Another Health Care Workshop? Five Reasons Why SQLA is Worth Experiencing

It's been almost six weeks since I left the IHI Open School Student Quality Leadership Academy (SQLA). Admittedly, I volunteered to put together a blog post weeks ago, but my hectic schedule as an outgoing student (classes, work, research projects, job interviews, networking, and summer visitors) kept stealing my attention.

As an emerging health professional, I have availed myself of numerous free networking events and educational seminars (and food). Eventually, after attending so many that fixated on the need for change in health care, I became jaded about how much these events actually contribute to inspiring innovation. But when I heard of SQLA, knowing IHI's great reputation for visionary leadership in health care improvement, I couldn't shake the feeling that this program was going to be different from the rest. Since attending, I have felt inspired to share my experiences with prospective attendees and, in the process, encourage you to apply for next year's Academy.

Upon reflecting on the lectures and activities from the SQLA weekend, there are five reasons why I would recommend taking part in SQLA to all students in any field of health care (I personally am a clinical social worker and MPH candidate in Health Policy & Management):

1. Exposure to Diverse Perspectives: At our table alone, we had two international students, a nursing undergraduate, a physician, several advanced med students, a Masters-level nurse, and a public health social worker (yours truly), representing great diversity in geography, race/ethnicity, age, and education. Each member contributed thoughtful examples and insight from his or her actual experiences, covering an even broader spectrum of sub-specializations (mine is behavioral health). This rich confluence of experiences was very enlightening, introducing me to the perspectives of professionals in other health care areas with whom I have literally never interacted, and may not have for much longer if not for SQLA. For too long there has been an unfortunate dearth of cross-disciplinary collaboration among our segregated health schools, and SQLA breaks down these barriers.

2. Unbeatable Expertise: All of the weekend's presenters were seasoned veterans of health care leadership and innovation. Each one holds or has held very senior positions in national policy advising and/or academic medical centers. This year's presenters were predominantly current or past leaders from Beth Israel Deaconess Medical Center in Boston - one of the most respected, innovative health care organizations in New England. The only one without at least 20 years of professional health care experience was Dr. John Halamka, who is merely the youngest chief officer in the history of BIDC, had served as a key health information technology (HIT) advisor to the Obama Administration, and was recently contracted by Japan to assist development of a new HIT system across their Northern region following this year's devastating earthquake and tsunami. To say his knowledge and perspective are expansive is a serious understatement, and each presenter was of equally strong caliber.

3. Gaining Essential Management Skills: Take a walk in the woods to build rapport with your opponents and identify shared values. Use interest-based negotiation methods to manage and overcome conflicts. Implement "double-loop learning" to learn from and prevent future conflict situations. Carefully choose when to identify people instead of numbers when quantifying problems. Learn how leadership vision and operations management can foster an environment that minimizes conflict. The "Transition Curve" framework offers a method for managers to conceptualize and facilitate change processes with minimal staff resistance. Before embarking on a difficult conversation, ask those involved about their understanding of a situation, and let this guide your approach and language. These are just several of many examples to evidence that SQLA actually covers concrete management techniques that any of us can apply to improve our team's performance, morale, and ability to adopt innovations.

4. Assessing Personal Strengths and Needs: Through exposure to new management concepts, personal anecdotes from presenters, and group and individual exercises, the weekend at the Leadership Academy gave me the time and tools I needed to identify where I may struggle and succeed as a new manager in the health care industry. This self-understanding will be handy for upcoming job interviews, and also in identifying positions where I'm most likely to succeed.

5. Having Fun! Of course, after days full of challenging sessions, self-evaluation, and passionate presentations on health innovation, we were able to unwind. Harvard Square (and the rest of nearby downtown Boston!) offers a plentiful assortment of interesting activities and quality spots to pass the time with good people and entertainment. This year featured a public dance party in front of Cambridge City Hall, which closed down the largest roadway through town and featured thousands of locals partaking in a good old fashioned outdoor celebration. After three years in the same social and professional circles, networking, story-swapping, and joke-telling with 100 new, equally passionate students was rejuvenating. The city offers an eventful, lively locale for this gathering, which is pivotal because our work, no matter how valuable or urgent, cannot become our entire life. So once the lessons have been learned, there is much-deserved time to get out and play! So come early, stay late, and enjoy the marvelous landscape, history, culture and nightlife of Boston. Good things should come to those who wait (and bravely work on the daunting challenge of health care improvement)!

- Sandy Cohen, MSW, Boston University School of Public Health

Chapter Corner: Happy Hour in Atlanta!

This is the newest installment in a series of posts written by chapter leaders and members. The goal, simply, is to share best practices and creative ideas with other chapters around the globe.

I love happy hours. But I love them even more when they are an excuse to spread the word about the IHI Open School.

My group, the Atlanta IHI Open School Chapter, is made up of students from Emory University and the Georgia Institute of Technology. We kicked off recruitment for 2011 on July 7th with an IHI Open School information session. We followed this up with a happy hour the following Saturday.

Why did we do a happy hour? We think social events like these build solidarity between group members from different schools. These are opportunities for our current and prospective members to meet other students outside of our particular programs. Events like the happy hour will help develop friendships and create an added incentive to participate in IHI Open School activities throughout the school year. We had a turnout of about 10 at our happy hour session, despite the pouring rain. The vice president of Health Students Taking Action Together (HealthSTAT) was also in attendance, and she and our president have discussed plans of co-sponsoring events throughout the year.

Even better, our summer information session turnout was great with over 20 attendees, including a handful of healthcare professionals. At our meeting we included snacks and distributed a fact sheet that summarized the IHI Open School, our goals for the year, and proposed upcoming events.

Here are three questions - and answers - we think might be helpful for other Chapters:

What did we include in our information session agenda?
1. A Denver Health patient safety video
2. Introductions around the room
3. Small groups to briefly share any personal stories of patient harm or unjust culture
4. A short presentation made by our chapter president describing what IHI is, the Open School, and what we've done so far
5. An overview of what we have planned for the year, including:
- Monthly "lunch and learns"
- IHI modules to be integrated into school curriculum
- Upcoming quality improvement projects
6. Don Berwick's Introduction to Open School video
7. A survey asking about interest in events and involvement

Why start recruitment in the summer?
We want students to start thinking about the IHI Open School and talk to their friends about it. We feel the interest-we just have to get the word out! We also want students to start preparing for any quality projects they might be interested in by taking the IHI quality modules as early as possible to prepare.

How did we advertise our event?
We asked our schools and departments to forward our event email and flyer to the current and incoming class, as well as posted flyers around schools. We also emailed any connections we had with faculty and professionals to pass on the word to any interested individuals.

We're trying to foster a supportive environment where we can build relationships and share ideas. Social events like the happy hour can help facilitate this, in addition to our group meetings and learning events. What are your thoughts?

- Becky Ng, Public Health student, Emory University

Chapter Corner: Five Rules of (Student) Engagement

This is the first in a new series of posts written by chapter leaders. The goal, simply, is to share best practices and creative ideas with other chapters around the globe.

One of the biggest challenges that we face as a group at UMass (in Worcester, MA) is encouraging people to come to our events and classes. The topics and the speakers may be fantastic, but the audience consists of only about 10 students. It is difficult to engage students in anything outside of the board exams even if the material will be important in their careers. We worked hard to increase student interest and attendance at events this past year. Things did not always work out for us, but the following are some of the strategies that we used to bring students in:

1. Make it personal for the students. Take a story that will really hit home and organize a speaker or a class around that one story. For example, we had a death at UMass Medical Center on the telemetry floor. The story was all over the local news broadcasts and many students were discussing the case, especially saying that they were embarrassed to represent UMass. We took a different spin and invited the physician who was working to solve the problem to come and speak. He talked about what UMass was doing to prevent future incidents of alert fatigue and really excited the students to get involved in solving the problems instead of gossiping about them.

2. Early preparation is critical! We had one event that had great speakers and a really interesting topic, but we had the worst luck getting a room. The day before the event a room finally opens up, and we emailed out to all of the students with the room assignment. The morning of the event room reservations calls us and switches the room. So we email again saying, "Last minute room change!!" Later that day, mere hours before our event, we get switched to yet another room. So we send out another room change email, but at this point, it is just about time to get started. In the end, we had fewer than 10 students in attendance. Lesson learned? Get all your ducks in a line quickly and early so you can accurately advertise long before the event.

3. Get creative with your advertising. This example doesn't come from our IHI Chapter, but one of the global health groups on campus sponsored an HIV/AIDS awareness event. To advertise, they gave out small goodie bags in class. These contained two condoms and enough M+M candies to represent a day's worth of antiretroviral medications. They also included a short written piece with some facts about HIV and an invitation to their event. Even if people didn't attend the event, they were exposed to the problem and the ideas they were promoting.

4. Bring in the big guns! Include professors and administrators in the planning, and definitely send them an invitation. It adds legitimacy to events that you are organizing. We ran a panel event on interprofessional communication, and we had the dean of the school of nursing in attendance. She really encouraged nursing students to attend. We had great turnout from the school of nursing, especially relative to medical and graduate students.

5. Schedule informal events around your class breaks. We started a series of "lunch and learn" events during the lunch breaks in our class schedules. These were short events, usually about 45 minutes, where students would pack a lunch and we would lead a discussion of a case study or recent article. The Open School web resources are fantastic for this sort of forum and attendance was good because people were sitting around campus anyways.

These were some of the strategies that really helped us this year, but we still have a long way to go in engaging students in QI and patient safety. Sadly free food tends to be the best motivator, and we just don't have the budget to feed hungry grad students with every event.

What have other people done at their chapters?

- Aubrey Samost, medical student, University of Massachusetts

Lessons Learned from the IHI Open School Student Leadership Academy

On June 24 and 25, many healthcare students and professionals converged on Harvard Square in Cambridge, MA, for a two-day forum on leadership. I think I speak for more than just myself when I say the weekend was fantastic -- both highly entertaining and educational. Our moderator for the weekend was Dr. James Reinertsen, the former CEO of CareGroup and current president of The Reinertsen Group. Over the two busy days of the conference, somehow his energy never flagged, and he was able to keep us energized and engaged. At the end of the weekend, Dr. Reinertsen left us with a parting message on life-long learning and how there are three equally important components of it:

1. The continuous acquisition of knowledge


2. Personal experiences


3. Reflection on the first two parts

So, just for you Dr. Reinertsen, these are my reflections on the incredible amount that I learned and the wonderful experience I had during those two days in Harvard Square:

The easiest, but perhaps most complicated place to start is to ask, "What did I learn?" Through didactic sessions, I learned conflict management (I wasn't surprised to find that I'm an avoider) and how to take a walk in the woods (a negotiation technique, actually). Through the lectures and anecdotes from the invited speakers, I learned about how to lead through a crisis (like a massive computer system crash), how to lead without authority, and the benefit of a fancy job title. Through exercises, I learned how to effectively have awkward conversations (like dumping a guy or firing an employee) and how to assess the safety of a patient care unit by observing its teamwork. All of these skills I anticipate using throughout my career and life.

While the lectures were useful and enlightening, I would be greatly remiss if I didn't discuss everything I learned from the other participants, the other students. We were assigned seating right from the start to force us to meet people we might not have interacted with otherwise. I ended up sitting with one other medical student, a psychology student, two nursing students, and three healthcare administration students. This medley of backgrounds and people's unique experiences made the discussion very lively. It was eye-opening to hear everyone's perspective on a problem because they could be so different from my own. Looking back, it makes me really appreciate a drawing that Dr. Barry Dorn (one of the speakers) made of a cone in a box which highlighted an important lesson: Where you are looking from greatly influences what you see.

Needless to say, I learned a lot this past weekend, both from the speakers and from my peers. The lessons I learned are not found in textbooks or medical school lectures even though they are critical to our future work. I am extremely grateful that I had the opportunity to attend the Leadership Academy. The knowledge and experiences that I gained are definitely going to stick with me as I continue on my path toward becoming a physician.



- Aubrey Samost, University of Massachusetts

Patient Safety in Iraq

I recently visited the Iraqi region of Kurdistan, both working with the International Federation of Medical Students' Association and arranging an interprofessional patient safety symposium for nursing- and medical students.

Iraqi Kurdistan is the northern region of Iraq with borders to Syria, Iran and Turkey. Given everything you hear in the media about Iraq and the war, I wasn't to sure what to expect, but what I did experience was a beautiful scenery, peaceful and friendly people and a well-functioning society.
The region has several nursing and medical schools, all fairly new and with a very international approach. The regional Minister of Health (a doctor) have been wanting to focus more on patient-doctor communication as well as patient safety, and it was on his request that we prepared the symposium covering these two topics. It was held on the afternoon on the 24th of April at the Ministry of Health.

We were not quite sure what issues the health professionals and students there had, so we started by asking some questions, and a lot of issues were raised. E.g: It is common to have consultations with up to 10 patients with the similar condition at the same time, not allowing much time to talk to the individual patient, hand hygiene, lack of guidelines, and a lack of educational resources, access to journals and evidence etc.

Based on this we chose to focus on practical tools, that the participants could use there and then, and that is one of the beauties of the IHI Open School courses. We took them through Patient Safety 101, and also introduced the "Check a Box-Save a life" campaign, and it generated a lot of interest. Some of the comments we got after the symposium were "I never thought I could do anything about safety myself" and "Why have we never heard about this checklist?". In other words, just keep up the good work in your campuses, it actually makes a difference.

- Jo Inge Myhre, medical student, University of Oslo

Hot Spot for Healthcare Improvement: Chicago

On March 29, twenty-six enthusiastic students, faculty, and health care leaders from the Institute of Healthcare Improvement met at the Sofitel Chicago Water Tower to network and learn more about quality improvement. The event was sponsored by the IHI Open School and Aleta Belletete, a retired board member of the Institute of Healthcare Improvement who has thought about quality in another industry that gets a lot of attention, banking, serving as the Chief Quality Officer for Bank One.

During the Institute of Healthcare Improvement Annual Forum in Orlando, Aleta was perusing the IHI Open School posters and stumbled upon our Chapter poster sandwiched in between several other Chicago-based chapters. She knew that one of the most valuable things to create change is to get them all in a room together and that is exactly what she did.

Multiple institutions were represented and it was a lot of fun meeting other professionals excited about making health care safer, better, and more efficient. We were lucky enough to get some hands on instruction from quality improvement guru Bob Lloyd, Institute for Health Care Improvement Faculty and Executive Director of Performance Improvement, as well as Richard Scoville, who is also IHI Faculty. We learned about the IHI’s Model for Improvement and how to implement a Plan, Do, Study, Act (PDSA) cycle to achieve meaningful and lasting change. Attendees had the chance to interact with health professionals across the spectrum including: medical students, physicians, paramedics, administrators, pharmacy students, and residency program directors. This was really just a launching point to get the Chicago QI community connected and learning from one another.

Much of the discussion focused on how to get Chapters started or sustain activity. Interestingly, our own Chapter, which is still very young, seemed to be in an advisory role, assisting other student leaders in finding mentors or thinking about activities. They key ingredients to a successful Chapter seemed to be the same: (1) committed students; (2) committed and capable faculty advisors; and (3) a shared vision around a specific activity the Chapter would sponsor. We are fortunate to have quality and safety as a major thread in our curriculum. Sustainability is also an issue with turnover of student leaders - one thing our Chapter is doing this year, is creating a "senior advisor" role for 4th year medical students who are coming out of their clinical clerkships to guide the preclinical students on the highest yield activities. Our own Chapter has been focusing on interprofessional collaboration with our health administration students and has started outreaching to pharmacy students as well. There was a lot of talent in the room and we look forward to future events!

- Anthony Aspesi, MS1 and Vineet Arora, MD MAPP

IHI Open School Southeastern Regional Event

My name is Dustin Cox and I am student at Clemson University studying Health Administration. The Clemson University Chapter is unique in that we are primarily undergraduate college students, and our group is a diverse mix of a variety of disciplines including health administration, engineering, architecture, business, nursing, and others. Our IHI Open School had elections a few weeks ago and I was elected President. Shortly after being elected, I was provided the opportunity to attend the Southeast Region IHI Open School Forum. Given that I have never attended any of these conferences before, I was anxious to see what was in store for a Southeastern Conference. To my surprise, there were over 350 people in attendance, including students and professionals alike!

Upon arriving at the conference, I was amazed at such an energetic and exciting atmosphere. After hearing the opening remarks from the Southeastern directors, we were introduced to two professionals who would go on to give us a better understand of public narrative. The ability to share experiences and motivate others with the stories we told were the main focus of the afternoon. Everyone has a story of what brought them to where they are now, and where they would like to go in the future. When we left however, we were all able to tell that story in a way that influenced others in a positive light.

I was able to take this experience back to Clemson with me and excite the other officers, that we are a part of a national movement to improve quality care. Not only was this Conference a good way for me to become more enthusiastic about healthcare improvement, but it was also a great way to network. Throughout the day, I was introduced to many local healthcare and IHI Open School Chapter leaders. I look forward to next year’s Southeastern conference and recommend this to any and everyone I come in contact with!

- Dustin Cox, Healthcare Administration student at Clemson University

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