June 2, 2020
Plan B: Beyond the Caution Tape
This is the conclusion to last week’s healthcare journey blog, A Cautionary Tale, which describes the author’s visit to a respected health system for a surgery consult. The experience in this COVID-19 era was so unsettling that she scheduled her surgery elsewhere.
Since posting A Cautionary Tale, I’ve been amazed to hear from people across the country – health system leaders, physicians, former colleagues, friends and new voices. I’m blown away by the interest and grateful for the appreciation of my story and understanding of my intent in sharing it. Now several days out from my gallbladder surgery, I’m beginning to feel a whole lot better and grateful to be on the other side.
Here’s the promised sequel, featuring my experience with my Plan B surgeon at Plan B health system. I also threw in some practical advice for providers everywhere. So, here goes.
After asking my PCP for another referral – this time to Dr. H at another respected hospital – her staff got me in the next day and let Dr. H’s office know I needed to be on the shortlist for surgery. In advance of my visit, I got a call letting me know where to park, to wear a mask and to be aware that they would take my temp upon arrival. When I walked across the pedestrian bridge and into clinic building, it was clean, well-lit and, given some of the departments were closed, there were patient navigators to assist with wayfinding.
I found my way to Dr. H’s office and was one of two people in the waiting room. When I told Paula at the front desk that I was there to see the surgeon for a consult, she said, “You must be Ms. Toomey. We’ve been expecting you.”
Paula handed me a clipboard and pen with paperwork to fill out. And as she did, she let me know it had just been sanitized, but if I wanted to use my own pen, that would be fine.
I was called back on time, put into a clean, bright room where I waited for Dr. H. He appeared within minutes. He bumped elbows with me as a greeting, and we talked for a while. He asked me what an “h/c consultant” does – given that had been the shorthand I’d used on my form for my occupation. I shared a little about our firm and how we work with healthcare providers through high-stakes times and that we’ve been busy with COVID-19. He was intrigued and respectful.
He told me all about what his hospital is doing to keep COVID-19-positive patients isolated and mentioned that the OR where I would be treated is only used for electives, like me. He brought a female nurse in prior to examining my abdomen. He talked me through the surgery and risks and recovery. He sat with me; he didn’t stand over me. And, while I know he had other patients, he made me feel like I was the only one.
We decided the surgery needed to happen quickly, and by the time I left the room, Paula had me on his schedule within three days. She walked me through every detail of pre-op.
I left the office feeling very good about my decision.
Later that day, I received calls from the pre-op surgical nurse and from the anesthesia team. They were both clear about what to expect related to COVID-19: I must pass the temp check, I must wear a mask the whole time, my husband could drop me off and come back to pick me up following surgery, etc.
The surgery itself was clockwork – in and out in about five hours. I had five nurses and three doctors taking care of me – all of whom greeted me, made me feel as comfortable as can be expected and whose faces I could see displayed on their name badges (helpful, given the masks).
Following surgery, Dr. H called my husband personally to tell him how it went and what to expect with my condition. And when I was in extreme pain 24 hours later, I left a message with his office to make sure it wasn’t anything to worry about. I figured a nurse would call me back, but it was actually Dr. H himself. He told me all about my surgery, assured me the pain I was feeling was ok and gave me some pain management tips. He didn’t hang up until I was ready to.
The contrast between my two hospital visits is revealing. Both health systems are caring for COVID-19 patients while reopening other services. Would I have had a similar clinical outcome at either hospital? Likely, yes. Yet, in one, I felt like they were glad to have me and in the other, well, not so welcome (or safe).
I’m also aware that the hospitals I visited are different. Different sizes. Different missions. Some might even say they serve different communities. But those differences are largely irrelevant to patients. Every patient experience is an intensely personal experience, and every patient deserves a good one. In the age of consumer-driven healthcare, the experience is mission critical. No excuses.
So now you know my story. Allow me then, as a “h/c consultant,” to offer a few tips for healthcare leaders who are working hard to deliver a patient experience worthy of their mission:
- Share proactively what you’re doing to keep patients and caregivers safe. The pre-call to patients is important so we know what to expect. Make sure every staff member can recite the handful of sterilization, testing, isolation, etc. procedures you’ve codified since the pandemic’s onset. Be proactive about this conversation with patients. Often, a patient doesn’t know what to ask, but you can wager they’re mulling over their safety with surgery – especially in this new era.
- Physicians and nurses are the best messenger for patients. This is always true, but especially now. Put them front-and-center to assure patients they will be well cared for and safe.
- Make it easy on patients. Have them fill out forms in advance. Tell them where to park and what to expect upon arrival, especially if changes have been made.
- Clean, clean, clean. Now is the time to have your environmental services crew visible constantly throughout the day. Patients want to see with their own eyes the sanitization that is taking place.
- Create branded/laminated fliers. Use these to explain the latest procedures you’re undertaking and hang them in common areas and patient rooms. This sends the signal that you are in control, thoughtful and vigilant about precautions.
- Keep the halls and departments lit (or partially lit). Even if those areas aren’t open yet, this projects that the facility is ready to take care of patients.
- Remove the seating you don’t want patients to use. Roping off looks haphazard. And caution tape – flat out – sends the wrong vibe.
Hospitals and healthcare providers have an unenviable responsibility – to care for patients with a wildly unpredictable virus, while treating others in need of different types of care. It’s a duality that is complex and tricky, and it may not be over for some time. For your incredible work, I thank you. And I hope my story is helpful along the way.
(PS. If you ever need a general surgeon, let me know. I’ll introduce you to Dr. H. They don’t come any finer.)