Monday, March 27, 2006

Baby Thomas

Baby Thomas – The patient experience is one of the best tools we can use to measure the overall quality of the care we provide; but too often, the actual patient experience gets lost in patient satisfaction scores and graphs. That is why we should take a step back every once and a while and actually talk to our patients. In that spirit, I am pleased to share a very moving and insightful patient experience.

Some friends of ours told us about the Bickle’s and directed us to their website. The Bickle’s, of Dallas, Texas, are going through an incredible, and heart-wrenching, experience. They have a 6-month old son, Thomas, who was diagnosed with a brain tumor. You can read more about Thomas’s story and how he is doing on their website, The Official Thomas Bickle Blog. I recently got the opportunity to communicate with Sarah Bickle, the mother of Baby Thomas, and she agreed to share some of their experience with me.

What follows is a series of questions I asked Sarah about their experience in the hospital and with their care givers. Sarah was kind enough to offer some very thoughtful and candid responses. Due to the length of the questions, I will post the second half of the questions on Hospital Impact tomorrow.

Describe the hospital room that Thomas is in?

All of the rooms that I've seen in Children's have a window and at least a couch for parents. One wall is painted a color like lavender in a wavy shape that goes around the room. There's a wipe board where staff for the day writes their names and a sink and a computer for staff that folds away. Thomas's crib has his name on a decorated piece of paper above it. The rooms are well-thought out; even in ICU we had a little shelf in the armoire that holds the TV to put our belongings in and there are 2 drawers under the bed/couch (in ICU, it doesn't fold out, but it is wide enough to sleep on).

What has the hospital or nursing staff done to make you more comfortable?

Writing their names on the board each day and night makes a big difference - even if we know our nurse we may not remember her name at 3 a.m. When we first arrived, the neurosurgery floor made it a point to let us know where the family kitchen was, how we could store food, what the cafeteria and chapel hours were, and things like that. The floor manager and some kind of customer care representative also introduced themselves in the first day or so, so we felt like we knew where to go with questions or needs from the beginning. Finally, the staff was just great with our son. I can think of 3 people out of probably close to 70 staff members we've seen who didn't seem genuinely thrilled to be with our son - and I include housekeeping in this list as well. There's no way we would've been as stable and functional as we are now if we hadn't had such an amazing staff and hospital system.

Do you feel like you are a part of the decision making process when it comes to the care and treatment of Thomas?

Definitely, especially when it comes to pain. I’ve never really had to defend a request for pain meds to anyone. They listen, but they take my word for the fact that Thomas is in pain. That was a big relief.

Tuesday, March 21, 2006

A Few Thoughts on Leadership

A Few Thoughts on Leadership – It has been a while since I have talked about leadership on this blog. I have been thinking lately about leadership and the role it plays in transforming healthcare. I saw leadership displayed firsthand this year at HIMSS. Everyone working towards the EHR at the federal level and in the private sector are showing tremendous leadership. The fact that all the major players are agreeing to work on a single set of standards is monumental – knowing when to follow is an important skill of a leader.

One of my heroes in healthcare leadership right now is Dr. Donald Berwick. I saw him speak last fall in San Francisco. He was rounding up support for the 100K Lives campaign. I have written before that I think this campaign is the most positive thing happening in healthcare right now. Dr. Berwick took some serious problems in our system and turned them into an opportunity for our industry to shine. I can’t wait to see the results of the campaign this summer.

Dr. Berwick appears to have caught the nation’s attention again with his commentary that regardless of race, American healthcare is mediocre across the board. That story was picked up in papers across the country last week (Boston, Seattle, Kansas City, Miami, Chicago). Again, he has brought focus to the problem at hand and has done it in a positive way. Now hundreds, if not thousands, of Americans will be asking their doctors if they are getting best-practice care. Dr.Berwick has set us up to succeed – another great leadership skill.

I think these examples of leadership are so important to our industry, but they must be supported by leadership at the local level. Hospital leaders need to stay informed of the positive trends in the industry and make every effort to bring local communities (gently) into the transformation.

Monday, March 13, 2006

No Wires

No Wires – I remember the wired remote that came with our first VCR. It seemed odd to have a tiny box with a few controls tethered across the room to our television stand. Sure it was more convenient than getting up from the couch, but it just wasn’t elegant. When we got our first wireless remote control, it felt right. This was what a remote control should be. This was an elegant solution. In healthcare, we need some elegant solutions.

One company, Hoana Medical, Inc., has envisioned an elegant solution. They have created a device (a pad the patient lies on) that measures a patient’s vitals without wires. In fact, the pad doesn’t require anything to be attached to the patient. It can sense heart and respiration rates while the patient lies on their bed.

Can you imagine what this could do for healthcare? Patients would be immensely more comfortable without wires protruding from everywhere. “What about the IV lines and the breathing tubes,” you ask. Perhaps someone is working on a technology that will make those go away as well. I hope so, because this is a step towards Star Trek. It is a taste of the way things should be, the way we have dreamed they could be.

What does an elegant solution do? It changes things. It changes the way we interact with the world and how we work. Elegant solutions in healthcare will change how patient care is delivered. They will open up new worlds that we didn’t even see coming. And they will change medicine just like remote controls changed television. You won’t be able to imagine how we lived without them.

Tuesday, March 07, 2006

I am a consultant?

I am a consultant? – Yesterday was my first day of actual, on-site, appear-to-know-what-I-am-doing consulting and…it went pretty well. We spent the first hour or so putting together the computers we would need for training, but then we really got started. We ended up training a handful of users on our software and really got them started on our process. The users seemed to understand what we were asking of them and I even think there were a few “ah-ha” moments. We didn’t offer profound, unknowable wisdom…we just got them started on the right foot. I know our executive sponsor was pleased that we were there.

I was happy to be back in a hospital again. I do feel like our software and process truly helps hospitals provide safer (at least more compliant) care and that is gratifying. I could see how consulting on billing practice or construction management benefits the hospital and leads to better patient care, but we are truly dealing with how the hospital provides care and what it does to make it better. That is what I got into healthcare for.

And so far I haven’t stolen anybody’s watch…to subsequently tell them the time.