tag:blogger.com,1999:blog-83478741502920887152024-02-18T20:22:37.191-08:00Unum Vox"Unum Vox" (One Voice) is the official blog of the South Dakota Chapter of the IHI Open School for Health Professions.IHI Open School, South Dakota Chapterhttp://www.blogger.com/profile/10794903062959078463noreply@blogger.comBlogger10125tag:blogger.com,1999:blog-8347874150292088715.post-79794029889442675212013-10-16T18:22:00.000-07:002013-10-16T18:24:22.833-07:00Coming Together for Improvement<span style="-webkit-text-stroke-width: 0px; background-color: white; color: #333333; display: inline !important; float: none; font-size-adjust: none; font-stretch: normal; font: 12px/15.95px Verdana, Arial, Helvetica, clean, sans-serif; letter-spacing: normal; text-indent: 0px; text-transform: none; white-space: normal; word-spacing: 0px;">This past August, three IHI Open School Chapter Leaders and I attended a state-wide interprofessional education (IPE) summit in South Dakota, the third conference in the country focused on this topic, and the first to be state-wide. We felt that the conference, designed to fuel conversations across our state on the importance of implementing IPE opportunities in our health science curricula and practicing health systems, was an incredible opportunity to contribute to our health systems both as students and IHI leaders. From the beginning, IHI has focused on the importance of patient quality and safety from a team-based approach, something that is often lost in a health professional curriculum.<span class="Apple-converted-space"> </span></span><br />
<br />
<span style="-webkit-text-stroke-width: 0px; background-color: white; color: #333333; display: inline !important; float: none; font-size-adjust: none; font-stretch: normal; font: 12px/15.95px Verdana, Arial, Helvetica, clean, sans-serif; letter-spacing: normal; text-indent: 0px; text-transform: none; white-space: normal; word-spacing: 0px;">During the summit, groups from a variety of disciplines and backgrounds came together to discuss the successes and difficulties they have faced while implementing different types of IPE learning experiences. For example, thanks to the tireless efforts of leaders across the state, “Interprofessional Day” is now held every fall on the University of South Dakota’s campus. During this important day, nursing, pharmacy, physician assistant, physical therapy, occupational therapy, and medical students come together in interdisciplinary teams to work on patient case studies while learning team-building skills and cultivating professional relationships. This year, the University of South Dakota is also working to design an interdisciplinary elective course focused on simulation education.<span class="Apple-converted-space"> </span></span><br />
<br />
<span style="-webkit-text-stroke-width: 0px; background-color: white; color: #333333; display: inline !important; float: none; font-size-adjust: none; font-stretch: normal; font: 12px/15.95px Verdana, Arial, Helvetica, clean, sans-serif; letter-spacing: normal; text-indent: 0px; text-transform: none; white-space: normal; word-spacing: 0px;">At the same time, challenges still arise as we continue to work towards finding better ways to communicate our ideas and progress. As current students, we were able to offer some great insight into these projects, and help facilitate ways to improve upon these current endeavors across the state.<span class="Apple-converted-space"> </span></span><br />
<br />
<span style="-webkit-text-stroke-width: 0px; background-color: white; color: #333333; display: inline !important; float: none; font-size-adjust: none; font-stretch: normal; font: 12px/15.95px Verdana, Arial, Helvetica, clean, sans-serif; letter-spacing: normal; text-indent: 0px; text-transform: none; white-space: normal; word-spacing: 0px;">As IHI Chapter Leaders, throughout the day, we were very excited about the number of health care professionals who spoke to us about the importance of IHI, in particular the IHI Open School courses and events we organized for health professional students. The IPE summit was a fantastic way for us to share the importance of IHI, both with those who have worked closely with us in the past and those who want to get more involved with IHI in the future.<span class="Apple-converted-space"> </span></span><br />
<br />
<span style="-webkit-text-stroke-width: 0px; background-color: white; color: #333333; display: inline !important; float: none; font-size-adjust: none; font-stretch: normal; font: 12px/15.95px Verdana, Arial, Helvetica, clean, sans-serif; letter-spacing: normal; text-indent: 0px; text-transform: none; white-space: normal; word-spacing: 0px;">Overall, it was an incredible day. Each of us were very thankful for the opportunity to be a part of the IPE summit, and look forward to working towards many of the goals discussed throughout the day. There are countless people across the state who realize the importance of team-based learning for health care </span><br />
<span style="-webkit-text-stroke-width: 0px; background-color: white; color: #333333; display: inline !important; float: none; font-size-adjust: none; font-stretch: normal; font: 12px/15.95px Verdana, Arial, Helvetica, clean, sans-serif; letter-spacing: normal; text-indent: 0px; text-transform: none; white-space: normal; word-spacing: 0px;">professionals. As they are working towards implementing these ideas into curricula and professional education opportunities, we are excited as IHI student leaders to help bring these goals to fruition.</span><br />
<span style="-webkit-text-stroke-width: 0px; background-color: white; color: #333333; display: inline !important; float: none; font-size-adjust: none; font-stretch: normal; font: 12px/15.95px Verdana, Arial, Helvetica, clean, sans-serif; letter-spacing: normal; text-indent: 0px; text-transform: none; white-space: normal; word-spacing: 0px;"></span><br />
<span style="-webkit-text-stroke-width: 0px; background-color: white; color: #333333; display: inline !important; float: none; font-size-adjust: none; font-stretch: normal; font: 12px/15.95px Verdana, Arial, Helvetica, clean, sans-serif; letter-spacing: normal; text-indent: 0px; text-transform: none; white-space: normal; word-spacing: 0px;"><em>--Rebekka Sneed is a second year medical student at USD Sanford School of Medicine and the IHI Open School SD Chapter President. This blog was also featured on the National IHI Open School blog on 10/8/13.</em></span>IHI Open School, South Dakota Chapterhttp://www.blogger.com/profile/10794903062959078463noreply@blogger.com0tag:blogger.com,1999:blog-8347874150292088715.post-72518967769321420412013-03-20T14:31:00.000-07:002013-04-01T16:08:07.494-07:00Never-Always: Part 1<br />
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<span style="font-family: "Times New Roman","serif"; font-size: 12pt; mso-fareast-font-family: "Times New Roman";">The month of March always features
an emphasis on patient safety by the National Patient Safety Foundation and
this year’s theme is <i style="mso-bidi-font-style: normal;">National Patient
Safety Awareness Week 2013:<o:p></o:p></i></span></div>
<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhbif8qTHHIaSnVkgEQwitQBdns5dyKvjuGSi-FnEJXGso37fVb5DI9OJcRcOLnfoB3lYbnCQq6rF5vKEB6h9BcLqydjihdj_ASV51RwwASJmmLTVSe813ANiQ_6TRGARTTNeXcTTLk1Ik/s1600/Wendell_Hoffman.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhbif8qTHHIaSnVkgEQwitQBdns5dyKvjuGSi-FnEJXGso37fVb5DI9OJcRcOLnfoB3lYbnCQq6rF5vKEB6h9BcLqydjihdj_ASV51RwwASJmmLTVSe813ANiQ_6TRGARTTNeXcTTLk1Ik/s320/Wendell_Hoffman.jpg" width="213" /></a><i style="mso-bidi-font-style: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12pt; mso-fareast-font-family: "Times New Roman";">7
Days of Recognition, 365 Days Committed to Safe Care</span></i><span style="font-family: "Times New Roman","serif"; font-size: 12pt; mso-fareast-font-family: "Times New Roman";">. This annual lifting up of the ancient <i style="mso-bidi-font-style: normal;">Primum non nocere</i> concept (latin for “First do no harm”) reminds us
of our fundamental obligation. Check it out on the link below.<br />
<br />
</span><a href="http://www.npsf.org/"><span style="font-family: "Times New Roman","serif"; font-size: 12pt; mso-fareast-font-family: "Times New Roman";"><span style="color: blue;">http://www.npsf.org</span></span></a><span style="font-family: "Times New Roman","serif"; font-size: 12pt; mso-fareast-font-family: "Times New Roman";"> <br />
<br />
Now you can actually translate and in fact summarize the profound implications
of <i style="mso-bidi-font-style: normal;">Primum non nocere</i> with 2 words – <i style="mso-bidi-font-style: normal;">“Never-Always”</i>. Dr. Bruce Pitts, our
Sanford Health Chief Medical Officer, has recently coined this weighty calling
with a very simple but poignant definition of what our care should/could be,
“Some things never happen and some things always happen”. You could say that
safety is “Never” and quality is “Always” or reverse them, for they are
imminently interchangeable. <i style="mso-bidi-font-style: normal;">Never-Always</i>
simply works as a call to greatness in healthcare…like always wash your hands,
always reconcile the medication list, always do a timeout, always get your
influenza shot or never do not wash your hands, never do not reconcile the med
list, never do not do a timeout and never do not get an influenza shot. Now add
your own <i style="mso-bidi-font-style: normal;">Never-Always</i> ideas….the list
is very long indeed. <br />
<br />
As Dr. Pitts reminds us, “Articulating greatness in terms of ‘never’ and
‘always’ provides clarity and direction…By the standards of ‘never’ and
‘always,’ no health care institution in the nation or the world has yet
achieved greatness. The new high ground is unoccupied.” Indeed this is a
daunting challenge to our industry and represents a very steep slope up Mount
Complexity. To accomplish this will require all of us climbing together, in
order to ever hope of occupying this ground? <i style="mso-bidi-font-style: normal;">This is why the IHI Open School matters!</i><br />
<br />
So why does <i style="mso-bidi-font-style: normal;">Never-Always</i> so resonate
and what is its connection to our South Dakota IHI Open School Chapter? The
answer it seems may lie, not outside of us, such as a required course to pass
or a mandatory benchmark to meet, but rather within us, as raised by Daniel
Pink in his book <i style="mso-bidi-font-style: normal;">Drive</i>. Pink exposes
the literature of intrinsic motivation and shows us that we humans are internally
motivated by three major drivers - Purpose, Mastery, and Autonomy. <i style="mso-bidi-font-style: normal;"><o:p></o:p></i></span></div>
<br />
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<span style="font-family: "Times New Roman","serif"; font-size: 12pt; mso-fareast-font-family: "Times New Roman";">Check out <i style="mso-bidi-font-style: normal;">Drive</i> and strongly consider it as your next read. Here’s the link: </span><a href="http://www.danpink.com/books/drive"><span style="font-family: "Times New Roman","serif"; font-size: 12pt; mso-fareast-font-family: "Times New Roman";"><span style="color: blue;">http://www.danpink.com/books/drive</span></span></a><span style="font-family: "Times New Roman","serif"; font-size: 12pt; mso-fareast-font-family: "Times New Roman";"> <o:p></o:p></span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12pt; mso-fareast-font-family: "Times New Roman";">Intrinsic motivation is far more
powerful than any extrinsic motivator, like a test or a benchmark. <span style="mso-spacerun: yes;"> </span>Those individuals and organizations, per Pink,
that tap into this rich bank of human capital can achieve extraordinary things.
It’s really what pulled us all into medicine…not? So let’s apply Pink’s
observations to Dr. Pitts’ notion of <i style="mso-bidi-font-style: normal;">Never
Always</i> and then work it out as our chapter’s response to National Patient
Safety Awareness Week, or maybe as our personal driver toward great
contributions to medicine.</span><span style="font-family: "Times New Roman","serif"; font-size: 14pt; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div>
<br />
<ul type="disc">
<li class="MsoNormal" style="line-height: normal; margin: 0in 0in 10pt; mso-list: l0 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in;"><i style="mso-bidi-font-style: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12pt; mso-fareast-font-family: "Times New Roman";">Never
Always</span></i><span style="font-family: "Times New Roman","serif"; font-size: 12pt; mso-fareast-font-family: "Times New Roman";"> restores the patient to the
reason for why we exist – and that is true Purpose <o:p></o:p></span></li>
<li class="MsoNormal" style="line-height: normal; margin: 0in 0in 10pt; mso-list: l0 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in;"><i style="mso-bidi-font-style: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12pt; mso-fareast-font-family: "Times New Roman";">Never-Always</span></i><span style="font-family: "Times New Roman","serif"; font-size: 12pt; mso-fareast-font-family: "Times New Roman";"> revolutionizes our work around the new science – or
the science of <i style="mso-bidi-font-style: normal;">the human caring for
the human.</i> In other words it challenges us to conquer ourselves and
that is true Mastery <o:p></o:p></span></li>
<li class="MsoNormal" style="line-height: normal; margin: 0in 0in 10pt; mso-list: l0 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in;"><i style="mso-bidi-font-style: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12pt; mso-fareast-font-family: "Times New Roman";">Never-Always</span></i><span style="font-family: "Times New Roman","serif"; font-size: 12pt; mso-fareast-font-family: "Times New Roman";"> engages the frontline imagination with joy and meaning
– or in other words “I matter and my work (and my learning)
matters…I can make a difference” and that is true Autonomy<o:p></o:p></span></li>
</ul>
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<span style="font-family: "Times New Roman","serif"; font-size: 12pt; mso-fareast-font-family: "Times New Roman";">Try pondering <span style="mso-spacerun: yes;"> </span><i style="mso-bidi-font-style: normal;">Never-Always
</i>as the motivator in your corner of the health care world and ask yourself a
few questions. What things would you never want to happen or you would always
want to happen in your setting? Better yet, ask yourself this, ”What would I
want never to happen or always want to happen, to myself or the person most
precious to me, if I/they were a patient?” Next, begin to connect the IHI Open
School modules (achieved that Core Certificate yet?) and our chapter’s event
opportunities, to this notion of <i style="mso-bidi-font-style: normal;">Never-Always.
</i>This is a fantastic way to begin to master the new science of the human
caring for the human and to reach for purpose and autonomy. <o:p></o:p></span></div>
<span style="font-family: "Times New Roman","serif"; font-size: 12pt; line-height: 115%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;">Every once in a while we run into words which
capture the essence of things and upon which we can hang everything that
matters. To that extent we owe a thank you to Dr. Pitts for articulating what
greatness in healthcare can look like…<i style="mso-bidi-font-style: normal;">Never-Always</i>.
I close with his challenge, “We…have concluded that we have no choice but to
lead the industry’s march toward greatness. We begin here by authoring
it.” Could the South Dakota IHI Open School Chapter begin to lead the
industry in interdisciplinary learning, and in some way help to author it? You
bet we can, but it will require all of us to climb Mount Complexity…students,
deans, faculty, frontline care givers, and healthcare systems. Our chapter is
perfectly positioned, given the extraordinary accomplishments of just the past
two years. We can achieve great things, because everyone of us just naturally
brings the drive toward overarching Purpose, the drive to Master our discipline…and
the drive toward Autonomy, or that <i style="mso-bidi-font-style: normal;">I
matter</i> in the vast sea of American medicine…<i style="mso-bidi-font-style: normal;">because I matter to the patient</i>. </span><br />
<span style="font-family: "Times New Roman","serif"; font-size: 12pt; line-height: 115%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"></span><br />
<span style="font-family: "Times New Roman","serif"; font-size: 12pt; line-height: 115%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;">--Wendell Hoffman, MD, FACP is the Faculty Advisor for the SD IHI Open School Chapter, Patient Safety Officer for the Sanford Health Sioux Falls Region, a Clinical Professor of Medicine for the Sanford School of Medicine and a practicing Infectious Disease physician with Sanford Clinic.</span><br />
<span style="font-family: "Times New Roman","serif"; font-size: 12pt; line-height: 115%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"></span><br />
<span style="font-family: "Times New Roman","serif"; font-size: 12pt; line-height: 115%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;">If you would like to contact Dr. Hoffman with questions or comments, you can email him at <a href="mailto:Wendell.Hoffman@sanfordhealth.org">Wendell.Hoffman@sanfordhealth.org</a></span>IHI Open School, South Dakota Chapterhttp://www.blogger.com/profile/10794903062959078463noreply@blogger.com0tag:blogger.com,1999:blog-8347874150292088715.post-18371420242266681542012-11-08T16:15:00.000-08:002012-11-16T08:18:21.378-08:00The Tenets of Professionalism<br />
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<span style="font-family: Calibri;">I have often heard the legal profession described as the
“second oldest profession” and with the “oldest profession” being an
inappropriate topic area for this blog, apparently that would put the medical
profession as the “third oldest” profession.<span style="mso-spacerun: yes;">
</span>Whether or not either the medical or legal profession can lay claim to
precedence to an “older” title is probably irrelevant but the key is both
professions have been around for thousands of years; while much has changed,
their basis hasn’t.<span style="mso-spacerun: yes;"> </span>For the medical
profession, this basis is probably best summed up by the famous quote from Dr.
Mayo, “The best interest of the patient is the only interest to be considered”.<o:p></o:p></span></div>
<br />
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<span style="font-family: Calibri;">It may be fairly obvious but by choosing to be trained in
one of the medical disciplines, you have “joined” a profession!<span style="mso-spacerun: yes;"> </span>Based on the discipline, professionals may
voice different oaths, but in the end, we all have committed to several basic
behaviors: <span style="mso-spacerun: yes;"> </span>confidentiality of the
information we have received from those we will serve, clear and effective
communication with both the patient and others that will be assisting us in
serving the patient, being respectful of those we serve and modeling respect
for ourselves and the profession that we represent by our words and actions,
and finally actually being available when called upon to take care of our
patients or clients.<span style="mso-spacerun: yes;"> </span>In the complex
world of today’s medicine, in order to meet the “best interests” of the
patient, being professional also means that the concept of team needs to be
promoted as well.<o:p></o:p></span></div>
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<span style="font-family: Calibri;">One of the other major concepts of a profession is that
professionals are self-regulating.<span style="mso-spacerun: yes;"> </span>This
is sometimes thought as merely a personal obligation, but in many instances
this can also be peer-to-peer or group obligations.<span style="mso-spacerun: yes;"> </span>Essentially, all of us require the skills to
provide and receive feedback, especially from our peers, so that the feedback
is constructive.<span style="mso-spacerun: yes;"> </span><o:p></o:p></span></div>
<br />
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<span style="font-family: Calibri;">For the last several years, I have been involved in the
Patient Advocacy Reporting System (PARS) created by Vanderbilt University.<span style="mso-spacerun: yes;"> </span>The program was developed from research that
showed that there was a direct correlation between patient complaints and
medical malpractice suits.<span style="mso-spacerun: yes;"> </span>The program
has been enormously successful because it uses peer messengers to make
physicians aware of patient complaints that have been received about them.<span style="mso-spacerun: yes;"> </span>Vanderbilt’s research has shown that when
physicians receive peer feedback, they are more likely than not (70%+) to act upon
the information and bring their focus back to patients and consequently the
amount of patient complaints decline (as does the risk of lawsuits).<o:p></o:p></span></div>
<br />
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<span style="font-family: Calibri;">The success of the PARS program is directly related to
professionalism.<span style="mso-spacerun: yes;"> </span>The recognition by our
peers that the profession is worth self-regulation and that they can play a
part by providing feedback about issues that are important to both patients and
physicians.<span style="mso-spacerun: yes;"> </span>The recognition by the physicians
receiving the message and feedback reflects that our peers have a common basis
to discuss the feedback with them and that they should take the time to listen
to their peers about how to improve their own professionalism.<o:p></o:p></span></div>
<br />
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<span style="font-family: Calibri;">Being part of a profession is an honored path that we should
all recognize and take responsibility for by making the profession better than when
we first joined.<o:p></o:p></span></div>
<br />
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<span style="font-family: Calibri;">--David Danielson, JD, CPA, is Senior Vice President of Clinical
Risk Management at Sanford Health, is an Assistant Professor of Internal
Medicine at the USD Sanford School of Medicine and is a member of the National Patient Safety Foundation's Board of Governors</span></div>
IHI Open School, South Dakota Chapterhttp://www.blogger.com/profile/10794903062959078463noreply@blogger.com0tag:blogger.com,1999:blog-8347874150292088715.post-32475918469925155052012-10-01T12:08:00.001-07:002012-10-01T12:08:43.449-07:00Reflections on 100,000 strong for our patients
<br />
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<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: major-latin; mso-bidi-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Recently, I have come to agree with Dr. Berwick, viewing the IHI
Open School as not just a movement, but a revolution started by students who
are motivated to change the culture of care in the systems where we work.<span style="mso-spacerun: yes;"> </span>We are finding that in order to make the
changes we need to achieve higher quality care at a lower cost, we must
transform entire systems of care.<span style="mso-spacerun: yes;">
</span>100,000 students and residents signed-on to the IHI Open School is an
incredible number and is certainly a huge milestone!<span style="mso-spacerun: yes;"> </span>These students are entering their respective
health professions as natural leaders in quality and safety.<span style="mso-spacerun: yes;"> </span>In many ways, they have now become the
experts in their systems.<span style="mso-spacerun: yes;"> </span>But our
patients need us more than ever.<span style="mso-spacerun: yes;"> </span>We need
more students to sign-on.<span style="mso-spacerun: yes;"> </span>The systems
are not changing quickly enough and we require a small army to teach others how
to develop safer, more effective, patient-centered care that is timely,
efficient, and equitable.<span style="mso-spacerun: yes;"> </span>This means
teaching the science of quality, safety, teamwork, and communication.<span style="mso-spacerun: yes;"> </span>We must do this together.<span style="mso-spacerun: yes;"> </span>And it must be multi-disciplinary.<span style="mso-spacerun: yes;"> </span>Health care delivery is increasingly
complex.<span style="mso-spacerun: yes;"> </span>Patients are confused,
vulnerable, and are being harmed more than we would like to admit.<span style="mso-spacerun: yes;"> </span><o:p></o:p></span></div>
<br />
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<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: major-latin; mso-bidi-theme-font: major-latin; mso-hansi-theme-font: major-latin;">The IHI Open School is the absolute best way for us to come
together, connecting with students of all disciplines in our local chapters,
advocating for IHI Open School courses to be integrated into the curriculum at
our schools, teaching other health care providers about these important topics,
and engaging in dialogue with students and faculty around the world through the
IHI Open School chapter network.<span style="mso-spacerun: yes;"> </span>I
originally thought of the IHI Open School as a motivator, an entity designed to
encourage students to complete courses on their own time and develop the skills
they need.<span style="mso-spacerun: yes;"> </span>However, after four years of
existence, it is now becoming an integrator.<span style="mso-spacerun: yes;">
</span>The concepts we learn through IHI Open School are the threads that
connect all health disciplines.<span style="mso-spacerun: yes;"> </span>Every
student in every health discipline should have these skills.<span style="mso-spacerun: yes;"> </span>Application of these skills has solved many
complex problems and will continue to solve problems and improve patient care
on a larger scale.<o:p></o:p></span></div>
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<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: major-latin; mso-bidi-theme-font: major-latin; mso-hansi-theme-font: major-latin;">So let’s bring 100,000 more students to the IHI Open School. 100 years
ago, Dr. William James Mayo stated in his commencement address at Rush Medical
College in Chicago, “The best interest of the patient is the only interest to
be considered, and in order that the sick may have the benefit of advancing
knowledge, a union of forces is necessary.”<span style="mso-spacerun: yes;">
</span>Indeed, our union of forces is the IHI Open School.<span style="mso-spacerun: yes;"> </span><o:p></o:p></span></div>
<br />
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<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: major-latin; mso-bidi-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><o:p> </o:p></span></div>
<br />
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<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: major-latin; mso-bidi-theme-font: major-latin; mso-hansi-theme-font: major-latin;">--Ryan
Miller is a 3<sup>rd</sup> year medical student at the Sanford School of
Medicine and Chapter President for the South Dakota IHI Chapter<o:p></o:p></span></div>
IHI Open School, South Dakota Chapterhttp://www.blogger.com/profile/10794903062959078463noreply@blogger.com0tag:blogger.com,1999:blog-8347874150292088715.post-3970846273297340192012-09-03T15:14:00.001-07:002012-09-03T15:17:30.998-07:00Doctor is Spelled T.E.A.M.<br />
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<span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="font-family: Calibri;">I am a first year medical student who has come to this point in my
life via a different path compared to most other medical students. As a college
and high school basketball coach for eight years, I learned to study
performance as if it were a science. The most interesting part of athletic
coaching to me was not who could develop the most complex or innovative
strategy, but who could get their individual players to execute their roles within
the team strategy as close to perfection as possible. I am coming into medical
school from a background of studying players to learn how to help them perform
to their highest capability. </span></span></span><br />
<span style="font-family: "Times New Roman","serif";">
<br />
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<span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="font-family: Calibri;">Understanding how to assist individuals to reach their capacity
translates to medicine, and to every other field. The problem that I find interesting
is not <i style="mso-bidi-font-style: normal;">how</i> to find new information,
but how to <i style="mso-bidi-font-style: normal;">use</i> the existing
information better. As a coach, my job was to find new ways to help each athlete
get to a place where he does his job flawlessly. As a student, my day is now
currently filled with gathering information. There is so much to learn, I feel
as though I may never quite grasp things with as much detail as I would like.
But, I know eventually I will be as prepared as I need to be - just as those
before me have been. So, in thinking about becoming a doctor someday, I now
think about how I will ever be able to keep things straight and not make any
mistakes. Because I know if I do make a mistake, the consequences will be much
more severe than a low test score. That brings me back to the same question
that I faced in coaching. How can I get the most out of what I have? How do I
consider all the data and tendencies that we will learn, and not leave anything
out? So far, I think we have learned about maybe twenty drugs - and I struggle
to keep them separate. How will I be able to do the same, when that number is
in the hundreds or more?</span></span></div>
<br />
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<span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="font-family: Calibri;">The answer, I think, is to realize that a complete knowledge of
medicine is too complex for me. I am going to need help from other people. In
order to be able to rely on others in the future, I need to start working on
doing so now. The time to cultivate professional, trusting relationships is not
when disaster strikes and I can't quite remember the correct sequence of
remedies I need to apply. It is the days and months before that time. Thus when
it all comes crashing down, I know I will be able to trust those around me to
help achieve the best outcome.<o:p></o:p></span></span></div>
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<span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="font-family: Calibri;">This idea is the ultimate lesson in
being part of a team. That is what makes athletics so valuable, and is
hopefully the lesson that we will start to learn as we begin our medical
careers. Learning how, not just to work with other people, but to rely on them
and allow them to rely on you. Of course the knowledge is important. Of course
it is my responsibility to know it all myself as well as I possibly can. This
is not an excuse to be lazy and rely on others to get you by. This is just
understanding that more can be achieved when people work together. Being a
great teammate is a skill that needs to be cultivated. It takes some humility
to ask for help or to ask for other ideas. The time to start working on those skills
is before you actually need to use them. <o:p></o:p></span></span></div>
<br />
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<span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><o:p><span style="font-family: Calibri;"> --Scott Stevens is a first year medical student at the Sanford School of Medicine</span></o:p></span></div>
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IHI Open School, South Dakota Chapterhttp://www.blogger.com/profile/10794903062959078463noreply@blogger.com0tag:blogger.com,1999:blog-8347874150292088715.post-73778468076227329792012-07-29T13:18:00.000-07:002012-08-04T13:35:53.900-07:00A Season of Renewal<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj1HzrfO6AnqTikzrT3xRREdZvF2YrztfxUclW6FzD-vBMHevX4DtrrThQPls9FKP-BHO1h-gWFclu5gKhmPFJDdBTH0EQiT3tDD0tmHoBJytwZQI26CDOcELmUgYseeMaqHa3Q98kuNOM/s1600/Nettlleman-Mary.jpeg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj1HzrfO6AnqTikzrT3xRREdZvF2YrztfxUclW6FzD-vBMHevX4DtrrThQPls9FKP-BHO1h-gWFclu5gKhmPFJDdBTH0EQiT3tDD0tmHoBJytwZQI26CDOcELmUgYseeMaqHa3Q98kuNOM/s200/Nettlleman-Mary.jpeg" width="140" /></a></div>
<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">It’s
the season of renewal at the University of South Dakota Sanford School of
Medicine.<span style="mso-spacerun: yes;"> </span>Our former senior medical
students have moved on to residencies to complete their transformation from
student to colleague.<span style="mso-spacerun: yes;"> </span>Men and women who
were college students a few short months ago are now medical students.<span style="mso-spacerun: yes;"> </span>They bring with them their enthusiasm,
aspirations and hope for the future.<span style="mso-spacerun: yes;"> </span><o:p></o:p></span><br />
<br />
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<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Our
new students will find a medical school that is undergoing its own process of
renewal and transformation.<span style="mso-spacerun: yes;"> </span>In 2012,
USD SSOM was rated in the top ten schools in the nation in rural medicine and
in family medicine and was named one of the top ten most popular medical
schools in the country by US News and World Report.<span style="mso-spacerun: yes;"> </span>Our graduates have enviably high rates of
passing national boards and high median board scores, and the school recently
passed accreditation with flying colors.<span style="mso-spacerun: yes;">
</span>Despite this great foundation, changes are afoot because we recognize
that the curriculum of the past will not adequately train physicians of the
future.<span style="mso-spacerun: yes;"> </span>.<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span><o:p></o:p></span></div>
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<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Soon,
students will notice fewer lectures and more interactive small group
sessions.<span style="mso-spacerun: yes;"> </span>Basic science courses will be
coordinated with each other to provide a more vivid and memorable picture of
the function of the human body.<span style="mso-spacerun: yes;">
</span>Clinical work will be more clinic-centered, because the outpatient
setting is where most diagnoses are made and where 75% of visits in the U.S.
occur.<span style="mso-spacerun: yes;"> </span>More time will be set aside for
electives and this will occur earlier in the curriculum to allow students to
gain more experience in an area of interest before they have to choose a
specialty.<span style="mso-spacerun: yes;"> </span>Our new Frontier and Rural
Medicine (F.A.R.M.) program will allow a select group of students to spend
significant time in a rural community of less than 10,000 people.</span></div>
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<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">This
is a lot of change and we are not alone.<span style="mso-spacerun: yes;">
</span>Virtually every medical school in the country is overhauling its
curriculum right now.<span style="mso-spacerun: yes;"> </span>In part this is
in response to the recent Carnegie report that pointed out that the structure
of medical education had not changed in more than a century.<span style="mso-spacerun: yes;"> </span>Medical education has simply not kept up
with educational theory.<span style="mso-spacerun: yes;"> </span>Long-term
memory is created when learning is interactive, uses multiple modalities, is
repetitive, and is directly related to patient care.<span style="mso-spacerun: yes;"> </span>Clearly, it is time for us to change.<span style="mso-spacerun: yes;"> </span>But how do we know that we are creating a
better system?<span style="mso-spacerun: yes;"> </span>The answer is that USD
SSOM is uniquely positioned because the Carnegie report cited the Avera Sacred
Heart Yankton campus of USD SSOM as a national model for educational
reform.<span style="mso-spacerun: yes;"> </span>This means that the school has
experience in delivering the modern clinical curriculum and has the outcome
data to show that students who go through this curriculum are highly successful
as measured in many ways including performance and test scores.<span style="mso-spacerun: yes;"> </span>Only a small handful of schools in the
country have this experience.<span style="mso-spacerun: yes;"> </span>Another
major asset in this process is the high quality of the teaching faculty in the
school.<span style="mso-spacerun: yes;"> </span>It is difficult to ask basic
scientists and clinicians to change the way they teach, yet they are not only
willing to do so but they are also highly engaged in creating the new
model.<span style="mso-spacerun: yes;"> </span>The best systems (and the best
people) are those that are flexible and responsive to changing needs.<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>The
communities and health systems are strong supporters of medical education, and
we will continue to rely on these important partners.<span style="mso-spacerun: yes;"> </span>Our final important asset is the students
themselves, who provide critical input and advice to us at every stage of the
process.<span style="mso-spacerun: yes;"> </span></span></div>
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<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">The
new curriculum must be responsive to the medical needs of South Dakota and the
nation.<span style="mso-spacerun: yes;"> </span>It is always important for
physicians to provide excellent care in a face to face environment.<span style="mso-spacerun: yes;"> </span>However, there is an increasing need for
physicians to step back and consider the health of populations.<span style="mso-spacerun: yes;"> </span>The modern physician should insist that the
quality of care be measured and improved, leading the effort rather than
resisting it.<span style="mso-spacerun: yes;"> </span>Medical school needs to
provide the tools for young physicians to do this.<span style="mso-spacerun: yes;"> </span>Many diseases now are related to behaviors
and social factors that are not going to be influenced by medications or
tests.<span style="mso-spacerun: yes;"> </span>Modern physicians need the tools
to motivate behavioral change.<span style="mso-spacerun: yes;"> </span>Physicians
also need to be competent to practice in an increasingly multi-cultural
world.<span style="mso-spacerun: yes;"> </span>Finally, and perhaps most
importantly, physicians need to adhere to the highest standards of
professionalism.<span style="mso-spacerun: yes;"> </span>These are tall orders,
but they can be accomplished.</span></div>
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<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">One
of the things I like best about academic medicine is the variety and change
that is inherent in it. We have the privilege of working closely with some of
the best minds and some of the nicest people in the country.<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>Building on this foundation, we share our new
students’ sense of optimism and look forward to the future.</span></div>
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<br /></div>
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<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">--Mary Nettleman, MD, MS, MACP is Vice President for Health Affairs and Dean of the University of South Dakota Sanford School of Medicine</span></div>IHI Open School, South Dakota Chapterhttp://www.blogger.com/profile/10794903062959078463noreply@blogger.com0tag:blogger.com,1999:blog-8347874150292088715.post-13946810272677098252012-06-29T08:43:00.001-07:002012-06-29T08:49:48.225-07:00June 28, 2012--A Day in History<span style="font-family: Calibri;">June 28, 2012…..will this become a landmark date within the
history of our country?<span style="mso-spacerun: yes;"> </span>Perhaps not, but
as I pause to collect a few thoughts for Unum Vox, it is hard to take one’s
eyes off of CNN, or the explosion within the blogosphere, over today’s Supreme
Court ruling relative to the PPACA (Patient Protection and Affordable Care Act).<span style="mso-spacerun: yes;"> </span>Without a doubt this is a critical moment in our
country’s lurching, ponderous journey towards universally accessible,
affordable, safe and reliable health care.<span style="mso-spacerun: yes;">
</span>Rest assured, the political debate will only escalate, pundits will
continue to pontificate, but a stake has now been placed firmly in the ground,
and any effort to diminish, augment, or change our approach to health care
reform will have to travel through this historic piece of health care
legislation, or at least be measured by/compared to it.</span><br />
<div class="MsoNormal" style="margin: 0in 0in 10pt;">
<span style="font-family: Calibri;">Regardless of an individual’s political or philosophical
persuasion, the PPACA pushes this country in several positive ways.<span style="mso-spacerun: yes;"> </span>In fact, many laudable accomplishments can
already be attributed to it.<span style="mso-spacerun: yes;"> </span>The
misfortune of severe illness no longer renders an individual uninsurable.<span style="mso-spacerun: yes;"> </span>“Pre-existing illness” will disappear from
the insurance industry’s lexicon.<span style="mso-spacerun: yes;"> </span>Young
adults will continue to be able to access the benefits of family coverage rates
until age 26.<span style="mso-spacerun: yes;"> </span>Through exchanges,
employer based plans, and expanded Medicaid coverage we should be able to
approach fully accessible health care for 95% of all citizens, and simultaneously
remove a long standing embarrassment for this country amidst the roll call of
nations within the developed world (even many countries considered to be “third
world”).</span></div>
<div class="MsoNormal" style="margin: 0in 0in 10pt;">
<span style="font-family: Calibri;">Admittedly, this piece of legislation was/is far from
perfect.<span style="mso-spacerun: yes;"> </span>Much of the “tough medicine” true
reform requires was side-stepped by our political leaders.<span style="mso-spacerun: yes;"> </span>Sustainability is only possible within the
context of affordability, and most will agree that the measures taken within
the PPACA fall far short of dealing with the difficult decisions needed to take
control of the inexorable climb of health care costs.<span style="mso-spacerun: yes;"> </span>Until we hard-wire care that is fully cost
conscious, and high value, this effort will collapse under its own weight.</span></div>
<div class="MsoNormal" style="margin: 0in 0in 10pt;">
<span style="font-family: Calibri;">However, I take great solace and daily inspiration from two
critical observations by Dr. Donald Berwick, past director of CMS, and founder
of IHI.<span style="mso-spacerun: yes;"> </span>First, he likened the journey
towards high quality, safe and reliable health care to a car trip, and he
stated that the health care community (i.e. <u>not</u> <u>Congress</u>) drives
that car.<span style="mso-spacerun: yes;"> </span>Secondly, he opined the
following:<span style="mso-spacerun: yes;"> </span>“the key to improvement is
coverage, and the key to coverage is improvement.”<span style="mso-spacerun: yes;"> </span>In other words, we will never produce high
value, high quality care for our country until everyone has access to that
care.<span style="mso-spacerun: yes;"> </span>Likewise, unless we produce care
that is of the highest quality, universal coverage will be unsustainable.<o:p></o:p></span></div>
<br />
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<span style="font-family: Calibri;">As for me, I choose to be greatly encouraged today.<span style="mso-spacerun: yes;"> </span>The keys are in OUR hands.<span style="mso-spacerun: yes;"> </span></span></div>
<br />
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<span style="font-family: Calibri;">--Tom Braithwaite, M.D., FACP is Chief Quality Officer at Sanford Health in Sioux Falls<o:p></o:p></span></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjsvKS613YCpzFSbl6Aau4xjDx9DD5n3B9P8q6XArSrGSIJ-OOAJExJlRNxbhYpc44k29MZlpqAIqGLPk0i_z4J5yQ_LKc4a3WfVyHVKA7S6ylPLWMnZ1nkfHtetuGxyIJ3SSFm8SKrWO8/s1600/Braithwaite,Thomas+8x10.JPG" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjsvKS613YCpzFSbl6Aau4xjDx9DD5n3B9P8q6XArSrGSIJ-OOAJExJlRNxbhYpc44k29MZlpqAIqGLPk0i_z4J5yQ_LKc4a3WfVyHVKA7S6ylPLWMnZ1nkfHtetuGxyIJ3SSFm8SKrWO8/s200/Braithwaite,Thomas+8x10.JPG" width="160" /></a></div>IHI Open School, South Dakota Chapterhttp://www.blogger.com/profile/10794903062959078463noreply@blogger.com0tag:blogger.com,1999:blog-8347874150292088715.post-2968412660463893582012-06-01T06:25:00.000-07:002012-06-01T06:26:50.970-07:00The Art and Science of Nursing<span style="color: #1d1d1d; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: major-latin; mso-bidi-theme-font: major-latin; mso-hansi-theme-font: major-latin;"></span><br />
<span style="color: #1d1d1d; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: major-latin; mso-bidi-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><div class="MsoNormal" style="margin: 0in 0in 0pt; mso-layout-grid-align: none; mso-pagination: none;">
<span style="color: #1d1d1d; font-family: "Times New Roman","serif";"><span style="mso-spacerun: yes;"> </span> </span><span style="color: #1d1d1d; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: major-latin; mso-bidi-theme-font: major-latin; mso-hansi-theme-font: major-latin;">My
desire to be a nurse came about eight years ago when I was hospitalized on a
pediatric floor for three weeks. I was the crazy kid who wanted to go back to
the hospital when I came home because I missed “my nurses.” I remember the
nurses who comforted me and listened when I was scared, and the nurse who told
me “honey, crying isn’t going to help anything.” After my experience as a
patient, I knew I wanted to be a nurse who made a difference. I strive to be a
genuine nurse of integrity and compassion, a life-long learner dedicated to
collaboration and teamwork so that I can provide the best quality care
possible.</span><span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: major-latin; mso-bidi-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><o:p></o:p></span></div>
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<span style="color: black; font-family: Times New Roman;">
</span></div>
<div class="MsoNormal" style="margin: 0in 0in 0pt; mso-layout-grid-align: none; mso-pagination: none;">
<span style="color: #1d1d1d; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: major-latin; mso-bidi-theme-font: major-latin; mso-hansi-theme-font: major-latin;"> Jesus has called me
to love the people around me—“Love one another. As I have loved you, so you
must love one another (John 13:34).” He has also blessed me with a love for
science and a longing to understand how the body functions so complexly. Being
a nurse is one of the most tangible ways I can think of to love others using
the characteristics and talents God has given me. Nursing is both an art and a
science. To be a nurse is to care for the whole person—physically, emotionally,
and spiritually. A nurse cannot adequately care for a patient unless he or she
considers all aspects of care; being a nurse is not merely the ability to start
an IV, remove sutures, or administer a medication.</span><span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: major-latin; mso-bidi-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><o:p></o:p></span></div>
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</span></div>
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<span style="color: #1d1d1d; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: major-latin; mso-bidi-theme-font: major-latin; mso-hansi-theme-font: major-latin;"> I firmly believe I
can be the “smartest” nurse, but if I do not have compassion and know how to
care for the whole person, my patients will suffer. Knowledge is important.
Keeping up with research and being able to explain the complexity of a
patient’s health status to the family is essential to nursing care. However,
nursing is also about comforting the family of a dying patient, celebrating the
little milestones of a stroke victim, and holding the hand of a crying child.</span><span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: major-latin; mso-bidi-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><o:p></o:p></span></div>
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<span style="color: #1d1d1d; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: major-latin; mso-bidi-theme-font: major-latin; mso-hansi-theme-font: major-latin;"> I remember my first
day of nursing clinicals, just two years ago. I was terrified to give a bed
bath. Looking back I think, “Wow! Look how far we’ve come.” I remember my first
patient; her name and diagnosis but little else. When I first started nursing
school, I was so focused on disease and trying to make things perfect. Now I
look back to more recent experiences, and I remember something different.</span><span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: major-latin; mso-bidi-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><o:p></o:p></span></div>
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<span style="color: #1d1d1d; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: major-latin; mso-bidi-theme-font: major-latin; mso-hansi-theme-font: major-latin;"> I remember an older
gentleman who was scared out of his mind for a complex surgical procedure he
would be undergoing the next day. I remember seeing fear in his eyes, and
seeing that fear eased when I simply asked if he wanted to go for a walk. With
a smile on his face he said, “If I get to go on a date with you, then ABSOLUTELY!”
I remember his wife, and how all three of us joked around about me “stealing”
her husband to go on “walking dates.” We talked about his fears, and he told me
about his faith in God and how it was the only thing that was going to sustain
him. Yes, I learned a lot about his disease process, but I remember more than
his diagnosis. I remember his family and his stories and his faith, and I
remember praying for him every time I entered his room.</span><span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: major-latin; mso-bidi-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><o:p></o:p></span></div>
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<span style="color: #1d1d1d; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: major-latin; mso-bidi-theme-font: major-latin; mso-hansi-theme-font: major-latin;"> Ultimately, nurses
see patients at the best and worst moments of their lives, yet accept them the
way they are. Nurses acknowledge the uniqueness of each patient by
individualizing care, and through this they integrate knowledge and research
with compassion and love. A nurse of integrity is a lifelong learner, someone
who recognizes he or she is not all knowing, and one who is willing to ask
questions of others in the clinical environment. A nurse realizes that he or
she is just one part of a patient’s plan of care, and strives to interact with
the entire healthcare team in order to provide patients with the best quality
care.</span><span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: major-latin; mso-bidi-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><o:p></o:p></span></div>
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<span style="color: #1d1d1d; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: major-latin; mso-bidi-theme-font: major-latin; mso-hansi-theme-font: major-latin;"> After graduation I will be
starting a new career as a pediatric intensive care nurse. Nervous? Yes.
Excited? Absolutely. I know I am starting out in one of the most challenging
places in nursing. I am going to have days when I feel like I do not know
anything. I am going to be placed in situations where I do not have the perfect
words to say. But this is what I do know: </span><span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: major-latin; mso-bidi-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="color: black;">GOD IS GOOD.</span><span style="color: #1d1d1d;"> He has given me this
opportunity to love children and their families, and to grow as a leader.
Ultimately, nursing combines the science of the human body and research with
the art of communication, compassion and love, and I am blessed to be part of
it.</span></span><br />
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<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: major-latin; mso-bidi-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><span style="color: black;"><span style="mso-spacerun: yes;"> </span>- Caitlin Leimbach is a recent
graduate of South Dakota State University, and currently working as a nurse in
the Sanford Pediatric Intensive Care Unit in Sioux Falls. Caitlin is also a
graduate section leader for our SD IHI Open School chapter.<o:p></o:p></span></span></div>
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</div>IHI Open School, South Dakota Chapterhttp://www.blogger.com/profile/10794903062959078463noreply@blogger.com0tag:blogger.com,1999:blog-8347874150292088715.post-2764730979935124692012-04-23T05:01:00.000-07:002012-11-09T07:12:43.308-08:00Teamwork: For Better or for Worse<br />
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As a first year medical student looking into the future, I often wonder
what it will be like not to fly solo, as we must to earn a grade in medical
school, but to solve problems as a part of a health care team. This idea has
been touched on, but not fully explored as of yet in my medical career, though
it can be said to be an essential aspect of health care. I have personal
experience with both the positive and negative sides of teamwork. When I was in
the third year of my chemical engineering major, one of the required classes
was a chemical engineering lab, Unit Operations (it was like a chemistry lab,
except we used industrial sized equipment). The class was designed so that
students were employees of a company and were sent “Memos” asking for reports
or designs on different topics; the memos did not provide any instructions on
how to complete the task. Students were divided into groups, and members of the
group were assigned different jobs which changed for each lab: Planner, Experimenter,
Analyst, and Consultant. The group had to complete a minimum 50 page paper
every other week, as well as present every week on their progress to their
“Supervisor”. Each member received their own score, but it was impossible to
complete any one section if the other members hadn’t completed their own work.
Unit Operations created a situation where you are only required to complete
your job, but you are penalized if a member of your group doesn’t do their job.
At the time I began this class, I was excited because we used real industrial-sized
equipment, but I quickly learned the frustrations inherent in mutually
dependent teamwork. I struggled in the first semester of Unit Operations because
my group members did not pull their own weight, leaving me to pick up the slack
if I did not want to be pulled down. Actually, in the end, one of my group
members failed the class. However much work it was at the time, I truly learned
how essential communication and follow-through are for successful teamwork.
Now, the failed teamwork in that case led to a member’s failing the class (and
poor grades for the rest of the team), but on a health care team, such failure
could end up having a negative impact on a patient. </div>
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I first encountered the
importance of health care teams when my father became sick my freshman year of
undergrad. He went to the ER with severe abdominal pains anticipating that it
would be another blockage resulting from scarring from his past abdominal
surgeries. However, the general surgeon and ER physicians he saw upon arrival
discovered that he had acute necrotizing pancreatitis. As they couldn’t figure
out why my father had pancreatitis (turns out the pancreatitis was a side
effect or a reaction to his blood pressure medicine), and he was rapidly
deteriorating, multiple other health care providers were called to provide
assistance. These physicians included: internal medicine, GI, pulmonary/Critical
Care, interventional radiologist, and ID. All of these physicians were needed
to maintain his health until a decision could be made for a recovery plan. After
three days with no progress, it was decided that he could not be successfully
cared for in Sioux Falls, so he was airlifted to the Mayo Clinic<a href="http://www.blogger.com/blogger.g?blogID=8347874150292088715" name="_GoBack"></a> where he was under the care of a whole other set of the
same type of physicians caring for him in Sioux Falls with the addition of a
thoracic surgeon, a general radiologist, a biliary surgeon, and a transplant
doctor. It took another three days in the Mayo ICU surrounded by dozens of
doctors, fellows, residents and nurses before someone finally realized the most
likely cause of his pancreatitis. The blood pressure medicine was pinpointed
and discontinued, and my father was able to leave the ICU two days later,
though it took another couple of months before he was able to return to a normal
life style. Throughout this ordeal, my father was frequently not aware of what
was going on to him and about him; he did tell me two things he managed to notice,
1) that many times there were potential miscommunications between different
doctors and between doctors and staff (nurse, respiratory therapists etc.)
which luckily my mother was able to catch and 2) from the many doctors who
assisted on his case, it was a GI doctor, who had clearly been in excellent
communication with the other doctors, who first recognized the pancreatitis as
a potential side effect of the medication and took control of my father’s care
once he had stabilized. </div>
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My father’s case clearly
demonstrates the need for inter-disciplinary collaboration, the need for
improvement in the communication between physicians and other supportive health
care providers, as well as the importance of family support. The IHI Open
School was created to ensure that health care teams, like those that took care
of my dad, can succeed beyond their current level. If the students of today
truly learn to collaborate, then situations like my dad’s may not occur;
instead of 6 days to figure out what was causing his condition, it could have
been discovered in the first couple of days. Acute necrotizing pancreatitis is
not something that is easily survived and it was only with the successful
collaboration of multiple health care teams that my father is alive today.</div>
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<span style="text-indent: 0.5in;">- Laura Danielson is a first year medical student at the Sanford USD School of Medicine and is the editor of Unum Vox. </span></div>
IHI Open School, South Dakota Chapterhttp://www.blogger.com/profile/10794903062959078463noreply@blogger.com0tag:blogger.com,1999:blog-8347874150292088715.post-47845802364403607882012-04-22T11:21:00.000-07:002012-04-22T12:04:11.724-07:00Introduction to “Unum Vox” & The Importance of Health Care Team<div class="separator" style="clear: both; text-align: center;">
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<table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: left; margin-right: 1em; text-align: left;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgI2DKon32mqSs6aSVKB3jOqsdiNYMzM9UsyHb0C-NrZIQ9F2Ow81pGasBA35X5Q21iaXCcDZBqxOKU_MVb6F_HoJaM5UEnTzgTV4lB1N4y7g1eMnfNvEO22me9kdDnbKXwQHq6erbUtoc/s1600/IMG_1123.jpg" imageanchor="1" style="clear: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgI2DKon32mqSs6aSVKB3jOqsdiNYMzM9UsyHb0C-NrZIQ9F2Ow81pGasBA35X5Q21iaXCcDZBqxOKU_MVb6F_HoJaM5UEnTzgTV4lB1N4y7g1eMnfNvEO22me9kdDnbKXwQHq6erbUtoc/s200/IMG_1123.jpg" width="161" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-size: xx-small;">Ryan Miller, second year med student<br />IHI Open School, SD Chapter President</span></td></tr>
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<span style="font-family: Calibri; font-size: 11pt;">In 1910, William James Mayo
spoke of what we now call “patient-centeredness” at the commencement address of
Rush Medical College. He stated,
"It (has become) necessary to develop medicine as a cooperative science;
the clinician, the specialist, and the laboratory workers uniting for the good
of the patient.” He further
stated, “Individualism in medicine can no longer exist." As you can see, teamwork in medicine is
not a new concept yet 20<sup>th</sup> century medical education and healthcare
delivery has greatly struggled not because we haven’t seen new and improved
ways to treat the patient’s disease but because we have been doing this largely
in “silos”. So here we are in the 21<sup>st</sup> century with its growing
complexity, having to revisit<s> </s>these fundamental concepts and place them
as priorities. <o:p></o:p></span></div>
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<span style="font-family: Calibri; font-size: 11pt;">The
Institute for Healthcare Improvement (IHI) South Dakota chapter’s mission
is <i>“To bring together multiple
healthcare disciplines and teaching institutions for learning and collaboration
on patient safety and quality improvement. We seek to do this through the
common platform of the IHI Open School and by building teamwork among us as
South Dakota learners. All of this is for the patient’s best interest, which is
healthcare’s reason for being. We therefore seek to foster patient-centered
environments through learning approaches that address the complexity inherent
in healthcare delivery systems, into which the patient enters. To these ends we
seek to help equip students from all disciplines and at any stage of learning,
with the tools necessary to become leaders in patient safety and quality
improvement.”</i><o:p></o:p></span></div>
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<span style="font-family: Calibri; font-size: 11pt;">Students
recognize the need to work as a cohesive team. When members of our IHI Open
School chapter were asked what they think most needs to be improved in
healthcare settings today, the themes of teamwork, communication, and
patient-centeredness were far and away the most mentioned. One of our Physician
Assistant students said, “Ensuring that the patient and family are WELL
informed and understand the situation. COMMUNICATION between disciplines. No
one is ever on the same page. E.g. order CT with contrast on patient with renal
disease… causes lots of delays to determine if risk outweighs benefit.” An occupational therapy student said,
“Professionalism both with interactions between workers, patients, and
co-workers; true empathy or care for the patient at all times.” </span><span style="font-family: Calibri; font-size: 11pt;">Maureen
Bisognano, President and CEO of the Institute for Healthcare Improvement, has
spoken widely about the impact of these types of stories on the care we provide
patients. <o:p></o:p></span></div>
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<span style="font-family: Calibri; font-size: 11pt;">Recognizing the power of story
and perspective, we would like to introduce the inaugural blog of the IHI Open
School, South Dakota Chapter! The
blog, “Unum Vox,” (Latin for “One Voice”), serves as a new way to share our
experiences, learn from each other, and most importantly, speak with one voice
for the patient. </span><span style="font-family: Calibri; font-size: 11pt;">“</span><span style="font-family: Calibri; font-size: 11pt;">Unum Vox</span><span style="font-family: Calibri; font-size: 11pt;">” will feature the writings of South
Dakota health care students, professionals and faculty on topics related to the
South Dakota chapter’s theme “Together One Voice For The Patient.” Potential
areas include patient safety, performance improvement, leadership,
professionalism, communication, teamwork, systems thinking, human factors,
reliable design and just culture. It is hoped that these subjects will be
explored through stories of real patients and their caregivers, allowing all
who read it to continually improve their own ability to seek out the patient’s
best interest. This blog will be updated monthly and every South Dakota health
care professional student, who is also a member of IHI, has the opportunity to
contribute. We are delighted that Laura Danielson has both taken on the
leadership for editorial review of Unum Vox…and has written the first Unum Vox
blog with a compelling account of events in her personal journey as a learner
and as a family member.</span><span style="font-family: Calibri; font-size: 11pt;"><o:p></o:p></span></div>
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<span style="font-family: Calibri; font-size: 11pt;">Blog
posts may be a maximum of 1,000 words and must relate to the chapter’s theme
“Together One Voice For The Patient”. Ideas can be drawn from clinical,
classroom, personal experiences, opinion, responses to articles and more. Upon
submission, several editors will evaluate blogs and the chosen blog author will
be notified. Individuals who are chosen will be identified on the website.</span><span style="font-family: Calibri; font-size: 11pt;"> </span><b><span style="font-family: Calibri; font-size: 11pt;">To submit a blog post, email
Laura at </span></b><b><u><span style="font-family: Calibri; font-size: 11pt;">Laura.Danielson@usd.edu</span></u></b><span style="font-family: Calibri; font-size: 11pt;">. We encourage you to write for
this blog! With the diverse
experiences that members of our chapter have had, we can truly learn from each
other to improve care, and speak as “one voice.” </span></div>
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<span style="font-family: Calibri; text-indent: 0.5in;">Ryan Miller is the founder and chapter president of the South Dakota Chapter of IHI Open School and is a second year medical student at the Sanford USD School of Medicine.</span></div>
<br />IHI Open School, South Dakota Chapterhttp://www.blogger.com/profile/10794903062959078463noreply@blogger.com0