I got a call from my mother last night. She was in the hospital. Apparently, she woke up in the middle of the night with chest discomfort. When she woke up later in the morning, she still had discomfort, so she took herself off to the hospital about a mile away. She'd already talked to my brother (who lives about an hour away). She called me to let me know where she was, and what she knew thus far.
They did an EKG (fine) and took some blood tests (Cardiac Enzymes -- also fine), and so they suspect this is just a bout of gastric reflux. When she talked to me, I asked her details about what tests they had done (she knew they did blood tests, but not what kind). Because women who complain about heart attack symptoms don't always get taken seriously, I wanted to double check that she was getting the right kind of care.
She handed me over to her nurse, and he and I conversed briefly about what tests they had done, and how the results came back. I was reassured that they had taken her complaint seriously, and had done the necessary things. Then I explained to him that I wasn't a doctor, just had a bit of education, and he was vaguely surprised that I knew to ask about what tests they had done.
My brother called me this morning so we could compare notes. He had contacted a friend of Mom's who is a nurse, and explained to her what he knew. She had talked to mom as well, and folks at the hospital. So, everything seems to be OK, and mom will probably be going home today, and everyone seems to be satisfied (for now) that it was just reflux. Mom will follow up with her regular provider.
What I learned from this experience is that even in a good facility (and this one is brand spanking new), with good people, telling the patient what they need to know about what tests are being performed and why is still not a big focus. Fortunately for my mother, she's got a network of family and friends who know what to ask, and where to go for more information. But there are plenty of folks out there who don't.
I recall my days in computer repair, and also my interactions with other folks who work on technology for me (like my car). I always want to know what they are doing, why, and what each diagnostic they've done tells them. I loved to teach customers what I was doing, how I figured out what was wrong, and what I had done to resolve the problem for them. Often, I included information about how to avoid a future occurrence. It made my customers very happy, and often answered questions they didn't know how to ask. When dealing with repairmen these days, if they cannot or will not explain to me, I'm dissatisfied.
Why is it, when we keep talking about making healthcare better, we so often leave the most influential person out of the communications loop? There's a simple way to address this. As a healthcare provider, answer the questions you would ask if you were in the patient's shoes. And do so in a way that the patient can understand. Arguably, this isn't an easy skill to develop or teach. In fact, nobody ever taught it to me. However, I've learned that it's probably the singular skill that makes this blog the most effective, and quite a bit of the rest of my work.
To provide effective care, or create implementable standards, you have to do two things: Think like the customer, and like a highly skilled expert. Melding those two skills well is how you provide the best care, or the best standards.
Now, back to more implementation.