May 26, 2020
A Cautionary Tale
How did this story turn out? Head over to part 2, “Plan B: Beyond the Caution Tape.”
Dear Healthcare CEOs,
If you want me back, you better be ready.
Right now, every hospital and physician practice has a common goal: Bring patients back.
For most Americans, it may be months – if not more than a year – before they’ll feel safe to return. Yet some who are in pain or who have had to put off a procedure for several months are ready (albeit a bit nervous) to seek care.
I fall into that latter category: in pain, with a gall bladder that needs to come out. So last week, following the advice of my PCP, I went for a surgical consult at a highly regarded health system (whose name I’ll protect). The television ads they were running were reassuring; I decided to put my trust in them.
In fact, the experience was so stunningly terrible that I’m compelled to share in hopes healthcare leaders can learn from it.
Let’s start from the beginning. The parking was a mess. Valet typically takes up the first three floors of the garage. Of course, there is no valet right now, but there were no signs or guides to help confused patients (especially older ones) with where they could or should park. Once heading into the building, everyone was forced to take dirty elevators together, due to closed walkways across to the hospital.
Patients were greeted at the hospital clinic entrance by intimidating red signs that read “No Visitors” and “Masks Required.” Just beyond that were four long folding tables where staff took your temp, asked you all the “Do you have COVID questions,” gave you a sticker if you passed, then permitted you to continue.
Very dystopian. Necessary for the times, but without an iota of warmth or empathy. Already unsettling, the experience began a steep decline.
The hospital was dark. Literally unlit hallways and closed units. The air was thick and warm. The patient in front of me complained about the temperature and the employee checking us in explained, “I think they keep it warm to better control the spread of the virus.”
Well, that’s comforting.
Yellow caution tape was duct-taped everywhere. It’s how they are “guiding” patients where to sit and not sit and where to go and not go. It felt like a crime scene.
At check-in, I was handed an old brown clipboard and pen to fill out forms. I wondered if either had been cleaned since the last person. Or the 10 before that. Odd to be required to fill this out, especially since they already have this information in my medical record.
I was called back by a kind nurse who took my vitals and told me I looked tense and needed to relax for my blood pressure reading. Then, as he took my temperature (again) with an oral thermometer, he mused, “Seems so strange we still use these, with the virus and all…”
The hospital itself was visibly worn – and looked unclean. I didn’t see a single environmental service professional cleaning during my two-hour visit.
There were throw-away paper signs taped around like you’d see makeshift fliers along a high school hallway that tell you all the things you are not to do. But there was nothing about what they are doing to keep caregivers and patients safe.
I sat alone in a patient room for about 40 minutes. I watched as the computer screensaver flipped through slide after slide hoping for some useful information. Nothing but messages about where to get new badges for employees and a cancelled health screening event.
Finally, a resident came in and talked to me, asked me about my health history, my symptoms, etc. – the exact same information I’d just written on those forms. She was in and out in two minutes.
Then came my surgeon. She introduced herself, looked at her watch and said, “So, I need to make this quick because I’ve just been called into surgery… You need your gall bladder out. Looks like I can fit you into my schedule next week. Here’s a brochure on what to expect. If you have any questions, the resident or nurse can answer them, or you can wait for me here. I could be gone 30 minutes, or it could be an hour.”
I was speechless. It was a 45-second interaction.
With tears of frustration and an incredulous bout of anxiety building in my gut, I grilled the resident (who returned quickly and was the only real bright spot of my entire experience). The usual questions about the surgery and recovery and risks. And then a lot about COVID.
I learned about all they are doing to keep patients safe through masking, sterilization, isolation of positive patients in a particular wing (they have about 30 to 40 on any given day), testing patients like me 48 hours pre-op to make sure I am in the clear, regular temp checks for staff, etc. The chances are low, but there is a minimal risk of transference in the hospital.
The deal killer came when I asked her about the operating room: I learned that they are using the same surgical suites for positive and non-positive patients. And that I could be in the same recovery room – you know, with the curtains surrounding each bed – post-op as a positive patient.
Unlike many patients, I’m fortunate to know that I have options for where I receive care. And you’ll be unsurprised that I’ve taken my business elsewhere. I’m scheduled for surgery at another health system where, so far, I have been welcomed, educated and cared for in a starkly opposite experience. (Stay tuned for highlights from that one on the backside of my surgery tomorrow.)
Here’s the point: Patients are scared. Even ones like me, who are educated and in desperate need of care.
If you are a hospital or physician practice or other healthcare provider, know that you have to meet patients where they are. Lean into their fear. Listen to them. Talk (proactively) about what you are doing to keep them and caregivers safe. Treat them as you would a family member.
And for God’s sake, create an environment that doesn’t feel like a war zone. The little things matter a lot right now.
Finally, don’t claim you’re ready unless you are. Be ready, because we need you.
UPDATE: To their great credit, the health system has contacted me and eagerly sought my feedback. Even better, they were clear that they took it seriously and are actively making changes to improve the patient experience.