Power To The Patient: How Hospitals Can Improve - InformationWeek

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Commentary
10/24/2014
09:06 AM
Alison Diana
Alison Diana
Commentary
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Power To The Patient: How Hospitals Can Improve

A loved one's week in the hospital provides insight into ways hospitals can enhance the patient experience and cut costs. Here are seven suggestions.

My sometimes esoteric discussions of hospital care became personal this month when a young family member was unexpectedly admitted to the hospital for about a week.

Now that the shock of alarming and false diagnoses is easing, the hours of lost sleep abating, and the patient is recovering from the traumatic experience, I've been translating our nightmare into several ways in which hospitals can enhance care and cut costs, both with and without technology.

Nothing ever prepares you for seeing a loved one in a hospital bed. And nothing opens up your eyes to areas that need improving when an organization's inadequacies hurt that special person. Some hospitals do a better job than others of putting themselves in the place of patients and families. In doing so, they're discovering tools and techniques that remove some of the fear, uncertainty, and doubt that can worsen a hospital experience.

[Want more on how health practices can improve? Read Remaking Healthcare To Improve The Patient Experience.]

Here are seven steps healthcare providers can take to improve a patient's experience:

1. Use a system, automated or human, to follow up after patients are discharged.
Surprisingly, nobody from the hospital itself ever called or texted to check up on this patient, even though her stay was extended twice.

2. Instead of contracting with a pharmacist close to the doctor's office, why not use GPS and location technologies to find a pharmacy close to the patient?
In this case, a pharmacist's driver twice made a round-trip of more than 100 miles to deliver medications; a similar, reputable compounding pharmacy, in the same insurance plan, is less than seven miles from the patient. Similarly, two medical device companies drove about the same distance when, possibly, local businesses could have provided the products.

3. Provide video discharge instructions.
This would help eliminate confusion for everyone -- clinicians, nurses, home health nurses, and caretakers -- especially when multiple doctors provide differing directions on the same medications and equipment.

4. Encourage patients to use your patient portal.
Make sure all clinicians use the portal to update patients and caretakers about appointments, follow-up care, medication doses and orders, and physical therapy. If a hospital has a portal but doesn't fully use this tool to communicate with patients, it's worse than useless; it's frustrating.

5. Live up to HIPAA.
Regularly educate clinicians that hallway conversations about patients, especially when visitors sport badges with patients' names and room numbers clearly visible to all passersby, are not permissible. 

6. Use your portal or website to provide patients and caregivers with information on conditions and diseases.
Don't just tell people not to research potential diagnoses. While awaiting test results it's only human to worry about the worst possible outcome and our phones feed that fear. Rather than order us to wallow in fear, uncertainty and doubt, give us useful references if you don't want us to Google conditions. Because we will.

7. Unclear communication can be as bad as inadequate communication.
When too many people offer different messages to patients and caregivers it's challenging to know who to trust, to figure out what is actually true. The goal is admirable but the result is an off-key cacophony, not a symphony. Figure out the conductors and let them lead.

Most importantly, the patient continues to thrive. The clinicians and hospital did their job: They treated her and she's doing well. But, as one healthcare IT executive told me the other day, nobody adds up the cost these emotional tolls take on patients, caregivers, and family members. No one tracks how the pain of FUD, overheard conversations, or the wait time for clarification affects people's health over time.

Perhaps we should.

The owners of electronic health records aren't necessarily the patients. How much control should they have? Get the new Who Owns Patient Data? issue of InformationWeek Healthcare today.

Alison Diana has written about technology and business for more than 20 years. She was editor, contributors, at Internet Evolution; editor-in-chief of 21st Century IT; and managing editor, sections, at CRN. She has also written for eWeek, Baseline Magazine, Redmond Channel ... View Full Bio
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asksqn
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asksqn,
User Rank: Ninja
10/25/2014 | 1:21:44 PM
Perhaps but not likely
These are all really great suggestions, but once upon a time, they all used to be part & parcel of a discharge (particularly following up with a patient after s/he had gone home - technology was not necessary to remind the hospital to make the call.)  Today, the name of the game is all about saving money any way possible, even if it's not in the patient's best interest.  According to many hospital personnel personally known to me, Obamacare has transformed hospitals into shystie con artists.  Based on that feedback, it is questionable that any of your suggestions will be implemented since it would cost money the hospital would not want to spend because it would cut into its profit margins.  
nasimson
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nasimson,
User Rank: Ninja
10/26/2014 | 6:19:38 AM
Re: Perhaps but not likely
> These are all really great suggestions, but once upon a time, they all used to be part & parcel of a discharge.

@asksqn:

Really? Were all of these implemented earlier? When was that? I dont recall such good times in hospitals.
saliknaqi
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saliknaqi,
User Rank: Apprentice
10/26/2014 | 8:54:04 AM
Re: Perhaps but not likely
I will have to agree with asksqn here. These are some really good suggestions, and obviously will benefit the paitents and assist the hospitals too but they aren't cost effective, not yet.
Alison_Diana
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Alison_Diana,
User Rank: Author
10/27/2014 | 10:10:59 AM
Re: Perhaps but not likely
True -- but part of hospitals' funding comes from patient satisfaction scores. I truly hope the patient gets a satisfaction score (the family already got a rating questionnaire for one doctor involved in this fiasco and you can only imagine how well this doctor will fare, given her lies and miscommunication). Given the notable and fixable mistakes the hospital made -- things that have nothing to do with taste or are suggestiveness -- i'd imagine they would want to resolve these issues. 

Also, since hospitals have to reduce readmissions you'd think ensuring patients leave in good condition would make sound business sense, one of those penny spent, dollars saved initiatives.
nasimson
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nasimson,
User Rank: Ninja
10/26/2014 | 6:13:54 AM
a little bit of training
@Alison:

You are spot on. Today's hospital experiences leave so much to improve. And whats really ironic is that so much improvement can be brought with already available technology with just a little bit of training.

I hope and pray that your young family member is now happier and healthier.
Alison_Diana
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Alison_Diana,
User Rank: Author
10/27/2014 | 10:14:29 AM
Re: a little bit of training
Thanks for the kind words, @nasimon. She is doing a lot better now she's back at home and school! It was interesting to hear so many nurses complain about the electronic health record. They also didn't like all the automated tools that forced them to follow particular steps since it eliminated any control from the nurses, some of whom had created their own best practices over years of specializing in a particular area of medicine. I don't know if that's good or bad: I'd imagine, if it's a great nurse, that could be bad. OTOH, if the nurse was less experienced or dedicated, having a system ensure all steps were followed could be -- and perhaps is -- a lifesaver.
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