Saturday, February 25, 2012

Accredited and Complaints

Accredited Facilities

I was always pretty confident that I would recommend a Joint Commission accredited facility instead of one that is only inspected by the state.  Joint Commission standards are higher than the state and the state can easily say they are overworked and don’t have the budget to hire more people to check on problems.

As I visited a local healthcare organization recently which was not accredited by The Joint Commission, the differences started to unfold in front of me.  Although I am far from being an expert, the whole feel of cleanliness and care was very different than any place I ever visited.
Besides the fact that almost none of the staff say hello, greet the patient or visitors with anything but a “did you call?” or even smile when I smile at them, they seem unhappy having a job and particularly working in this facility.
I went to the nurse’s station and asked a woman if she had an antibacterial wipe that I can use to wash a television remote that fell on the floor.  She handed me a container that was empty.  I showed her it was empty and asked if she had antibacterial wipes.  These, I explained do not say they kill germs and are for hands, not objects.  She stared at me for a moment and handed me another container of the same product.
I can’t be sure that if this facility was accredited by the Joint Commission it would be any different, but when I started to see areas of concern, I thought about who the patient or their family would complain to.  The state has reported being low on funds.  What if they never got to my complaint?  Who would I complain to then?  The Department of Health is not going to go out of business, even if they are backed up for years.  Organizations like The Joint Commission are independent and would have to hire more people if the problem got out of hand.
I wouldn’t say that a facility not accredited by the Joint Commission is a better choice or not.  What I am concerned about is what if things aren’t going smoothly.  Who would you want on your side

Friday, February 3, 2012

Being Alone With a Healthcare Provider

Alone with the Doctor
I got a text message from my teenage son who is away at college and he tells me he is at the nurse with his female friend and the nurse told him to leave the room. Yes, the same son who asked a doctor to wash her hands and got an “annoyed attitude”.  As her advocate he expected to stay with her.
I reminded him that the nurse may have wanted to ask her about her sex life, drug use or sexually transmitted disease and was not going to ask, or expect an honest answer, in front of him. 
“She fell and hit her head, it has nothing to do with sexually transmitted diseases” he told me.  But, I explained to him, being pregnant might make a girl become dizzy or, was she actually being beaten or abused?
It was a good reminder that patients need time alone with their healthcare provider.  As advocates, we tend to want to be with the patient – always – but it doesn’t always make sense.
A few years ago I was at the bedside of a patient following her surgery when the nurse was asking standard questions; do you smoke, snore, are you safe at home………?
I later pulled the nurse aside and suggested that a question about a patient’s safety be asked privately.  “What if I were the one abusing her?” I asked the nurse.
Although we want to be with our loved one, it makes sense to leave a husband, wife, friend or other family member alone at some point to have these private discussions with their healthcare provider if they want.  One way to do this is to say ahead of time to the patient, “I don’t mind leaving you alone to talk privately with your doctor”.  If warned in advance, it can be done at any time during a visit.  A patient can always say “no, stay with me” but it gives them an opportunity to be alone and not offend you.