Just when I start to feel jaded, I’m handed a nice surprise.
Once again, I found myself performing a frustrating chart review. It involved a young patient who presented to the hospital for a scheduled outpatient procedure. The procedure took place without complication, and she recovered without incident over a few hours. She was medically ready for discharge to home but when it was time to go, she said she was scared to be home alone. The physician was called, and she requested a bed for the patient to spend the night. No IV fluids, no meds, no special precautions, she slept soundly all night. After breakfast the following morning, she headed home in her own vehicle.
I composed a letter to the physician via our electronic medical record. You know the drill: “Dear Dr. You’re Killing Me Softly. Please remember that patients should only be hospitalized when it is medically necessary. If a patient does not require hospitalization but expresses concern about discharging to home, please contact the case manager….” Within 15 minutes, my phone was ringing and it was the doc!
Astonished, I proceeded to have a prolonged conversation with her about the scenario and her feeling of helplessness when addressing the situation. Somehow, she genuinely had no idea that case managers were available to assist the patient with making arrangements for discharge, such as contacting friends or family or even arranging for assistance at home out-of-pocket. She expressed how she very much did not want to put the patient into the hospital overnight, but thought her hands were tied, especially with all of the health system’s focus on customer service and positive Press Ganey scores.
Going forward, that physician will hopefully avoid unnecessary hospitalizations with the new information she’s learned. Not only will there be a benefit to the hospital, but to the patient, as well. As for me, I feel re-energized knowing that when I reach out to docs, it’s not necessarily to deaf ears, and shouldn’t routinely be considered something they already know but choose not to act on.
What simple, no-brainer info do you think YOUR physicians know but just don’t put to use? Might want to take a second look at those assumptions.