As health reform sets in, hospitals are gearing up for many challenges. While some of these are new to the health industry, several are against the backdrop of old problems that have plagued us for decades. Speaking as a doctor who has worked in a number of different hospitals up and down the east coast, I would like to identify 5 of these that I believe are fairly universal.
1. Medication reconciliation. This is being certain about what the patient’s correct medications should be, and is both a problem on admission and upon discharge. Not knowing the patient’s correct medications when they are first admitted to hospital can naturally start off a chain of events that leads to adverse medical events. The same applies to when a patient is discharged, when any medications changes (including new ones) must be made clear.
How does the confusion arise? Well, for a number of reasons including the fact that a patient who takes several pills may not always remember the names and exact dosages. There’s often nowhere for the doctor to go, especially outside of regular business hours, to obtain an accurate list. What hospitals need is a simple “no ifs, ands or buts” medication list. Studies are increasingly showing that pharmacists are the ones who are best placed to do this. Having a pharmacist stationed in the ER is a great idea, to hand every doctor who is admitting the patient a complete and accurate list. The same should happen on discharge, and can be targeted to high-risk patients. Think this is expensive for hospitals? Imagine the money (and lives) saved by reducing medical errors.
2. Dealing with patients’ most basic complaints. Nowadays, hospitals and health care organizations are using too many gimmicks when it comes to improving patient satisfaction and enhancing the patient experience. These include things such as flashy surveys, customer service agents, and computer apps.
Forget these. Why not just listen to your patients’ most basic complaints? Two of these would be getting a good nights’ sleep and tastier food! These are by far the two biggest complaints that I hear each and every day. Hospitals everywhere are failing to grasp the fact that what patients want is really quite simple. The list would also include more time with their doctors. It’s not rocket science. Listen, learn and create the right hospital environment.
