CEO: Practice-Based and Life Long Learning
Objective: Seek out and apply best practices, measure the effect of changes and develop strategies to improve performance
The start of medical school was a bit rocky. It was quite the transition from undergraduate education and I realized that I had to change the way I studied in order to succeed. I had to find different strategies and try them out to find what style led to the best results. As I look back on that period of my journey, I realized how similar my approach was to our AHSS project. Our group had to identify the problem, seek out the best practice guidelines and develop a strategy to address and fix the problem. That is the same framework for how I adjusted my studying as a first year. I identified my problem, worked to develop a plan of attack, and ultimately put it into effect to see how my grades would be affected.
Admittedly, our AHSS project was dealing with a topic of higher importance than my studying as we were working to identify the cause of increased thromboembolic events in post-operative patients and why the administration of heparin after neuraxial anesthesia was poor. We worked with our faculty advisor, following the same thought process that I went through as a first year. We identified that the problem lies with the lack of education and reminders regarding heparin administration in the pre-operative period after receiving a block. After deliberation and discussion, we planned to attack the problem on multiple fronts, with a presentation during ground rounds, a best practice advisory alert on the EMR, and a mandatory qualtrics form that all providers were required to fill out. Our hopes are that these actions help to improve the initial problem and adherence to the guidelines.
This is part of the survey for our intervention. It has important themes that I have put in my own practice for when I have identified problems in my life and how I went about improving them. One of these is obvious, but it is identifying the issue. Sometimes this is easier said than done, and it often takes an extraneous source that alerts you to the presence of this factor. It can come in the form of a test grade, a thoughtful friend, or anonymous comment. The next important theme that translates into my life is that one has to identify any contributing factors to the problem. For me in my first year, those issues were feeling the pressure from my friends and the resistance to change that I felt as I blindly thought I could just continue my undergraduate study techniques without change. But that, like a lot of quality improvement projects, is the root cause. A fear or refusal to change. There is something so innate and comforting about the familiar. So when one faces change, it is almost natural to retreat to what you know and try to ignore the glaring facts that are present. I think that this applies to life and also to medicine. Sometimes, time is all we need to see change. But often, we need to put in the effort to make a change in order to see a different result. That is the conclusion I have drawn from this experience. I will try to approach each problem I encounter in the future with this same framework.