Aultman Hospital is located in Canton, OH. It has 682 beds, more than 550 active physicians in 43 different medical specialties and a staff of more than 5,000 employees, Aultman is Stark County's largest hospitaland largest employer. Aultman is a separate entity from my medical school. It is actually one of a number of hospitals in Northeast Ohio at which we have the opportunity to rotate. The hospital has its own training programs in nursing, physical and occupational therapy, etc.
I did a number of my third and fourth year rotations at Aultman Hospital. During this time period, the medical education staff and I grew to know each other and each other’s interests quite well. When the opportunity to start a chapter of the Open School was presented to me by one of Aultman Hospital’s physicians, I knew that Aultman, because of its positive learning environment and drive to constantly improve upon an already established high quality of patient care, would be a great place for the Open School.
At the time, the Aultman Chapter was unique in that it was one of the first hospital-based chapters of the Open School. Because of this, it presented unique challenges as well.
As stated above, the hospital had students apart from those of my medical school. The thought of a hospital-based chapter was exciting to me because of the opportunity to work with students from other health fields. The challenge was and continues to be the fact that schedules and interests between groups of health professionals and health professionals-in-training vary widely.
Initially, I dealt with this challenge by using my advisors’ connections at the nursing school to get in touch with nursing classes which dealt specifically with issues of quality improvement and patient safety. Honestly, I was not sure how nursing students would approach the meetings. I was a student with interests in helping to improve patient care, and my hope was that there were some nursing students with similar interest. At the meeting, itself, I got the sense that there were 2 groups of attendees – those who were present because of their interest in the subject and those who were present mainly to fulfill class credit. Nevertheless, both groups found common ground in the discussion of clinical cases. For instance, one of the main topics of discussion was the differences in the type of patient care that was taught in classes and that which was witnessed during clinical rotations.
Finding members from the medical school, itself, was a different issue altogether. Having obviously been an M1 or M2 myself, I knew that discussion of clinical cases may find some interested students, but medical students at that level of training have not yet had clinical rotations. Further, many of the students really are worried about 2 things: exams and building CVs. I could not promise that the topics we cover would be on Step 1, but I could promise them that I would work very hard to involve them in a research project that was both interesting and applicable to daily practice. The medical school Open School “kick-off” occurred about one month after my meetings with the nursing students. Jordan Bohnen was invited to speak about his experiences in the field of QI/PS as well as with the IHI. A meeting was scheduled a month later for interested students. And, at that first meeting, the goal of a research project was discussed with input from those present. Next, details of the research project were hammered out between my advisors, the group’s VP, Holly Dyer, and myself. Finally at the second meeting with the medical students, the research project was established. Responsibilities were assigned, etc.
At the next meeting, the groups of nursing and medical students will be combined and the discussion will include the research project (as well as inviting interested nursing students to help), a broader discussion of the research topic (medication compliance and management), and discussion of topics such as QI in the curriculum and clinic cases. My hope is that the merging of the groups will be seamless. Though, that remains to be seen…..
So, what worked?
1. Finding common interests and allowing your audience to see that you, the chapter leader, are passionate about the very topics you are asking them to care about. The fact that people are showing up to meetings may mean many different things: fulfilling class duties, merely building one’s CV, or even deep interest in the quality of patient care. Nevertheless, keeping a captive audience and then keeping a captive audience coming back means more than merely being animated and interested - it means keeping things interesting for them too. Leaders must show their passion and even infect others with it!
2. Network. On several occasions, at both the hospital and the medical school, I was introduced to people who grew to become very involved and important people to the chapter. These people who I speak of are extremely interested in the quality of patient care and very passionate about the topic. Further, they too understand the importance in sharing this passion with others. The thing is – I was introduced to them by people who were only slightly interested in IHI and in patient care. Therefore, I quickly learned that the networking I do may not directly improve the Chapter, but it may do so indirectly. In other words, it may not be who you know that is important, but who knows the people you know!
3. Assign responsibility. You cannot do it all alone – although, if many of you are like me, you may want to. The individuals in your group have their own gifts and talents and are hoping to use them. Some are organizers, budding web-designers, meticulous note-takers, etc. Ask who wants to help and allow your members to gain your trust. They will end up feeling like they have a personal stake in the Open School and, hopefully, that personal stake will quickly transform into a passion to achieve the ideal of perfect patient care.
4. Lastly, stay organized: away from and then during meetings. As I mentioned earlier, people have schedules and other responsibilities. My medical school and Aultman Hospital are about 35 minutes apart from each other. Therefore, people may be traveling quite a ways to attend my meetings. I do not want to waste their time by fumbling through documents, and I most certainly do not want meetings to lose focus. The opportunity for everyone to be in one room together may be rare and many goals can only be best accomplished while everyone is in the same room and able to discuss – ie. not through e-mail. Face to face is better than e-mail. It creates community. It allows people from different backgrounds to get to know one another. So, create an agenda, email the agenda to your members prior to your meetings, and do your best to follow that agenda during the meeting. Limit the official length of meetings to an hour and if the meeting goes over that time-period, invite those who must leave to leave and promise to inform them about the meeting's subsequent events through e-mails or phone calls.
Now, quickly, what did NOT work. Of course, these things may work at other hospital-based chapters, but did not work at mine.
1. Posters, stacks of free informational handouts with contact information. There is so much visual “noise” at the hospital that these things tended to get lost amongst the posters of events for CME credit, daily lunch menus, resident block schedules, computers, notes to staff, random Post-It notes on walls, etc.
2. Conversations based on e-mail, alone. Most of my conversations to gain interest that occurred only by e-mail turned up as empty leads and wasted key strokes. One is better off setting up face-to-face meetings – even for 15 minutes – in which one focuses on 3 things: what the IHI Open School is, how it will benefit the student, how it will benefit the hospital.
3. Letting meetings run themselves. Meetings absolutely need goals and these goals need to be accomplished. At the very first meeting of the Open School, I made the mistake of letting the first half be too open to being driven by the conversation alone. My original goal was to let everyone get to know each other through conversation, but what resulted was less than perfect. The first half of the meeting was aimless and nothing was accomplished in terms of setting the tone for the Chapter or even dispersing information about my goals for the Chapter. I cannot even recall what the discussion was about – but I do remember the emptiness I felt when that conversation came to its natural end. So, create an ice-breaker, if you must, but do understand that your members will feel more positive about your meetings when goals are established and eventually accomplished.
My next post will focus on the topics of the reaction to my Chapter in the medical school and hospital community and transitioning from one Chapter Leader to the next.
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