Sunday, April 27, 2008

How to Make a Hospital Hospitable

Hospitals can be very unfriendly. Even though hospitals are meant to serve patients, in real life they seem to be designed to serve doctors. Not only do hospitals strip you of all your dignity (having to wear a half-open hospital gown which barely covers your body properly does not do much good to your ego!), but they also subject you to painful routines and humiliating rituals performed by a retinue of strangers. You are woken up at any time of the day, (or night), deprived of your privacy, forced to eat unpalatable food, cut off from friends and family, and denied a lot of the independence which you take so much for granted in daily life.

What are commonest complaints patients have about hospitals ? It’s a long list, but the primary concerns are:

1. Waiting interminably to see the doctor

2. Being kept in the dark about the treatment

3. Not knowing how much it’s all going to cost

What can you do to take care of yourself ? The simple answer is – find a good doctor in a good hospital. While this is the best possible solution, it’s also a fact that you may not be able to do this. So, is there anything hospitals can do to resolve the problem ?

Hospitals need to reinvent themselves to keep up with the changing times, and there is a simple solution which can help them to keep their patients happy . The answer is Information Therapy for patient education. This is a win-win situation, which will help hospitals, doctors and their patients.

Hospitals need to understand that patient education is not an expense – it’s a basic service which can actually help them to improve the quality of their medical care – and their profitability as well ! A Patient Education Resource Center is a great way of marketing medical services and getting more patients. For example, if a patient is admitted with asthma and they sell books on asthma, the chances of the patient ( or his relatives) buying this book are huge ! Ideally, the hospital should have a circulating collection of books, which patients can borrow and read, so they understand more about their illness. This is an effective way of empowering patients.

Another great opportunity which hospitals routinely ignore is educating the patient’s visitors and relatives. Every patient in hospital routinely gets about 10-15 visitors every day. However, most hospitals barely tolerate the presence of visitors, who are usually treated as pests who just get in the way of the staff and the medical treatment. However, these are all potential future customers for the hospital, and should be treated with respect ! Because they have come to visit someone who is ill in hospital , they are very motivated to do something to prevent themselves from falling ill. ( For example, if you go to visit a friend who has had a heart attack, your wife would be very happy to buy books on how to prevent a heart attack !). Not only is this a great “teachable moment”, it’s also a good way of promoting the hospital’s heart health care services to potential new customers !

Similarly, the TV screens in hospital OPDs can be used to show health educational films, so that patients can learn about their health and ways of improving it, instead of watching soap operas or the news.

It’s a fact that patients are increasingly unhappy in India today – and while they are still not as likely to sue as in the US, angry patients do burn down hospitals and beat up doctors. Errors do happen even in the best run hospitals – and well-informed patients ( who ask questions and know what to expect) are extremely good at preventing problems because they can speak up and prevent errors. Patient education has also become an integral part of risk-management. While a bad outcome does not always mean to a lawsuit, if this mistake is compounded by poor doctor-patient communication, this is likely to lead directly to the court. By educating patients and communicating with them on an ongoing basis, the chances of the aggrieved patient going to a lawyer are dramatically reduced.

Some doctors used to feel threatened by a well-informed patient. However, this is no longer true; and the younger generation of doctor respects a well-informed patient, because both doctor and patient are on the same side. It’s true that patient education can take time – but it’s much better to answer the patient’s questions now , rather than his lawyer’s questions in a court of law !

In a hospital setting, doctors are a scarce resource and they are usually the bottlenecks. By setting up a separate Dept of Patient Education, the doctor’s time can be saved; and your time can be utilized constructively, instead of wasting it. Patients often get impatient when made to wait without rhyme or reason ! Thus, if you go to see your doctor and if he is running 45 min late because he is held up in surgery, his secretary can request you to go to the library where you can read a book or watch a DVD about your problem. You will be called on your mobile when the doctor comes to the clinic. Not only will this prevent you from getting upset because of the delay; it will also help to save your doctor’s time, because you will be much better informed about your problem. Similarly, your doctor can hand out patient educational brochures ( published by the hospital, with their logo and address) to you patient after the consultation. Not only will this reinforce the information given to you; it will also help to improve the level of health information in your family - and thus the community .

Patient education can be a great way of improving patient satisfaction, because a patient who has had all his questions answered , is likely to be much happier with the doctor; and have realistic expectations of the treatment. Patient education also helps to cultivate empathy in the medical staff, who learn to see things from the patient’s perspective; and can help to teach the staff to respect the patient.

If it’s so simple and obvious, why doesn’t every hospital do this ? Actually, the world’s best hospitals do this routinely. For example, Mayo Clinic has a separate building devoted to Patient Education. Also, the JCAHO guidelines ( the US body which provides accreditation to hospitals) also makes patient education compulsory. Unfortunately, it’s not a very glamorous service to provide, which is why most Indian hospitals don’t bother to do so. Also, they are so busy competing with other hospitals on how many slices their newest CT scanner offers, that they end up ignoring such a basic need. This is a shame – and a great opportunity as well , because a simple inexpensive change in attitude can remarkably improve the patient’s hospital experience – thus improving the hospital’s bottom line !

I write this article for my Empowered Patient column for Times Wellness.


  1. Anonymous4:04 AM

    Am I missing something? My wife has congestive heart failure... and she has been in Christus, St. John Hospital twice in the last month.

    I keep seeing something that bothers me a lot.... With my wife, and with other patients too, I see doctors going down the halls on their rounds, quickly reading the nurse information, briefly entering their notes, then going on down the hall to see others without even opening the patients door to see the patient at all.

    Makes me wonder if the doctors are more interested in cooking-the-books for the lawyers instead of treating the sick? Maybe this is rare... don't know, but it certainly bothers me a log.

    Any thoughts that might help?

    R. Travis
    [email protected]

  2. yes, you are absolutely right. Patient education can help in reducing fear and makes a patient prepared for treatment.


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