A Hospital Stay Can Make You Think

Staying at the hospital made me think about how I got there in the first place; and what if I hadn’t.

Because I had checked in over the weekend, it meant that there was time to kill, especially on Sunday when many clinical services weren’t running. Plus the usual weekday ensemble of medical staff were off-duty.

So there was really nothing much to do with the patients, except the routine blood pressure checks, dispensing of medication and meal service.

With much time on hand, I started to ponder the possibilities of what the docs might find in my body that’s making me sick. And contemplate the consequences of such diagnoses and the impact on life afterwards.

Oh yes, I was worried about my health. Who wouldn’t be in this environment?

Old Habits Die Hard, Really

We had this newly-warded patient who came in due to a stroke. Apparently, his visitors were jesting him about how life would go on and smoking is still okay. So much so that the gang, patient included, decided to try to sneak out for a puff at the public area.

Of course the hospital staff were alert enough to prevent these chaps from going too far. In short, the patient was denied his treat and had to return to bed.

Observing this episode made me wonder if ill health and its attendant effects on both patient and loved ones don’t matter to some people. I would think it more normal that a hospital stay would make one want to try changing old ways and restore their health.

I mean, it isn’t uncommon that some who come in don’t make it out, due to the seriousness of their health state. If we were given a second chance, so to speak, and are able to recover from illness, wouldn’t it make sense to treasure the opportunity to live longer?

Take Two

As if one incident wasn’t enough, there was another man who was admitted because of a heart attack. Nurses and doctors were seen advising him to quit smoking but it looked like to no avail.

Even the suggestion that he attaches an emotional angle to cutting down on cigarettes — like, for his young son’s sake — didn’t quite sink in. If a heart attack isn’t a wake-up call, I don’t know what is.

Certainly, the advice given was sound. Even if you weren’t sick, nicotine consumption will soon make you. For sure!

Seeing how others react to their life situation made me remark later to my wife: “There are only two outcomes for patients after their hospital stay — some will change their ways for the better; others will remain status quo.”

For me, it was pretty obvious which option I’d take. Letting current bad habits rule my life ain’t the way to live. Of course I know it can be trying to rid the old, but try I must!

Organizational Diseases: Redundancy, Processes Rule, Just Doing the Job, Etc

It’s turning out to be a cool Sunday morning as I took notes for this post on my mobile, lying in the hospital bed.

Earlier, a medical officer had interrupted my breakfast to get a brief medical history from me. I had been transferred to a different ward — this time on Level 8, one focusing on respiratory issues — last night, after spending a day at the ward catering to stroke patients.

And so, I was regarded as a “new” case, with a different medical team looking after me. That officer had to record my history for the senior doc to refer to when he or she makes the rounds.

Now, how can it be that within the same hospital there is a need to keep asking the patient for the same background info?

Don’t different wards share patient’s info? What’s the use of personnel keeping busy hammering data into the computer that wouldn’t be cross-referenced?

Bigger Means More Redundancy

One can easily see the massive opportunity to streamline the system and cut down on unneeded duplication. Sure, doing it the way they are now makes for more job positions.

And larger departments which then attract bigger (read clumsier) organisational structures.

But is this larger pool of hospital staff being deployed effectively to improve medical care?

Or is every group running their own mini-empire oblivious to the bigger picture?

Increased medical costs is not without a reason, but a poorly structured organisation surely can’t be one of those reasons. Anyone can tell this particular issue has a clear-cut solution.

It Must Be The Processes

There is indeed an obvious pattern here in this hospital.

As I was about to be transferred to the first ward from the A&E holding area early Saturday morning, the nurse recorded my blood pressure and SpO2 numbers. Never mind that they have taken readings barely 30 minutes ago.

Sure, they might have exit procedures to follow — I’d give them that.

But once I was at the ward and barely settled, another nurse came by with equipment to gather the same SpO2 and blood pressure data! So, this must be the entry process the ward is following, I reckon.

For heaven’s sake, what’s wrong with the measurements taken just five minutes ago before ward transfer? Do they not trust their medical colleagues? Maybe they don’t trust the (different brands of) equipment they are using? What?

Just Doing the Job

A similar situation arose when that medical officer came to me during breakfast today. A day before, the other ward had recorded all the answers to the same questions she had. But they aren’t sharing their findings, it seems.

She explained she’s just doing her job, when I suggested her colleagues — and the computer system — have the data. This is what they call SOP – standard operating procedures. You simply follow and aren’t expected to ask why.

Never mind that such repeated questioning can add more stress to a hospital stay.

So off she went inputting what she gathered from me into the same big system, presumably to get ready for the senior doctor to peruse later. Couldn’t she just retrieve an existing record from the other ward and reference it?

Missed Opportunities for Positive Change?

Without much doubt, things often look clearer from the outside in.

If only those inside consider the perspectives of the customer they’re trying to serve (who is on the outside). And what truly is sorely lacking in their endeavour to do so.

What’s more, opportunities for beneficial change will just slip past unnoticed, even conveniently I reckon. Simply because they go against the more selfish need of organisational “survival”.

The key point here is the hospital could be missing the real focus: total patient care that’s cost effective.

Not sharing or using relevant patient data already captured in the system isn’t doing justice to that million-dollar computer capital investment.

Why keep separate yet duplicate records, containing the same answers but asked by different people?

Why waste time putting this data into the system repeatedly, instead of building a consolidated record with complete history?

Once again, is there no trust in what other qualified colleagues have done?

Parting Thoughts — Gratitude and Some “Sage” Advice from Me

I’m certainly glad that the hospital stay wasn’t a prolonged one and that the doctors didn’t find anything majorly wrong with me. What had occurred was an acute episode of lung inflammation which was resolved.

Also, I’m thankful for the good care given to me by the nurses and docs. Most have been attentive and helped put my mind at ease when I had questions. Mind you, I did ask a lot about what they were going to do with me and at times challenged the wisdom — and necessity — of certain procedures.

I must add that the meals I had were both tasty and nutritious. Imagine having fish porridge for breakfast one morning and turnip dumplings the next. My only grouse: breakfast serving size was too small — it must at least double!

Lunch and dinner were substantial though. The “trick” to enjoying them was to eat rather fast before the food turned cold. Finishing each meal within 15 minutes was what I did.

Before I go, let me wind down my “rant” on the organization ineffectiveness seen during my short hospital stay, I thought I’d end with some self-made guru-style advice.

Advice that would usually cost an organization money to have, though management would think it money well spent. But here I am dishing it out for free!

Will free be worth less? Let’s see…

Don’t Lose Sight of Actual Purpose

Start by taking a step back and ask: “What is the very service a hospital is set up to provide?”

We all know that trained resources are indeed valuable. So a better return on investment would be to deploy them to look after the needs of patients.

Keeping records that are redundant, per each department’s defined processes, is definitely a poor yield.

What about other redundancies which are obvious — to outsiders especially; perhaps even to some working on the inside but who chose to remain politically correct? What’s keeping the organisation from doing anything to streamline?

And let’s accept that not-so-obvious inefficiencies will surface as the probe goes deeper. What are you going to do about these?

Getting Behind All of This

Could there be something else hiding behind such a so-called process-driven organisation, which inevitably gives rise to the need of unnecessary duplication?

I think you and I know the real answer.

It’s all about where they can point fingers at should any mishap occur. Put in nicer terms, it is about having a defined scope of responsibility.

This to me is the typical disease found in large organisations everywhere! The cure is there; and a simple one. But that could be too bitter a pill to swallow.

Still, I remain hopeful that positive change will come. Change that would transform medical services, touching on pleasant (and shorter) hospital stay, holistic and comprehensive patient care and better overall administration.

I just wish it’d be sooner so that more people can benefit from it.

What are your thoughts about this post? Let me know by leaving your comments.