Earlier this year I wrote about the frustrating experience my family had trying to navigate the healthcare system and coordinate care for a relative after he fell ill, needed emergency surgery and then had complications that meant an extended stay in the intensive care unit.
Although he received good care and ultimately recovered, it was clear that the hospital could have done a better job communicating with his caregivers and making sure they understood what was happening throughout his stay and after his discharge.
This week my family experienced a health emergency that involved another relative and a different hospital over a three-day period. It began on Sunday when he experienced what turned out to be a grand mal seizure due to a rare complication to an antibiotic that he was on for a minor skin infection. After several hours in the emergency room, he was admitted overnight as an inpatient and later transferred to the cardiac unit.
Once again my family is grateful for the care our loved one received those three days. But the experience illustrated what works well within hospitals and where there is still room for improvement. Fierce has written about these issues before--and they are worth repeating:
Ask questions and then carefully listen to the responses. We were particularly impressed that the neurologist the hospitalist consulted took the time to examine my relative and carefully listen to his mother about his history and the events that led up to the seizure. It was because the doctor listened and realized the care team may have missed something that he went back to the notes in the electronic medical record and reviewed the vital signs and sodium level that were documented when he first arrived in the emergency room. And because the doctor also saw that he was on an antibiotic that has been known to cause seizures, he was able to point that out to the hospitalist in charge of his care.
Take a page from children's hospitals and make the patient's room and floor comfortable for patients and their families. In this case, the patient is autistic and nonverbal and needed a familiar caregiver in his room at all times. His mother never left his side, but the first night she was forced to sit in a chair the entire time because no one thought to bring her a chair that pulls out into a bed. Because she didn't want to leave the room in the event one of his clinicians came to examine him or confer with her about the test results, she couldn't venture out to the hospital cafeteria or even a vending machine for food or a snack. Instead, she had to wait for another family member to bring lunch and dinner. Would it be too much to ask for hospitals to allow a family member to order a guest meal at the same time as the patient orders breakfast, lunch or dinner?
If a patient has a known special need, ask the caregiver how best to communicate with him or her. We've previously talked about the need for medical interpreters and how some hospitals contract with an American Sign Language interpretive services provider to offer translators for the deaf community. But with the growing number of children diagnosed with autism spectrum disorder (the latest statistics from the Centers for Disease Control and Prevention indicate 1 in 68 children have autism but the number may be closer to 1 in 50 based on a recent survey), medical professionals must also learn how to communicate with this population. There is no one-size-fits-all approach, however. While some high-functioning people with autism can communicate verbally, others may be non-verbal and communicate by sign language or picture boards. Ask the primary caregiver how best to communicate with the patient and follow his or her lead. --Ilene (@FierceHealth)