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In my last Hospital Impact blog post, I wrote about recent research that my firm conducted for a healthcare client, contacting various hospitals in the Northeast to better understand how they treated patients searching for cancer care options.
This mystery shopping experience, particularly from our anthropological perspective, raised questions about what healthcare leaders are missing if they really want to deliver the exceptional patient- and family-centered care they so often promise and promote. Disappointingly, they seem unwilling to see, feel and think about their business with fresh eyes.
Car dealers make a little money selling you the car and a great deal of money servicing it. As a matter of fact Henry Ford stated when he was criticized for offering his new cars at such a low price, "I'd be willing to give the cars away for a guarantee that I would be engaged to service them and provide parts!" Like the car industry, the equipment maintenance market is an area where organizations invest significant portions of their expense dollars.
It's not uncommon for a medium size facility to spend $5 million per year on equipment maintenance and an average system to spend $50 million. The problem with any of these figures is that most organizations don't really know what they spend on an annual basis when all elements are considered and there is a fragmented location of the information and responsibilities. Total costs should include maintenance contracts, biomedical costs whether on site or outsourced, independent service organization (ISO) costs, original equipment manufacturer (OEM) costs, parts sourcing and internal labor to name a few. Step one in a best practice process is to perform an inventory of equipment and current practices and consolidate information and responsibility into one centralized location.
When we had children in school, my wife used to sing along with the Staples commercial every August, "It's the most wonderful time of the year." For her, it represented getting our kids out of the house. For me, it represented new teachers and new learning.
Ongoing education isn't just for kids. For those who feel that "surgical humility" is an oxymoron, I decided to go back to school this fall to take a course from Tom Atchison, my cherished mentor, entitled Physician Alignment: Dos and Taboos. My underlying pre-course assumption is that alignment doesn't occur without authentic physician engagement.
For those readers following the black cloud over our family's head this year, you know that my wife's brother and then my sister passed away less than a month apart earlier this year. On Aug. 23, so did my father-in-law, Lou. He was hospitalized July 3 and never made it home. While 51 days of his hospital experience were miserable, the last day of his life was peaceful and dignified.
His last day was spent in hospice, administered in the hospital through a separate company not affiliated with the hospital. The culture difference was glaring. And hospice workers were truly caring.
First, they respected the family's wishes. I married into a large Irish family and there were probably 20 of us around his bed as they withdrew support. Even a cousin from Northern Ireland, a priest, came over and administered last rites. Crowd control was not an issue. The hospice nurse simply let us have our space while she explained necessary information in a respectful manner.
by Lynn McVey
I had a stress fracture in my middle toe.
Against the advice of medical personnel, I taped my broken toe to its healthy neighbor next door, and stopped wearing stilettos for 10 days. My colleagues suggested I get an x-ray, see an orthopedist or go to the emergency room (ER). Unless I did one of those, how would I know for sure it was broken?
Many years ago, I worked with several young ER physicians who ordered a skull x-ray or CT of the head on every head injury patient. I worked with an older ER physician who never ordered either. When I asked the older doctor why, he said "I don't need to know." He clinically examined the skull for depressions, and if he found none, he assumed the patient had a hairline fracture with a concussion and treated him as such. "I don't need to over treat and over spend to verify something that needs no further action." Just like my toe.
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