One hot topic that has recently gained a relatively large amount of attention over almost all areas of medicine is quality improvement. Hospitals have created dedicated senior-level positions to oversee it, interdisciplinary councils have been formed to research and address it, and employees are reminded daily, if not more often, of their role in implementing it in the form of various quality benchmarks they are held accountable for (such as reduction in the number patient falls, increases in the accuracy of the medical record, and identification of possible information gaps in the system).
As an active participant on my hospital’s quality improvement council, I see first-hand how tedious and arduous the process of identifying and affecting various quality initiatives can be. A truly thoughtful project requires the input of multiple stakeholders including administrators, physicians, nurses, technicians/technologists, receptionists, patients, and caregivers. I bring up the last groups specifically because the main goals of these projects and initiatives are to improve patient care and increase patient satisfaction. Unfortunately, too often, in an effort to complete a project, we make assumptions on behalf of patients and their families and forget to actually ask them their perspectives on the situation.
So what does quality mean in the eyes of a patient? After a recent hospitalization following the birth of my second child, I was quickly reminded of how frightening it can be to be a patient (or in my case, the parent of a patient). Being from the health care field, I was privy to the various safety/quality practices in place to ensure proper name identification, medication administration, fall precautions, and the like.
From the perspective of the hospital, the system ran smoothly with various checks and balances being appropriately met. From my perspective, however, there were a number of missing pieces in my daughter’s care including unanswered questions, false assumptions, and “team-driven” decisions that didn’t involve my input. These issues all boiled down to one key flaw in the system: poor communication.
Through the experience, I realized that no matter how nice and attentive the nurses were or how thorough the doctors were being, there was a gap between what they valued as an organization and what I valued as a recipient of care. To each of the workers in the hospital, my child represented just another filled bed; another patient to see prior to morning rounds; another ordinary hospital illness.
When you are the patient, there is nothing ordinary about the experience, and the only thing that matters is getting better or knowing there is a plan you are okay with to get you better. I realized that quality for me meant staying informed and being a part of the conversation. Believing that my voice and opinion mattered made a difference in my level of satisfaction despite the success of any medical interventions. Needless to say, my idea of what quality is changed, and I intend to use this knowledge when planning quality initiatives for my hospital so that our patients can be better heard in the future.
Kerri Vincenti is a radiology resident. This article originally appeared in the American Resident Project.
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