May 4, 2009

Boston Regional Event Recap

On April 23rd, eight IHI Open School Chapters in the greater Boston area hosted the Boston Regional Event, bringing together students from a wide range of health professions to discuss health care quality.

Over delicious Bertucci's pasta and salad, the Open School students and faculty were led in a case study discussion by Dr. Dan Hunt, Assistant Professor of Medicine at HMS and Director of Inpatient Clinical Educator Service at MGH, and Dr. Meridale Vaught, Instructor of Medicine at HMS. Click here to see the case study we reviewed (Other case studies listed on IHI Open School page can be found here). While the case taught us all a little bit about the clinical symptoms and treatment of Adult-onset Still's Disease, the take home message was patient safety and the importance of the continuity of care. Dr. Hunt and Dr. Vaught discussed the case with the 50+ students as a large group and provided us with time to break into smaller groups to think about several important considerations. Questions such as:
  • What were her presenting symptoms?

  • What kinds of tests and questions need to be answered before a diagnosis can be confirmed?

  • Because the recommended drug is relatively new, what kinds of considerations must the care team address?

  • What's the patient's medical history? Does she have any other conditions that we need to be aware of?

  • Will any of her previous medications interact with the new drug?

  • How will the patient manage all of the different medications?

  • Can the patient afford the medication?

  • Will her insurance cover the medications?

  • How will the primary care physician be looped in?

  • What are some important details that the patient's family should know about?

  • What kind of training will the patient need in order to take her medications?

  • Will the primary care physician be familiar with treating and monitoring her condition?

  • Does the patient understand that this is a chronic condition and that she will have to consistently take her medications?

  • Because the drug she will need to take is relatively new, will her local pharmacy have the drug in stock?

  • What kind of follow-up will be needed as she is discharged from the hospital?

    ...and much more.

Each small group was made up of a mix of disciplines. We had public health students, medical school students, engineers, and nursing students--all in varying degrees of training. It was immediately evident that this case was too big to handle alone and it was necessary to work as a team in order to provide the comprehensive care the patient deserved. A question that my group continually came back to was, "how will the patient feel?"

We also touched upon the roles of several different care team members that I hadn't originally thought of. The care team involved more than just the patient's doctors, nurses, and pharmacists. She also needed support and guidance from case managers, social workers, her family, and her insurance company. It only took walking through one case study to realize how complex our health care system really is.

After the case study, we broke for some delicious tiramisu and got the chance to mingle and meet students from Harvard, Boston University, MGH Institute, Boston College, Suffolk, Endicott, Tufts, and MIT (Click here to browse through the Chapter Directory and find out if your institution has a Chapter. If not, create one!). It was fantastic to meet people who were also interested in quality improvement and patient safety. Now that we've all found each other, I can't wait for what's to come in the future!

Thank you to Dr. Hunt and Dr. Vaught for leading such an engaging and informative case study session. I'd also like to thank the Boston IHI Open School Chapter leaders who worked together to organize the event: Dylan Carney, Yian Xiao, Jennifer Chi, Kevin Knoblock, Courtney Nielsen, Brady Evans, Andy Wurtzel, and Shabnam Hafiz. Thank you for a fun night!

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