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What service does a hospital provide?
We recently had an experience with a hospital. A large, expensive, private hospital: St John of God in Subiaco. According to Wikipedia, "A hospital, in the modern sense, is an institution for health care providing patient treatment by specialized staff and equipment, and often, but not always providing for longer-term patient stays."
I think of a hospital as a place to go when you're sick because they will look after you. My imagination begins with health care, doctors and nurses. My imagination includes service and organisation.
To me, a hospital is a one-stop shop for treatment of sick people.
Wrong.
A hospital -- judging from our recent experience -- is a cross between a strata-titled office block and a hotel.
Here's how it happened
My wife needed some day-care surgery. She was booked in at SJoG day-surgery clinic. A week or two before, she met with the surgeon.The surgeon has an office at SJoG. We arrived at the surgeon's waiting room -- a rather bare and uninteresting room, shared with several other doctors. Behind a counter were three young women. Who do we approach?
Three young women, presumably doctor's receptionists. Three women in one doctors' office?! No hint as to which one would deal with patients for which doctor...
A general enquiry in the area of the desk... Two of the women responded, plus a third, older woman who had a desk hidden at one side. We were given a form to fill in.
My wife filled in the form: Questions relevant to the surgery, I guess. Just as likely to be questions relevant to our ability to pay... It was my wife's surgery, I left the form to her.
The form completed, we waited. In chairs shoved back against every wall. Reading the standard doctor's waiting-room magazines.
Hint: For an example of how good a waiting-room could look -- visit the City of Stirling offices and wait in their foyer. It doesn't look expensive. Just so much more welcoming and comfortable.The surgeon was soon ready. My wife had her questions answered and was reassured. She is now ready for the surgery.
Or not...
My wife had filled in a pre-surgery form. She had spoken with the surgeon. And, previously, with the doctor who had referred her to the surgeon.
The anaesthetist phoned. She needed more pre-surgery information...
Then the X-ray people phoned. They needed more pre-surgery information...
Then another medical specialist phoned... It could well have been the anaesthetist phoning again, I was losing track...
What was wrong with the pre-surgery form?! Why don't they ask all the questions up front, at one time?! Don't these medical specialists speak to each other??
What is the role of the hospital?
The hospital rents rooms to doctors. That's all. At the pre-surgery stage the "hospital" has no interest in "their" patients.Do the various medical specialists -- referring doctor, surgeon, anaesthetist, X-ray -- speak to each other? Apparently not.
Hint: If you claim to be a "hospital" -- offer some hospital services. Coordination, information sharing, patient-related services...SJoG clinic is an office block providing some shared office services. That's all. Here's a room, fill it how you like.
Design and provide a pre-surgery form... If SJoG were really a hospital, they would be well-placed to know what information is required. Ask all the questions in one form! Then provide the information to the doctors.
We filled in one form. Then answered several phone calls. What a waste of time -- for us and for the specialists. When we were in the "hospital" -- that was when we should be asked for all of the required information.
What happened on the day
And so the big day arrived...My wife started in X-ray. This was fine surgery, it needed a wire inserted -- lined up by X-ray -- to guide the surgeon's knife.
On the third try, they managed to line up the wire.
Okay, I accept that human error occurs. This was an unfortunate series of mistakes which can easily be blamed on the difficulty of the task. It just made the experience more difficult for my wife.
Once the wire was in place, my wife waited. For many hours. Again, this is just unfortunate. It's difficult to judge how long a series of operations will take, so waiting your turn is just part of the experience.
Okay, says the nurse, Here's the left side all ready to be cut...
Isn't it the right side that should be cut?
No, it's the left side.
So why is there a wire sticking into the right side?!
Okay, says the nurse, Here's the right side all ready to be cut...
Hint: If you claim to be a "hospital" -- offer some hospital services. Such as an instruction sheet to the people involved, showing what work is meant to be done...Are doctors and hospitals all so self-important that they refuse to speak to each other? Is there some lawyer-avoidance by not telling anyone else what is about to be attempted? Or is it just that the "hospital" is only in the business of providing a hotel room with an adjustable bed and a few machines that go ping...
Speaking of that machine...
After the operation, my wife was wired up to a fancy machine. It showed heart rate, blood pressure, various other graphs and numbers which looked impressive but meant nothing to me.
A nurse came in to check up on my wife.
The nurse looked at the fancy machine -- and wrote numbers onto a bit of paper.
Is there no record-keeping in the fancy machine? Is there no transfer of data from the machine to the patient's records? Why depend on transcription and re-writing? What happens when the nurse is distracted and writes the wrong numbers?!
Well, probably, nothing.
The machine and numbers were just for patient reassurance... It's all okay, they are telling us. We're watching over you, with a fancy machine and a dedicated number-copier...
My wife knocked the recording device off the end of her finger. The chart on the fancy machine flat-lined, nothing to record. Alarms rang, nurses and doctors appeared...
Well, no.
The monitoring machine flat-lined. My wife was -- as far as the machine could tell -- dead.
No beeps, no buzzers. No alarms. No interest.
Clip the connector back on the finger... It's a miracle! Returned from the dead!
But nobody knows. Nobody cares.
My wife had day surgery in a very expensive private hospital.
The surgeon was reassuring, she seemed to be very competent. We are not qualified to judge performance but it all seemed to go well.
The supporting cast was disorganised. There was no communication between key players. Information was hoarded rather than shared. Individuals were friendly. Overall, there was no coordination.
The doctor's waiting room could have been in any large office block. Information was gathered for each specialist, with no thought for the complete process.
Surgical techniques may be progressing in leaps and bounds. It's a pity that the support processes have just not kept pace.
Agamedes Consulting. Support for your thought: email nick leth at gmail dot com |
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