Hospitals: Still in the Middle Ages

I had occasion a year ago to blog about my experiences as a customer of the hospital system.  With a relative this week undergoing elective surgery, I am reminded forcefully of how antiquated, creaky, and dysfunctional the healthcare business is, as a business.

My relative’s surgeon, his PA, the nurses on the ward that he oversaw, and all of the staff, were individually superb.  It would be hard to find a group more knowledgeable, capable, and caring.

As an organization, however, the hospital was really really creaky.  When we showed up for admission, we were directed to a waiting room for “same-day surgery”, where the three staffers promptly disappeared for something on the order of an hour, turning out the lights in their office and leaving us with no clue where we stood or when things would change.  The hour of our surgery approached, when our surgeon happened by in the corridor.

“Why are you still in street clothes?” he said to us.  “I’ll fix that.” And he went backstage for a few minutes and produced one of the missing nurses.

With the surgery in progress, we were told to go downstairs to another waiting room where we could get a paging device that would let us know when we could visit in the recovery room.

Downstairs, the same thing: nobody in charge, a bunch of patients sitting around.  The staffer in charge had gone away some time ago.  No idea when she would be back.  Maybe 20 minutes later she sauntered back in.  Gave us a pager.

After two hourse had passed (the length of time we had been told the surgery would last) another staffer came around and collected our pagers.  They were done with them for the day.  No problem: security would tell us when the surgery was over.

Security, it turned out, was the lynchpin of this hospital’s operation.  Security knew everything; for the first time that stressful day, we felt someone was in charge.  Someone was acting as if a regular process might help patients and their families.

All’s well that ends well.  The surgery went well and we are recovering.  And, once again, most of the individuals we dealt with in the hospital were superb professionals.  But somehow the hospital doesn’t work as an overall organization.

Why not?  Thoughts?


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