Mar 13, 2009

AMSA: One of Many "Powers"

Quality improvement of health care requires the help and participation of all of the players in the health care system: patients, nurses, physicians, administrators, insurers, government, employers, etc. This joint effort reminds me of the classic TV cartoon, Captain Planet. In order to save the environment, Wind, Water, Earth, Fire, and Heart needed to be combined in order for Captain Planet to appear and save the world! Similarly, to save the world from escalating health care costs and improve the health and wellness of all, we need to combine our powers and cooperate!

On Wednesday, Shannon and I had the wonderful opportunity to meet the future of one of these powers in the movement to improve health care at the 59th Annual American Medical Students Association (AMSA) Convention’s Preconvention Symposium on Patient Safety and Medical Quality. We were joined by about 40 other MD/DO students for an interactive day and complete immersion into patient safety and medical quality.

The day kicked off with a keynote presentation by former AMSA National President, Dr. Helen Burstin, now at the National Quality Forum. Dr. Burstin provided everyone with a high-level overview of what medical quality means, specifically focusing on the six aims outlined in the Institute of Medicine’s (IOM) charter document on quality, “Crossing the Quality Chasm.” These aims include: safety, timeliness, efficiency, patient-centeredness, effectiveness, and equity. Dr. Burstin also stressed the need for cooperation among all players of the system and introduced the National Priorities Partnership that brings together 28 of these players to the table to discuss and set goals for health reform. Click here to see a list of the diverse partners.

Dr. Don Berwick, then took the stage and gave a keynote presentation that delved deeper into what patient safety means and how students can act and make an impact on the field. Through descriptions of IHI’s 100,000 Lives Campaign and 5 Million Lives Campaign, Dr. Berwick illustrated various bundles to improve the safety and effectiveness of care, such as a bundle to prevent central line infections.

After the two keynotes, Pre-Convention leader, Wes Fischer, led the students in a emergency situation simulation. Students role played and learned firsthand the many nuances of effective teamwork and communication in a chaotic situation. Great job to all of the volunteers!

During lunch, Dr. Berwick led the students in the Red Bead Game demonstration. This teaching tool developed by W. Edwards Deming illustrates the methods of improvement. It sounds like a very dull demonstration, but I’ve watched the demonstration at least 5 times and still really enjoy it and learn something new from it every time! Click here to learn more about the game.

After lunch were three very interesting break-out workshops. In these workshops, we learned and practiced skills in effective communication between physicians and patients (SBIRT: Screening, Brief Intervention, and Referral to Treatment) and effective communication in teams (iSBAR: Introduction, Situation, Background, Assessment, and Recommendation). We also participated in a reflective session led by Dr. Paul Uhlig of the University of Kansas on why we were all interested in patient safety and quality improvement and learned of ways Dr. Uhlig had implemented interprofessional rounds and meetings to transform the culture of medicine in his health system.

Both Shannon and I learned so much and were extremely grateful to meet so many wonderful students. Hearing everyone’s enthusiasm and eagerness to learn more was very refreshing. Thank you to all of the students we had the fortune of meeting and all of the AMSA leaders for having us! I feel reenergized in my work and hope to have the opportunity to meet students representing the other “powers” soon. I sense that we will be able to soon unleash a “Captain Medical Quality” on the world! I can just hear it…. “By your powers combined, I am Captain Medical Quality!”


Valerie said...

This is a great post!!! I think that Captain Planet is something that we can all relate to and reminds us of our childhood. It sounds like this was a really great meeting. I am interested in learning more about the student demonstrations particularly the role play to work through a chaotic situation. I think that would be a great situation to have available for chapter leaders to use as an activity at a chapter meeting. Thank you for your thoughtful post. I think we all need a "Captain Medical Quality."

Eva said...

Hi Valerie!
Thank you for your comment! There were several role playing and simulation exercises throughout the day. The most elaborate simulation involved a dummy being rolled into the room in a wheelchair screaming for help. A team of 5 people role played the dummy's care team. There was also an individual who played the role of a distractor (news reporter). The care team needed to calmly provide care for the dummy, take a patient history from the friend, exhibit the ability to work as a team with a distinct leader. Other things that were "tested" in the simulation was the ability to follow the ABCs of resuscitation (I'm not quite sure what this means but I'm sure med school students would). Each group of 5 or so students ran through this simulation acting out those roles. The other role playing activities were quite simple. Each person was given a small sheet of paper asking them to be either a patient with X, Y, and Z symptoms, or a physician to care for X, Y, and Z complaints, or a nurse trying to report X, Y, and Z concerns, etc. We participated in one simulation on effective communication between patients and doctors and the other simulation was a verbal SBAR between a nurse and physician. Please let me know if you have any other questions. I completely agree that these simulation/role playing activities would make fantastic chapter activities. They may be a little corny/uncomfortable at first because they require students to test their acting skills. But, regardless of how familiar you are with role playing, I'm sure everyone can get something out of the exercises!