As a hospitalist, I am pretty much always on the delivery side of healthcare: I help determine the treatment plan, write the orders, call in specialty services, and communicate the anticipated schedule for the day. This past week, a close family member was hospitalized, and I got to see how patients and families typically experience the receiving side of healthcare – and it really opened my eyes. Sure, as doctors, we are always taught to be empathic and to view experiences from the perspective of the patient, but there is nothing like going through the minute-to-minute uncertainties and fears that come with being sick… really sick.
If I were to make suggestions for improvements in the hospital experience, this is what I would recommend to all hospitals and healthcare providers:
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First, make the scheduling process much more transparent. I have no idea why we do this so poorly in healthcare. You are told on Saturday that a procedure or test is going to be done on Sunday – you wait all day Sunday, have no idea whether it is going to happen, but hold faith since you were “added to a high priority list” according to your nurse/doctor. Ultimately, it doesn’t happen that day — what’s worse, it doesn’t happen on Monday either — and ultimately gets done on Tuesday in the morning. By that time, the words of the provider and the deliverability of the hospital have lost all credibility. Furthermore, the certitude by which the plan was communicated, made the reliability of the provider’s that much less trustworthy. Just be transparent: let the patient know that the schedule is not certain and that you don’t know for sure when things will happen but provide an educated estimate based on your experiences. But more importantly, show that you are the patient’s advocate, that you have checked on the status of test/procedures and that you have communicated to the schedulers the importance of getting it done soon. For the patient and the family, having someone work on your behalf at a time of great vulnerability carries tremendous importance and value. Don’t underestimate this aspect of patient care.I also appreciate the fact that time is warped when you are sick. Every minute and hour stretches out in nervous anticipation of what may or may not happen. So naturally, when you are waiting for a test or procedure, your perception of time gets distorted and things appear to go much slower. I think the biggest culprit for this distortion of time is uncertainty – not knowing how things will go down or when. IMO, the best way to address this uncertainty is to make the whole scheduling process transparent in say, an App – just like Uber or Lyft do when arranging for a pick-up or when Doordash or Grubhub do when ordering food. There is first acknowledgement that your order has been received by the driver or the restaurant, then communication relayed that the order is being fulfilled or executed, then a real-time estimate of when the order is expected to be completed. Naturally, providing estimates for a medical test or procedure is much more complex and difficult given unpredicted emergent add-ons or unanticipated prolongation of medical procedures. But providing even a ball-park estimate at a granularity of hours would carry a long way for patients and families. Furthermore, it spares the nurses, doctors, and administrative staffs from dealing with frustrated families and from spending time on phones with technical staffs who are already fielding many similar calls. Patients and families would similarly feel less guilty about burdening the staff with their many questions regarding the timing of these procedures. To my knowledge, these Apps or software tools have not yet been implemented in any hospital – and, for the life of me, I can’t understand why not.