Saturday, March 23, 2013

When My Work is Easy

Patient's Safety and So Much About Communication

A man from the north eastern part of the country speaks to a colleague in the south about his brother’s friend in a Long Island hospital.   He feels that the care is below acceptable standards for a variety of reasons.  Knowing about PULSE of NY, the person in the south recommends that I might be able to help.  The man from the north calls me and I tell him he must have his brother call me directly.  It is not my place to call when I hear a story through someone else.  I am not looking for cases and if the patient or family have worked it out, I have no business getting involved.
Minutes later I hear from the brother, Bill (names are changed).  Bill is visiting Long Island when his friend became hospitalized.  He is concerned about the care.   Bill is not being permitted to stay overnight by the nurses.  He feels there is a shortage of nurses and his friends care is being compromised.  He does not feel he is getting a full accounting of his fiends care so he can be helpful.
I offer to go visit but first I will make a phone call.  I ask him to be honest, has he lost his temper?  Who has he spoken to?   Does he have names and dates?
When we finish this conversation I call to management at the hospital.  Explaining briefly what is happening, within minutes of hanging up the phone they are at the patient’s room clearing up misunderstandings.   The patient’s loved one’s received explanations and apology and days later the patient is released with only positive things to say about the hospital and care received.
The problem; The senior level staff are busy running a hospital expecting the people at the bedside are giving quality and patient centered care.  With the possibility of shortages of staff, overwhelming admissions and paperwork, compassion and communication can easily get lost.
A gentle reminder that there was a communication breakdown happening within the hospital is the best service we can offer.  In this case, as with most, there is a legitimate concern that rules and policies are not being followed.  Patients are permitted to have someone at their side.  There was no reason Bill couldn’t stay, but because that’s the way it’s always been done, no one was looking at how they could make this work so the family could feel safe and satisfied.  It took an outside phone call to help build a bridge to better communication.
How do we measure this success?  Would the outcome have been the same if there was no intervention?  There is no way of knowing.  What we do know is that there was a happy ending to this story.  Another day and the patient may have had a bedsore or been given the wrong medication or worse were the friend not at the bedside.  There is no system in place to count the lives saved by an advocate’s intervention.  If there were, we could start counting.

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