When Communication Works Well #PooleHospital


 

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I went along to Poole Hospital at the beginning of the week with my husband for an outpatient’s appointment.

On arrival in the Blue Clinic we were met by a lovely friendly volunteer who was eager to show us how to use the self-service booking system. She talked us through it chatting away whilst she was booking him in. Her lovely friendly nature was a breath of fresh air and it was obvious that she enjoyed being there. She then took us to the area we needed to be ready for our appointment.

The TV screen in the department gave out useful information as well as informing us that the clinic was running a bit late – this was extremely useful as it allowed my husband to pop off to the toilet without worrying that he might miss being called in for his appointment.

After a short while a healthcare assistant came out to apologise for the delay and she told us how many people were in front of us (we only had one other person before us) She went around everyone else in the department informing them of the same.

When his appointment came we were had a lovely welcome from the consultant together with a handshake, smile and great eye contact. The consultation wasn’t rushed, we had plenty of opportunities to ask questions and everything we needed to know was covered. Everything was explained in full details and in a way that we could understand.

We were in the department no more than about 45 minutes from arriving to leaving. It was a brilliant service and the most impressive thing was the communication, it was excellent and this must be so useful for people who perhaps are unsure, or somewhat confused at a being in such a large department.

We were both very impressed with our overall visit. Well done Poole Hospital, your staff, volunteers and communication was excellent.

 

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The Intensive Care Bed #Hospital


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Here in the UK last night the BBC aired a programmed called “Hospital”. It was a very moving programme showing how stretched the NHS is. It certainly opened my eyes to the daily nightmares that consultants, managers and nursing staff find themselves in on a daily basis. The shortage of Intensive Care beds the result in operations having to be cancelled and patients being turned away for life saving operations. The look of frustration and helplessness etched on the faces of many.

How I felt for the patient that had his operation cancelled for the second time, being sent home after waiting in the ward anxiously waiting to hear that an Intensive Care bed was available – it didn’t happen the bed was needed for another patient.

It brought be back to when my mum was “that patient”. Extremely poorly with bowel cancel, awaiting a life saving operation. She was prepared for the op by having nil by mouth for 24 hours the day before the scheduled operation. By 4.00 that afternoon she was still waiting, we her family were waiting with her trying to keep her spirits up. Finally, I went along to the nurse’s station to find out what was happening to be told that her operation was cancelled due to there being no Intensive Care bed that she needed after her operation. Her operation was delayed to the following week.

The following week arrives, my mum another week on, getting weaker by the day but we were all optimistic she was having her op that day. It got to lunchtime and we got the dreaded news her operation was cancelled again for the 2nd time. The Intensive Care bed was needed for a man who was involved in a road traffic accident. I remember feeling anger at this person who I didn’t know – because of him my mum was not able to have her operation again – and then the instant guilt of feeling like that. This faceless unknown person fighting for their life as my mum was doing got the bed first – WHY!! I often wonder how their family felt – they probably just took it for granted that the Intensive Bed was there – as I thought before this nightmare began. Her operation was delayed for yet another week.

The 3rd week arrived – just a few days before Christmas. We were told previously that mum would be first on the operating list. I sat with her – her fight all gone. All 4 and half stone of my beautiful mum wasting away in the bed before my eyes. They came around to get her prepped for the operation. Excitement building like this was something that we didn’t believe was ever going to happen. Somthing that before this we had just taken from granted. Patients starting going down to the theatre – the consultant came up and asked if he could have a word with the family. His dreaded words “I’m sorry but we are going to have to cancel mum’s operation again” Our grief at that moment was unbearable. My heat was torn in two – how on earth could she survive another week. Amongst all of the shouting and swearing the panic and the disbelieve I still remember the look of despair on the consultants face. He just didn’t know what to say. He apologised and said that he would have felt exactly the same if it had been his family. It was the same story – they didn’t have an Intensive Care bed for mum after the operation.

I would never in my wildest thoughts that it would have been a bed that would have prevented my mum from having a life saving operation. It just didn’t make sense. I actually believed at this stage that this was just a lie – that they didn’t feel that mum at the age of 70 years was worthy of this operation. I felt they were just waiting on her dying.

The consultant went and spoke to mum. She had lost the will and just nodded – perhaps like me she thought that she was never going to have this op.

I remember mum saying she was hungry – I sent my Dad to get her a sandwich from the canteen. This has been her 3rd week of starving for 24 hours before being told she wasn’t having the op. She then asked the nurse for the commode. The nurse went off to get one. The nurse took longer than mum could wait and she attempted to get out of bed to get to the toilet – as ill as she was she still had her pride. As she stood upright the tumour burst – all over the floor. Within 10 minutes she was being rushed to the operating theatre where she had the operation.

She finally had the Intensive Care bed that she was promised 3 weeks ago, albeit only for 2 nights instead of the 5-7 she was told she would be in there for. She was  then transferred to the high dependency unit. I often wonder if someone had to be moved out of intensive Care to make way for mum, or if someone who was waiting for it had been cancelled like my mum had.

Watching the programme last night brought it all back. It made me see the nightmares that the staff have on a daily basis trying to access Intensive Care beds for patients. As the programme showed last night we in the UK have the most wonderful consultants with the most amazing powers to carry out life changing operations, the dedicated staff who work around the clock to look after the patients before and after their operations and the most marvellous well equipped hospitals that we should be so proud of. But how shocking it is to think that it sometimes comes down to the “luck of the draw” when it comes to needing that much-needed Intensive Care bed.

Managers Training: The Other Side of the Desk


When managing staff it is always good to give them feedback. Yearly appraisals are a good opportunity for this but why leave it once a year?

Here is a little exercise I used to carry out on my Reception staff.

Sit in your Reception area at the busiest time of day. Observe what is happening in your Reception area – see how the receptionist deal with patients how they cope with the busiest time of day and how they copes with the pressure that the busy time can bring.

Put yourself in the place of a patient – see it from their eyes and ask yourself how do they see our Surgery?

Have a note-book with you and take notes – but the most important part of the exercise is not only to pick up on any negative issues but also highlight the positive issues too.

What should you be looking for:

  1.  Is patient confidentiality being broken? Can people in the waiting room hear conversations from the Reception Desk? Patient confidentiality it vital in any Practice – and more so at the front desk.
    People in the waiting room can often hear conversations at the front desk. Make
    sure you staff use as little personal information as possible. Make sure that
    all your staff has the appropriate training on Patient Confidentiality. (see
    blog on A Quick Confidentiality Checklist. http://t.co/S3E94mU8)
  2.  How does the Receptionist interact with the patients? Do they have good eye contact? Are they polite and always helpful? It is easy to be short with patients when you have a queue of people at the front desk. Training in dealing with such times is vital – train your staff in dealing with such times –
    how to move patients on quickly without being rude or appearing that they are
    not caring. A smile and a thank you go a long way.
  3. How does the Receptionist answer the phone? Is it answered quickly enough? Does the Receptionist deal with the call efficiently? Always make sure that your staff answers the phone with good morning/good afternoon – the name of the surgery and their own name. Staff than give their name takes ownership of the call more than those that do not give their name. Again, if they are in ear shot of the waiting room it is important that they remember Patient Confidentiality.
  4. What are the other staff doing whilst the busy time is happening – are they helping out?  Often in Surgeries you have Receptionists at the front desk and others doing other things such as admin, typing, prescriptions – have you got a contingency plan for such busy times – if someone is busy on the front desk or on the phone do you have someone who can come and help out for short periods of time.
  5. Can you hear conversations between Receptionists behind the desk? When the quieter times come Receptionists often will have a little chat – but they should be made aware to be careful on what they are chatting about – I had an incident where 3 Receptionists were discussing a TV programme that was on the night before. They were discussing the programme about Breast Cancer and about a lady having terminal Cancer – they talked in-depth about the programme – talking about people who had lost relative/friends to the horrible illness. What there were not aware of was a patient was sitting listening to them in the waiting room that had just recently been diagnosed with Breast Cancer – she found the conversation very upsetting. Whilst I was doing
    this exercise I also heard Receptionists discussing an issue that could have
    upset a patient in the waiting room.
  6. Is the Reception area being kept clean and tidy? It is important to
    keep your reception area clean and tidy. Not just for a good impression but for
    Health and Safety reasons too – magazines, children’s toys left lying around on
    the floor is dangerous – someone could easily slip and fall.
  7. Are the patients kept waiting for long periods of time (often a problem in surgeries) This unfortunately happens in every surgery. Observe how your patients feel about it – and how your Receptionists deal with the patients if they come back to the desk to complain/enquire about their appointment running late. Do you have a policy on Doctors/Nurses running late?Do you have a surgery policy about Doctors/Nurses running late?

After you have done your observation bring them to your next staff meeting.

I always find the best way to approach this is to tell your staff that it was not an exercise to “catch them out” but an exercise to find if and where improvements can be made.

Always start with the positive notes you have:

  •  How well you thought the receptionist dealt with a certain patient/incident.
  • How good their telephone manner is.
  • How lovely and tidy the reception areas looks.
  • How pleased you were to see others helping each other at the
    busiest time.
  • How good they are with dealing with confidentiality.

Then

If there are any (and I am sure there will be) go onto the negative things that you found – discuss them and ask your team to give their opinion. Ask if there is a better way it can be dealt with. Include them in any decision-making. Include them in your findings.

Staff do not like change so I always used to say – we can change it, try it and if it does not work we can look at it again.  This always used to work.

Make minutes of the meeting – ensure that you record any changes that are going to be made and ensure that everyone has a copy – including those that were unable to attend the meeting.

Turn those negative into positives.