Thursday, September 01, 2016

Why are systems in hospitals so broken ?

My father in law just got admitted for surgery at a leading hospital because he broke his humerus and he needs to get this fixed.  Being at the receiving end of medical care can be quite an eye-opener for doctors, and I was very disappointed by how broken so many of the hospital's systems and processes were.

We were told to get admitted at 8 pm, and had the admission papers signed by his consultant with us. In order to get an elective admission completed, we were told to go to the casualty, where the casualty medical officer asked him to lie down on a stretcher, while he took a perfunctory history. He then sent us to the billing department, so we could complete the paper work, pay the admission deposit, and get his indoor papers. We were then told to go back to the casualty and wait, until the cashier sent the completed file ( with proof of our payment) back to the casualty , where the medical officer instructed a ward boy to take him to his room.

After 30 min, the anesthetist came to the room for the pre-op examination, and then sent him back to the casualty so he could get a routine pre-op Chest X-ray done. A new ward boy then had to ferry him back to the casualty for his X-ray, and then bring him once again to the room. It seemed like the left hand had no clue what the right hand was doing , and unnecessarily cavorting him around the hospital just wasted everyone's time and energy.

It seemed that the hospital's system were broken even more badly than his humerus . What's even worse is that it would be so simple to fix all these issues if someone just applied their mind. While I did complain to the manager on duty, his just shrugged his shoulders, claiming that he was following standard hospital policy laid down by the management, and couldn't do anything about it other than sympathise with me.

If a patient is getting admitted for elective surgery, it would be so simple to inform them in advance as to what the procedure is, so they know what to expect.  They should be sent a standard checklist
( perhaps by WhatsApp and email) , so they are fully prepared, and there aren't any unexpected surprises . Patients need guidance to help them remember to bring everything they need ( such as their medical records and their insurance card, along with enough money). There should be someone to welcome them; and to hand-hold them during the process , because patients are usually anxious and upset. A hospital can be a scary place, even if your son-in-law is a doctor and is accompanying you.

All the unnecessary running around sapped his morale, and he became irritable and tired - hardly the best frame of mind to be in before planned surgery.  A lot of my time was wasted as well, and it took the better part of 2 hours before he was finally settled down in bed and ready to sleep - at which point the resident doctor came in to take his signature on the consent form.

What's tragic is that this happens on a daily basis with all the patients , and no one seems to be bothered , even though it would be so easy to fix these minor issues.

I think it should be mandatory for the CEO of every hospital to get admitted anonymously in his own hospital as a "mystery shopper" , so he can see for himself how well ( or badly) the system works. Hopefully this will provide him with enough incentive to want to fix it. The good news is it's not very difficult to improve it -  it just requires a desire to make sure that patients are treated as respected guests.

The processes are much worse in most IVF clinics, where patients are made to run around from pillar to post for scans, blood tests, medications ! Why can;t systems be designed around the patient, rather than around the doctor ?

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1 comment:

  1. 1) The System is Customer friendly when a Corporate signs up for Preventive Health Care Check Up Packages - a dedicated person is assigned for co-coordinating all the tests to be undertaken when an executive walks in. This is because the negative feedback from the executives may result in non renewal of the package next year.
    2) The same is not existent for individual patients because the feedback system is non existent for individual cases and individual patients family do not have much negotiating powers.


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