Saturday, January 2, 2010

Hospital Visit For Family Centered Patient Advocacy

I was called recently by a patient’s family. The patient is hospitalized and in ICU. A recent visit to the hospital for the family was to help the family ask questions, navigate the system and even look for things like hand washing, communication with the medical staff and comfort for the patient.

We were all pleased with the care but this family has experienced bad outcomes in the past making them more suspicious and concerned than the patient and family who has had only positive experiences using the health care system. My visit is often to help the medical staff as well as the patient and family so the whole experience is smooth and free of unplanned outcomes.

I showed the family how to wipe down the bed rail, door and other items after the nurse or visitors touch them. I asked them to wash their own hands. I suggested they don’t wait in the lounge for the doctor while he visits with the patient as the family was instructed to do, but stay by the door, if not inside, and sure enough the doctor tried to leave without speaking to the family. We wrote down names of doctors and the time of the visit and what he or she diagnosed. We asked the nurse for a list of all the medications the patient is taking so it becomes a record for his medical history.

I suggested they allow the nurse to explain what the doctor ordered. Never say, “yes I understand” always say “please explain it again”. This way the family knows if the orders are the same or, if they really didn’t understand maybe they will now when the nurse explains it in her words. The family was fighting traffic and arriving at 9 AM. I suggested they come at 5 AM. This way they can be there for the change of shifts, a common time for errors.

Most important, allow the patient to rest. Families often feel that they need to chatter and stimulate the patient. There is no need for that. Sitting quiet is the best way to be appreciated.

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