Where is the compassion for our patients?
By Stephen W. Earnhart, MS
CEO
Earnhart & Associates
Houston, TX
Most facilities now have online registration. Great! I want to see that expanded. Some facilities outsource the patient assessment also. Even better! It allows the patient to respond to medical questions in the comfort of their homes where they do not feel rushed. That gives us more accurate information.
By the time the patients arrive at the surgical department or ambulatory surgery center (ASC), they can be taken right into "processing for surgery." Love it! Get them in, and get them out, right? We have what we want with complete paperwork and no missing data. All the T’s are crossed and all the I’s are dotted. EHR supreme!
I receive many comments on my columns from readers. Your questions for the most part are supportive (thank you) or will take the broad topic of the column deeper than space allows in this newsletter. I want to share one of these, slightly paraphrased, comments with you.
Comment: "I picked up an older Same-Day Surgery’ newsletter in the lounge the other day, and I liked what you said about being more receptive to our patient’s emotional needs the day of surgery. Could you expand what you mean?’
My response: It is important to remember how scared practically everyone that comes to our facilities are. Not just the patients themselves, but family members, friends, or whoever comes with them. In our continuing efforts to be effective and efficient in our day-to-day activities, I fear we are sacrificing some good old human compassion for those who entrust themselves or family members to our care. I am just as guilty as the next person in making sure we "process" the patients through the system in the proper fashion and in a high quality, safe method. I think most of us have that process down now.
Almost.
After I received the above comment from a reader a few months ago, I had the opportunity to do some observations at a couple of hospitals and ASCs that I want to share with you. I watched patients go through the process at several facilities, and I was proud and impressed and at how well we have gotten down the processing of patients. However, because of the comment from one of you, I actually visually followed the patients at each of the facilities from the reception desk back to the waiting room chair and saw, sadly, where it all fell apart.
I could see the confusion on the patient’s face, the gesturing with their family members, the shrugging shoulders, and knew that we have made serious sacrifices and had done a disservice to those who pay our salaries and wages.
I went up to several patients at each location and asked if they had any questions. Here they are: "I’m scared that I will have a panic attack in there [pointing to the door into our chambers]. Has that ever happened before? Who can I talk to about my friend who had this operation some years ago and didn’t make it? There was no place [on the registration form] for me to ask that. Can you help me?"
Another patient’s comment. "Do I have to take off my underwear?" "Sometimes I have accidents, and I’m embarrassed about who will see that."
Here are more comments from patients:
"You are the first person who has asked me how I feel. Not one person asked me that. I feel like I have lost control over my body and my dignity and my modesty. It is horrible!"
"Does anyone here smile?" I could use a smile and a hug right now." (I gave him both.)
"When I brushed my teeth this morning I accidently swallowed some of the water. I was afraid they would get mad at me over there [pointed to the desk], so I didn’t say anything. Can that hurt me?"
"This place is really great. Everyone is so good at what they do, but I feel like I am being pushed’ through here, and it makes me a little nervous."
"I am so scared of what is going to happen when I get behind that door."
"My son usually has a bowel movement in the morning, but he will be in surgery when he normally goes. Will that mess up the surgery?"
"Has this place done this kind of surgery before?"
"I went online and tried to find out reviews from other patients who were here before but couldn’t find any. How long has this place been open?"
"Don’t a lot of patients die during surgery?"
"I feel helpless."
Let’s work on this, OK? [Earnhart & Associates is a Houston, TX-based consulting firm specializing in all aspects of outpatient surgery development and management. ]
