February 4, 2013

A Physician (and Psychologist) share personal perspectives

  More on healthcare, leadership and culture...

Today  there was an interview in the Boston Globe with a Physician whose mother died. He felt there were errors made and wanted to speak out to help prevent these things from occurring.  http://bostonglobe.com/lifestyle/health-wellness/2013/02/04/jonathan-welch/YDxG225lt80x7i4UG0MJbL/story.html  

His answer to this question stuck out for me:

Q. Do you think smaller hospitals, like the one in Wisconsin that treated your mother, make more errors than big, teaching hospitals?

A. I don’t know if size necessarily has a lot to do with it. What I think really matters at the end of the day is culture. I think you need [hospital] leadership to say: “This is important to us. We’re not going to have people die unnecessarily on our watch, and we’re going to listen to patients and families.” 

So, my thoughts....What will it take to ensure every hospital creates a culture that emphasizes listening to patients and families? What leadership is required?

This resonated with a personal experience I had many years ago.  My first husband died of metastatic melanoma as a young man. He received excellent care, by many providers and more than one hospital over many years; but the disease did eventually take his life. 

Despite this good quality care, he had one experience that almost led to a preventable early death. As his wife, by his side constantly, I could see things that were going wrong. He was misdiagnosed. He was being "observed" and not receiving active treatment in part because it was the weekend, the hospital was understaffed and they were waiting for the full array of hospital staff ("experts") to arrive on Monday morning. 

But that may have been too late. 

I was forced to  confront a resident who was over her head and not willing to get the help needed. I became pushy, persevered; no longer concerned with politeness, I raised my voice. I demanded a specialist. I demanded a CT scan. I insisted they get someone in who could deal with the situation. [At that point, I am pretty sure she was offended, but I no longer cared...we were talking life or death here].

Later in the day, when it was confirmed that he had been misdiagnosed, (he had a brain tumor that was causing swelling, delirium and eventually a seizure) and the situation was stabilized, I was commended by the medical staff for "catching" the problem before it was too late.

The point is not that I know more about medicine, I don't. The point is: I knew more about my husband. I knew what he was like "well" and I knew he was deteriorating.

I agree with this physician--Hospital leadership needs to set the expectation that staff listen to patients and families. It needs to be a core value. It needs to be supported. It may prevent unnecessary deaths, and it also will lead to an overall much better hospital environment.

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