The big day had arrived and we began the journey into find the hospital ward. It was 06:30, cold, raining, and dark, we needed to be there by 07:00 according to the letter.
Bags packed, paperwork in hand we walked down quiet eerie corridors in search of the right ward. At last we arrived!
The night shift had an hour to go, and were looking exhausted. They flicked the lights on in the ward to show us to the allocated bed waking the sleeping patients.
We were shown to the bed and invited to sit down. A few minutes later the first of a string of people arrived to fill in paperwork, take samples and ask questions.
You may have read an earlier blog about the previous visit for the pre op assessment. All the same questions were asked in the pre op appointment a number of times too!
No matter, as each person approached the bed they asked ‘can you just confirm your name for me please, and your address, and date of birth.
They wrote it down on their form and began asking questions for their bit of the system.
All standard stuff, all previously recorded on countless bits of paper, and doubtless entered into IT systems for their professional discipline.
As this was a surgical procedure each person also asked for confirmation of the surgery to be performed. This seemed to be done in a jokey was, as if it was some kind of guessing game.
Bemused we politely answered the question each time.
After all that a Doctor came a long with a marker pen asked all the same questions, and then proceeded to draw a large arrow on the offending area.
Then like a scene from a pantomime the consultant paraded in to the ward with his serfs in trail. He was very pleasant, but pompous and added no real value to the moment, other than to confirm everything that we already knew.
In practice he could have undertaken all of this previous activity, save perhaps for taking a blood sample, and the really helpful conversation with the anaesthetist. This would have given him a much better relationship with the patient. Even better if the consultant, anaesthetist, and a qualified nurse had all turned up at once and ran through the whole process together. Ten minutes would have completed all the tasks required in one go, with no duplication.
Could that ever work? Unlikely!
Sadly, functions and hierarchy prevent this from happening in the current way of thinking.
So in a round 90 minutes we had contact with well over half a dozen people, all very pleasant and polite, doing their bit to feed the system. Other patients looked on to watch ‘the show unfold’. Obviously they too had been here before!
However, from our point of view we had merely repeated basic information over and over again. A massive waste and duplication of effort, but this was only the start!
Next came the news that the trip to theatre was likely to be in the next five hours. As this was a morning surgery appointment ‘we would have to be done by 12 noon’ otherwise this would affect the afternoon surgery.
Five hours seemed like for ever, but at least we were not afternoon surgery, and at the mercy of slippage from the morning, and the inevitable emergencies that may arise from life outside the hospital.
From our point of view we had got up in the middle of the night my relative had starved since 18:00 the night before, and now had the prospect of sitting around in a ward environment killing time whilst ‘things took their course’.
In practice we could have arrived three hours later, and still had more than enough time to be prepared for theatre.
Then the big moment finally arrived, a full 90 minutes later than forecast – a porter: the only chap that seemed to know what we going on arrived.
He chivied the nurses and chased their paperwork and we were on our way to theatre….
I reflected as I drove home on the wasted time and effort that had gone in to the mornings events. Non of it was ‘patient shaped’, although most of it was done with the best of intention. Nurses caught in an endless cycle of activity.
Everything was designed to suit functional relationships between disciplines in the hospital, and little of this made sense from the patients perspective. All this effort could have been channelled in a more effective way saving resources, and improving patient well being.
The truth is that most organisations suffer from the same issues in terms of their design and operation. They make absolute sense when you are working within them, unless you take a step back and reflect upon what typical activities look like from the outside.
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