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A call for raised voices (with everyone included) as this year’s Medicine X begins

There was a buzz in the air this morning as Larry Chu, MD, took the stage (to the event's signature upbeat music) to kick off this year's Medicine X conference -- the highlight of a year-round program dedicated to the future of health care, with a focus on innovation and technology.

After reminding the audience of the importance of including multiple stakeholders -- especially patients -- in the health care conversation, Chu acknowledged the challenging times we live in. But, he said, we're also in an age of "citizen power." And, he said, "we are more powerful than we think. We can be change agents that disrupt the status quo." He also encouraged attendees to: "Stay curious. Stay open to new ideas. That is an act of resistance. That’s the work we do together this weekend."

Chu was followed by Harvard professor Amy C. Edmondson, PhD, who in an opening keynote discussed the importance of creating psychological safety in health care workplaces to create better outcomes for patients. She gave the example of a nurse who hesitates to call a doctor in the middle of the night for fear that she'll look incompetent or intrusive -- despite thinking something is not quite right with her patient. In order to get the nurse to make that potentially life-saving call, leaders must create an atmosphere where dissent is framed as depth and where being candid, honest and vulnerable are valued by leaders. "Think of it as felt permission for candor," she said. “What we’re really asking is for people to bring their full selves to work."

Instead of looking for blame when things go wrong, we should acknowledge that almost no one wakes up in the morning wanting to do harm or wreak havoc on their patients, she said. And we should aim for a health care culture in which asking questions and admitting mistakes is okay. But how to achieve that?

First, Edmonson said, leaders must admit their own vulnerability. “Every single one of us is a fallible human being," she said. "You know it. They know it. Close that gap." Second, leaders must ask good questions. To broaden the discussion, they must ask for different perspectives and for help seeing what they might be missing. She exhorted leaders to create an atmosphere where no idea is shot down and all viewpoints are embraced.

Finally, leaders must embrace team members who come to them with news they might not want to hear. “Don’t shoot the messenger is a pretty low bar," she said, laughing. "Let’s give him a hug instead.” If we don't thank the nurse for making the call and asking a question in the middle of the night, we can be assured that the next time they won't pick up the phone. Responding productively to failure is an important part of creating an environment where everyone feels safe to raise their voice, she said.

As Medicine X swings into full gear, expect to hear more calls for raised voices.

Previously: It's back! Stanford Medicine X returns to campus and Countdown to Medicine X: "Speak up," urges organizational learning expert
Photo courtesy of Stanford Medicine X

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