OUTLIERS--The Story of Success

Malcolm Gladwell is one of my favorite authors. His last two books, the Tipping Point and Blink, became best sellers. I reviewed both books in our Jefferson Health Policy Newsletter in 2001 and 2005, respectively. His newest book, OUTLIERS-The Story of Success, is another hit!! I especially enjoyed chapter 7--The Ethnic Theory of Plane Crashes. This could serve as a primer on the basic tenets of Crew Resource Management--the study of improved cockpit communication and its connection to safer flights and fewer crashes. Essentially, CRM teaches pilots, copilots and other crew members a standardized form of communication that empowers everyone to participate in a safe flight. It reduces "mitigated speech" patterns and helps to preserve communication "against the authority gradient" with out punitive damages. I am convinced that healthcare teams could use a heafty dose of CRM and that training programs across most hospitals would benefit as well. Imagine for a moment a team making rounds that chooses to ignore the third year student who has a crucial piece of history, taken from the patient, that may dictate a change in therapy?? Would your team be willing to listen to the lowly third year student, especially if her information would contradict what the attending has already decided?? Think about it, and let me know!! DAVID NASH

Interclerkship Day number FIVE

Happy New Year and let's make it a great 08!!On January 7th our Department will sponsor the Fifth Annual Jefferson Medical College Interclerkship Day on Patient Safety. This is a unique program in the nation where we bring the entire Third Year Medical College Class, all 255 students, to an offsite hotel and spend the day talking and learning about their role in improving patient safety. With the help of famous speakers like John Nance from ABC news and other faculty, we review the recent literature on patient safety and we give specific examples as to how Third Year Students can participate in the hard work of improving medical care. We have previously published our experience with this program in the American Journal of Medical Quality. Most Third Year Students, even with just six months of clinical experience, have seen a medical error occur or at least a near miss.They have seen obusive behaviours by their more senior colleagues, and they have been reluctant to speak up. Our program, focusing on the tenets of Crew Resource Management, helps them to overcome their fears and to make a difference for patients. I am proud of our entire Department and hope that these kinds of programs will make a difference in the future. What do you all think??? DAVID NASH