A hospital exec’s perspective from the other side of the bed

High-quality patient experience is always a concern for me, as I believe we must make our patients’ time with us as pleasant as possible. Until recently, though, I haven’t had much experience as a patient myself. The most serious procedure I have ever had done in a hospital is an inguinal hernia repair, and my experience was very good. That couldn’t have anything to do with the fact that I was also the CEO of that facility, right?

But a more recent hospital experience in a facility, where I was not known, has given me a different perspective. A little more than a year ago, I was visiting my mother-in-law and brother-in-law, who were both inpatients at a local community hospital on the same day. This hospital has a great reputation. I was looking forward to seeing how they were doing and to get a closer look “under the hood.” Little did I know that before the day was done, I myself, would be joining them as a patient at that hospital.

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While visiting my brother-in-law’s patient room, I experienced dizziness and fainted. It was an isolated event that I now attribute it to a very stressful time at work, a long day of travel to get to the hospital and poor nutritional habits for several days leading up this day. As a result of my fainting spell I got to see firsthand the hospital staff spring into action. I was whisked from the cardiac floor down to the emergency department on a gurney while fully awake. When I arrived in the ED, I protested that this was all a big mistake and that it was a brief lapse. I was ready to be discharged.

Not so fast. I would not be released from the hospital until it was understood why I fainted. OK--that makes sense. I do have to admit, however, that I was not a very cooperative patient. Soon that translated into not being friendly to the staff either. I still wanted to go home and get some dinner. I was assured that I only needed to stay while some testing was completed and then I could go. I had never been a patient in a hospital for this type of situation before.

Clinicians ordered and performed a cardiac enzyme panel, a 12-lead EKG and a chest X-ray. Apparently, the ED physician wanted to rule out a cardiac event causing me to faint. Then we waited and waited and waited. The good news was that all three tests were normal. At that point in time, my patience was growing thin. I soon felt that I was being held against my will for no good reason. I eventually signed out against medical advice—something I never thought would happen to me.

I have often thought about this experience and wondered what could I have done differently or what could the hospital staff have done differently to cause a different outcome. I am a hospital professional and I told the hospital staff so, but I felt that they didn’t care. It would have made a difference to me if they had acknowledged me as one of them, rather than an “outsider.”

Of course, that’s a claim that most patients cannot make. Hospital emergency departments are busy places--and this one was no exception. I felt like I was just another number, and I left the hospital that day as a different person than the one that entered the front doors earlier in the day. I felt discouraged and minimized--not elated, as one might expect, since they didn’t find anything wrong with me.

That event has had an impact on me. Now back in my own hospital, I make a point of rounding in the emergency department daily and observing to see how our patients are doing. I have had the joy of meeting visitors from Ireland in our ED and grateful local citizens as well. I have found that even a hospital CEO can make a difference by visiting patients in our ED. I try to make their stay as positive as possible.

By the way, my story had a happy ending. A local neurologist examined me as soon as I got home who confirmed that it was an isolated incident of syncope and not related to a major medical condition.

Raymond Hino, MPA, FACHE, is the president and CEO of the Sonoma West Medical Center in California.

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