how much I still didn't know.

On day one, we enter the health care environment and are thrown into an ocean of providers from every discipline. People from different professions often think in really different ways – and that leads to awful misunderstandings and mix-ups in clinical settings.

So what can we do about it? The IHI Open School can help you form good habits early and show you how to work with people from other disciplines – before you get thrown together caring for patients in a hospital.

I wish the IHI Open School had existed four years ago, when I was an undergrad studying health policy and administration. During our orientation, they required we take the "colors" personality test. Like Myers-Briggs, the colors test identifies your personality type (creative thinker, Type A, etc).

Out of the 25 health policy and administration students, would you like to guess how many of us were categorized as "Gold" (type A)? I think it was somewhere in the neighborhood of 13. We wear suits. We keep the lights on in the hospital. We are responsible for the "bottom line." When it came to group projects, inevitably, two people had rough drafts on color-coded excel spreadsheets before the first meeting even began.

Then it was on to grad school for public health. To date, I've never met so many positive Pollyannas in my life (cue the song “Heal the World”). It was an awesome, motivational point in life, but perhaps not an accurate portrayal of the care environment.

Think about how different this is from your typical med student. Motivated? Yes. Organized? Probably, but I'm under the impression their thought process is different. From day one, medical/nursing/pharm students are inundated with data. Calculating drips and converting kilos to lbs is second nature to them. I, on the other hand, want a pen and paper to write it out, step by step.

All of us in health care may share a common goal, but we think differently – and the time to find that out isn’t at the patient’s bedside. We must learn how to work together as a multidisciplinary team, communicating effectively. It's not that nurses dislike physicians or physicians dislike pharmacists; we just don't always speak the same language.

The IHI Open School will help us overcome this obstacle. We'll bring students of all disciplines together. If your care team can't communicate effectively, you’re doing a disservice to the years of training you’ve put in.

1 comment:

Anonymous said...


In an era of complex systems, busy lives, and not enough time or consideration for a global picture we find ourselves as students clearly feeling left out or wanting more of an understanding of issues that come to bear shortly after graduation. The point Shannon makes is an important one. For me involvement in organizations and excellent initiatives like the Open School end up being my school beyond "the school" (in my case medical school). It gave me such a grounding and valuable understanding of issues ranging from policy, economics, medical education, public health, health quality, organizing, and patient safety. Time and time again opportunities like the IHI school have made a difference for myself, my career and my patients. The IHI School is an incredible opportunity for the next generation of leaders to be the kind of health care leaders and caregivers our patients need. It is an opportunity for mentorship, for leadership, and for developing the skills to help you and the system you work in focus on quality improvement and patient safety. These issues become very real and important day to day issues once you are in the workforce.

The Institute of Medicine says, health disparities inarguably exist among racial and ethnic minorities. Furthermore, there is evidence that shows health disparities and cultural competency is inextricably linked. We can read about cultural competency, understand its meaning, and hope to incorporate it into our medical practice. But until we have immersed ourselves in other societies, cultures, and geographic locations, and systems we cannot fully grasp the need for cultural competency. While access, insurance, and other factors may impede patients’ health care experiences, the healthcare giver-patient relationship and system should not. Learning the skills to deal with ethnicity and other subcultures such as the culture of poverty, the culture of other health care professionals, and the culture of health systems can go a long way in improving quality and achieving patient safety.

We must change our attitudes and recognize that the challenges our patients face aren’t always “in the book” and that we may often need to rely on empathy, building “trust” compassion and initiatives like the IHI Open School to help us find a feasible solution.

So I encourage you to follow your passion, find new mentors, connect with issues that will become very important in the near future, develop your own curriculum outside of "the school" and be the change you wish to see in the world.