Tuesday, August 21, 2012

Patient Safety or Mystery Shopper?

Patient Safety Observer

I have been called a “mystery shopper” of hospitals. I don't think that's what I do.   I like to be called in to the hospital to visit a patient by the family or the patient themselves.  I usually get the call because the patient doesn't know who is in charge of their care, aren't getting their needs met or feel that the care they are receiving is substandard.   That call gives me a reason to go into the hospital and see some of the problems that may cause unsafe care to a patient.  I don’t make the trip if it can be handled over the phone, but sometimes I just can’t get someone in administration to help and the bedside staff are just too busy.  In that case, I will go to the hospital.
When walking through the halls I will observe things like a cluttered hallway, overflowing garbage pails and empty hand sanitizer holders.  I will see if medication carts are unattended and listen for staff who are loud and un-attentive.  I will even look to see if there are any patient safety brochures or posters.  If you have read past posts you know that I will watch how the cleaning crew washes the bathrooms and if they touch items in the room with soiled gloves.
I don’t do this to get people in trouble.  Goodness knows the staff work hard, but if there is a discomfort to me about being in this facility, someone, with the power to make changes needs to know about it. 
The problem is the response I get when I write.  Some places answer immediately and ask for help and input.  Some leave the impression that I was seeing things and many others (most) hospitals don’t respond at all.
The letter sent out explains that it is for informational purposes only.  There is no official report going out to any of the places we are to file a complaint like the Department of Health or The Joint Commission or the news .  I am not looking for a pretty atmosphere but I do look at patient’s safety. Accessible   information, courtesy and comfort will bring a patient back in the future.  Early intervention is also safety.  A patient who feels chest pains but won’t go back to the hospital because it was dirty, they felt the people were rude or they didn’t feel welcome is, in fact a patient safety problem and should be addressed.
Personally, I don’t need to know how things are changed, or even if they are.  I’m pretty confident I will be back again to see for myself.

Wednesday, August 1, 2012


I jokingly asked my friend at her birthday party if she was able to drive home.  She looked at me with her droopy eyes and sleepy smile and said “sure, but you can drive if you want”.  Together, we had already planned that I was her designated driver and prearranged for a mutual friend to drive her car home.  At the time we made these plans, she was not drinking and she was thinking straight.  I have no doubt that if the plans were not previously made she wouldn’t want to “bother” me and may have insisted on driving.

A few days later I visited someone on pain killers for a shoulder injury.  His wife commented on how medicated he was and how he was not thinking straight.  I wondered how he might be when the time was to stop taking the pain pills.  Would he even bother stopping?  It was a chronic condition he had, after all.

I thought it would be a good idea if before he went on the pain medication, he and his wife made a decision that not unlike a designated driver, she would start to have some control over his pain medication or planning the pain management.  If the pain pills are working, and he feels in control, even if he isn’t, it is understandable why someone wouldn’t want to take the chance of being in pain all over again, unless of course there is a Designated Medication Manager in the home. 

The conversation may not be pleasant but at least it will not be a surprise when the DMM starts the conversation about getting off or reducing the amount of the pain killers a patient is taking .