Mistakes are painful when they happen, but years later a collection of mistakes is what is called experience. Denis Waitley
One of the biggest problems in hospitals today is a lack of communication. This occurs at
* Patients and caregivers often do not understand medical jargon and are scared to tell
the doctor that they cannot make sense of anything he has said. Doctors are busy people
and are often in a rush when they are on their hospital rounds. They breeze in and out
of the room, and even before the patient or her relatives can collect their wits, they have
disappeared. The doctor is blissfully unaware of this lack of communication, and feels he
has done a good job.
* The communication gap is not only between the patient and doctor – there are gaps between doctor and doctor as well. Typically, many medical specialists are involved in providing care to the patient, and the care often gets fragmented. They are rarely in the room at one time, and this lack of coordination is a huge problem. The right hand does not know what the left hand is doing, and sometimes the information they provide to the patient is different, leading to even more confusion.
* This is true for nursing care as well. When the shift changes and a new nurse comes on duty, sometimes the hand-off is not done properly, and patient care suffers because of these gaps. Ideally, the medical record is meant to ensure that the care is properly coordinated, but this doesn’t always work well because when the record becomes voluminous, it’s easy to miss critically important information.
* Also, patients don’t have easy access to their own medical records, which means they are often in the dark as to what’s going on.
Adding to the confusionThis lack of communication is one of the major preventable reasons why medical errors occur. The problem is compounded when the patient’s family members are not on the same page, which means that they end up talking to the doctor at different times, thus wasting his time and irritating him. Often, they may disagree with each other and this makes matters worse, because they express conflicting wishes as to what they want done for their patient - often behind each other’s backs.
Visitors and well-wishers are concerned about the patient’s health and have lots of questions as well. What’s the diagnosis? What’s the treatment plan? Is he doing well? Is there anything they can do to help? The poor patient (or his relatives) has to keep on repeating the same story many times, and this can be quite fatiguing. In a perfect world, we would be able to get everyone together in the room at the same time, but this is not possible in reality.
The simple solutionHere’s a simple, low-cost solution that could be implemented easily in all hospital rooms today:
* Every hospital room should have a whiteboard, on which everyone is free to write and comment. The whiteboard would come equipped with markers of different colours to be used for different purposes.
* The doctor could use it to explain to the patient what is wrong with them and how he plans to fix it. An image is worth a thousand words, and this could help to overcome lots of misunderstandings. Readymade anatomical medical magnetic stick-ons could be used for doctors who are artistically challenged.
* The doctor could write down the proposed treatment plan; and the other medical specialists and nurses could modify and edit this. For example, there could be a daily list of medications that need to be given, along with the time they are meant to be administered. Once the medicine is given, it could be struck off the list. In case there is a delay, the family member could gently remind the nursing staff about this oversight.
* Checklists could be easily incorporated on the board. This is especially valuable before a planned operation; or at the time of discharge, when there are multiple moving parts that need to be synchronized to ensure that they work in tandem.
* Patients could write down their concerns, so that the doctor would address them on his rounds. This ensures they don’t forget to ask a critical question; and this way they don’t need to bother the doctor by pestering him with queries on his mobile. This board would help to make the patient better organized as well!
* Warnings (for example, allergies) could be highlighted on the board, so that everyone is aware of them.
Patients often forget the instructions that doctors and nurses and therapists give them. These could be written down on the board, as a list of Do’s and Don’ts, to make sure they are remembered correctly. It would be easy to develop readymade templates for common problems , and these could be stuck on the board, as needed.
A section of the board would be reserved for the patient and the family members. Here they could write down their story (of what happened, for example) and what help they need, so they could share this with friends and loved ones. More importantly, they could write down their doubts and concerns.
Not only will this help to make patients feel empowered, the hospital staff would get a chance to hear the patient’s voice directly. This would prevent problems from escalating, and help to improve patient satisfaction.
The board is environmentally-friendly, as it can be reused daily. If a long term record is needed, patients could take photos of the board, and share them as needed. A whiteboard is a very simple tool to get everyone on the same page, and every hospital room should have one!