Transparency is a hot subject in health care these days. The front page of last Sunday's New York Times carried a story about a physician who told his patient immediately after surgery that he had made a mistake, and basically apologized and asked for forgiveness. Even with about 1,000,000 active attorneys in the United States working to make a living, the concept of telling the truth before it evolves into a lawsuit is more and more in the forefront of our literature.
This week, I received a three page E-mail that was transparent, but it was not from us, it was about us. It was so transparent that it should rock our collective souls. As a patient-centered hospital that has reached some degree of recognition nationally, this letter represented not an A in patient centered care, but very close to a C, or worse.
The person who took the time to record their stay at Windber Medical Center was painfully thorough. Their hospitalization was over a 74 hour period when the house was full. We were extremely busy, and somewhat short on some staff members, and a few key physicians were away. This patient recorded every aspect of their experience. They let us know when water was or wasn't delivered to the room, when the rooms were cleaned, where the nurses were and how often they delivered meds, checked their IV's, provided them with medicine, and met the patient's medical and/or personal needs.
If it were not possible to determine who this patient was from the content of the letter, in the spirit of full disclosure, I would have reprinted it here for everyone to read. Instead, I will simply delineate the lowlights of its content.
The hardest thing about this letter for me was that we have been working for eleven years to bring improvement to the entire process, to improve health care delivery, and to provide an optimal healing environment. But, when things get rough, we seem to revert back to business-as-usual, circa 1997, and from the transparent report that this former patient provided, we did not always act appropriately.
At a board, physician, and senior leadership meeting last week, I found out that one of our patient-centered practices had simply been discontinued without notification. This practice provided appropriately for patients, families and staff. When it was discontinued, only the patients were being taken care of, and they were being cared for in an inferior manner compared to the original practice. We have met with the appropriate staff members, and we are now back in the business of nurturing all of our stakeholders.
It seems to me that our reaction to stress and hard work might be like that of a rubber band. As soon as the tension reaches its peak, that rubber band attempts to go all the way back to its original shape. We are a Planetree Hospital. We DO NOT do brain surgery, heart surgery, trauma or neonatal care. We DO NOT have hundreds of specialists surrounding our campus like most academic medical centers. Rather, we are a primary acute care hospital and our differentiation is patient and family centered care. We are philosophically dedicated to treating our patients and their loved ones with dignity. We are known for providing the highest touch care in the region. After reading this patient's letter, it seems to me that they could have been in any hospital USA.
If we believe that our mission is to provide the most wonderful, nurturing care, then we need to do that consistently. A few weeks ago, a patient who was leaving the hospital said to one of our vice presidents, "Do you ever empty bedpans here?" The question struck her as unusual . . . until she read the letter.
We are all in this together. We can only be as good as our weakest employee, and our future depends totally upon working not only as a team, but as a humane, caring, nurturing, loving team.
Between our nurses, Integrative Health Team, our volunteers, pastoral care, our aids, housekeepers, dietary department and couriers, we should be in and out of rooms dozens of times a day. No one should have to wait for an overdue medication or just a cold glass of water.
In closing, this is not a blog that is intended to demean, take unfair shots, or berate our staff, it is meant to say that transparency is exactly that: transparent. Between the State Inspections, the Joint Commission and our own secret shoppers, transparency is here to stay, and we won't continue to grow without the total commitment from each and every one of us to work above and beyond the call of duty on all shifts.
In closing, the letter said, "You had one Golden Girl who was amazing in every way throughout my entire stay. Her name is Debbie, and she is the pinnacle of everything you stand for as a Planetree hospital."
So, special thanks from us to you, Debbie. You and people like you are our future.
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