Friday, May 09, 2008

Dear Interns

As each new class of interns arrives at the hospital, it is important to provide a context for their experience. Most of their advice and training comes from their clinical leaders, but the CEO has a role, too. Here are excerpts from one of my notes to the current class:

Dear Interns,

I'd like to turn to some important matters facing BIDMC and explain your role in helping us achieve some very important goals. The context is this: While you as doctors -- along with others who have come before you -- have received excellent training in biology, disease, diagnostics, and treatment, there is a growing part of clinical care that requires all of us to expand our scope and consider the manner in which we actually deliver care and how we might improve that. Our hospital has decided to be a leader in the science of care delivery, reviewing and enhancing our overall system of care to reduce harm to patients.

Several months ago, our Board of Directors voted to set an audacious goal for BIDMC, to eliminate preventable harm over the next four years. See these entries on my blog for more details. Our chiefs of service are fully in support of this goal and are now engaged in many measures to make it happen. We know of no other hospital in Boston that has taken on this challenge, and there are likely very few throughout the country. It is a bit daunting. But we believe that we have a lot to learn and a lot to teach by making the effort.

Part of the context for setting this goal is to hold ourselves accountable to the public and ourselves. We have been the leaders in this region in transparency of our clinical outcomes, for we believe that self-reporting of medical errors and process improvement is a sure statement of our commitment to progress in this arena.

We have also established an overall process improvement program called BIDMC SPIRIT, in which you will be trained after your arrival. Here's the introductory message about this program. The concept is simple -- to encourage people throughout the organization to call out problems as they see them and to solve them to root cause -- rather than creating work-arounds that just add layers of poorly designed process in the organization. Here are a couple of examples to give you the idea.

I look forward to having you join us as we invent and implement these programs and eliminate preventable harm for our patients.



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