Fixing the System

Although hospitals, the federal government, nonprofit groups and insurers want to improve the system, efforts to boost coordination and teamwork still have a long way to go contra angle handpiece.

Last summer, the Joint Commission, the nation’s hospital accrediting group, developed a tool for hospitals to help guide communication when a patient is transferred from one hospital setting to another – for instance, from an intensive care unit to a regular floor.

Some medical centers have taken steps to improve communication, assigning color-coded ID tags or scrubs to staff members so patients know who’s a nurse and who’s a doctor, and installing white boards in patient rooms, where a nurse starting a shift can jot down his or her name. At some facilities, hospitalists write their names on those boards, and hand patients and their relatives business cards or sticky notes with their photos.

A few hospitals have gone further. At the Mayo Clinic in Rochester, Minn., patients having surgery attend a pre-admission education class so they know “almost to the hour, let alone to the day, what’s going to happen,” said Chief Medical Officer Michael Rock.

In Pennsylvania, Geisinger Health System has developed a checklist on laminated cards that fit in caregivers’ pockets. It includes questions that doctors and nurses need to keep uppermost when reviewing cases, such as: “Is the patient taking high-risk medications? When is the patient going home? Does the patient have any catheters or lines that should come out?”

Virginia Mason Health System in Seattle completely overhauled how they did things after sending representatives to Japan to learn from Toyota. Now nurses spend 90 percent of their time near the patient “so the shift handoffs don’t happen at the nurses’ station anymore,” said Dr dental handpiece. Gary Kaplan, Virginia Mason’s chairman and CEO. “Patients don’t have to use the call button.”

Consumer advocacy organizations, meanwhile, advise patients entering the hospital to have a relative or close friend, or even a hired hand, who can communicate on their behalf and be at their side through the hospitalization dental implant machine.

But not all patients have such advocates, and even when they do, playing that role can place a difficult burden on families or make second-class citizens of those who do not, said Wachter, the hospitalist.

When his own mother had lung surgery in Miami several months ago, “I went down there and didn’t leave her bedside,” he said.

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