When my daughter was eleven, I sent her to stay with her grandmother in rural New Mexico for a month, as the brewing storm in our relationship seemed certain to explode in the long, hot, empty Georgia summer days. When she returned, our suburban family included a devoted horse enthusiast, and none of us have ever been--or really wanted to be--the same.
My daughter is deaf, and she uses a cochlear implant to hear. If you're not familiar with what that means in functional terms, it's this: my daughter hears, but not always or well. The precision, quality, and reliability of the sounds received are not the same as what a person with normal hearing experiences. Distance, background noise, and lack of contextual cues bother people with cochlear implants more than they bother others. Toilets flushing are easy to discern. Speaking voices are hard. Giddy-up!
Early-on, I remember spending a fair amount of time and energy at Radio Shack, purchasing, then returning, an array of electronic widgets that might help the trainer's voice reach across the dusty, windy arena to further "level the playing field" for my daughter. But the most vivid memory I have from that era is when the trainer, now a dear friend, called me to say, "I know you know your daughter doesn't hear well. But she doesn't listen either."
I knew that.
I think there are times when we all know things like that. People who work in quality and patient safety are learning that it's impractical to rely solely on linear approaches to improve outcomes in a highly complex system, like healthcare (especially if you're looking for changes that are both safe and satisfying). Just ask anyone who is still hungry after being fed their Core Measure Happy Meal.
Therapeutic riding programs are often used to bring horses and people who have profound physical, developmental, and emotional disabilities together, with results that often exceed the primary objective for showing up in the first place. My daughter never enrolled in a riding program that claimed any particular expertise in facilitating the needs of hearing-impaired people. But hang around horses and the people who love them for any sustained amount of time, and you'll likely conclude what I have: All riding is therapeutic riding. How easy it is to see what's broken is what distinguishes riders with special needs from others.
I didn't go to the National Patient Safety Foundation Congress this week. But I followed tweets from people who did, giving me the opportunity to be pleased in real-time when I saw that teamwork and relationship-building, as vehicles to enhance outcomes, were championed. We need results that exceed the articulated primary objective, results that, as equine activities model, can be predicted to come through relationships centered around high-stakes activities and hard work. Sounds like healthcare!