By guest author Janet Cromley, healthcare journalist and author
Each year, roughly 20 percent of adults in the U.S. will end up visiting an emergency room for one reason or another. Last month, New York writer and taxi driver Chuck S. joined that group. I’d like to tell his story because I think it captures the problems that many patients experience in the hospital and ER. Full disclosure, Chuck is the friend of a colleague, and I’ve changed his name to protect his identity.
During a regular physical therapy session for back pain, Chuck began experiencing weakness in his left arm and then, even more worrisome, began to have trouble speaking. His PT noticed that the left side of Chuck’s face was drooping and immediately sent him to the ER of a large urban medical center with a suspected stroke.
Once in the ER, Chuck began an odyssey that featured overall good clinical care but that left him feeling dispirited, anxious and alone. It’s a story that he wants to share with every hospital leader. “I think every person who manages a hospital could benefit from seeing the process through my eyes,” he said.
Among his experiences:
Being kept in the dark: Chuck was in the ER for five hours, and during that time received very little information about his condition. “The whole time I was wondering, ‘Am I having a stroke? Am I going to die?” he recalled. The single parent of a 10-year-old daughter, Chuck was suddenly confronted with the unthinkable. “The prospect of having a stroke is terrifying for so many reasons, and I got zero information,” he said.
Endlessly retelling his story: At every juncture, Chuck was asked what had happened and to describe his symptoms. “I wish I had recorded a CD beforehand telling my name and story, because I had to repeat it so many times,” he reported. “They should have one person asking all the questions.”
Confusing handoffs between tests and procedures: Chuck was wheeled into what seemed like endless tests, and was given scant information about the timing or purpose of the tests. Often, he was asked about tests he had not yet received, and could not get information about when the tests would take place or when doctors would receive and discuss the results. “Honestly, the process felt like speed dating,” he said. “I didn’t know half of what was going on.”
Lax processes: Fortunately, Chuck wasn’t having a stroke. He was suffering from Bell’s palsy, a generally benign, short-term condition with stroke-like symptoms that strikes about 40,000 Americans annually. Bell’s palsy is often treated with antiviral medication, but Chuck didn’t receive an antiviral until he visited his internist three weeks later. “My internist was furious. I can only assume that somehow I fell through the cracks at some point,” he said ruefully.
Obviously, there is no one quick and easy solution to these problems, but they are absolutely solvable. Improving hospital care nearly always starts at the top, and requires adopting a “patient first” attitude. This is not a revolutionary idea, of course, but it often gets lost amid the many competing demands that hospital leaders face. We all understand that patient-centered care not only improves the patients’ experience, staff morale and your hospital’s reputation, but hospital leaders are also finding that the concept pays huge financial dividends.
Your facility may need to change established ways of doing things, and adopt new, more efficient processes. True patient-centered care requires an efficient care model and staff deployed at the right place at the right time. Fortunately, cutting-edge technology is now available that performs real-time tracking of patients, beds, staff availability, transport and more. This technology can dramatically boost efficiency and put patient and staff time to the best possible use.
Patients like Chuck and their families want a better experience. They want to know what’s going on and to be moved efficiently from the ER to admission to discharge. Going to an ER or being hospitalized will never be anyone’s idea of a rousing good time, but the experience can be surprisingly enriching and reaffirming if people, processes and technology are all working together for the betterment of the patient.