Canada’s Hospitals, NOT Canada’s ERs, missing mark on waiting times, new statistics reveal – The Globe and Mail

The Globe and Mail missed the mark.  Hospitals, NOT Emergency Departments (EDs), leave patients in overcrowded EDs for nearly 30 hours before moving them to an inpatient bed.   EDs do not make admitted patients spend too long in the ED.  Hospitals do.  Hospitals could empty EDs of admitted patients at any time, if they wanted to.

Canada’s ERs missing mark on waiting times, new statistics reveal – The Globe and Mail.

Hospitals choose to leave 15 extra patients admitted in the ED; they could spread them out over all the inpatient wards.  Few hospitals enter the political battle of angering unions by placing extra patients on inpatient hallways, despite the nearly 400 articles published showing that mortality and morbidity increase for every hour admitted patients get warehoused in EDs.

Full Capacity Protocols empty EDs, have been used in Canada, and leave no excuse for exposing patients to the proven risks of long waits in the ED.

When will government change incentives so that hospitals start emptying EDs?

 

Medicare Without Debate Will Fail, From JS Mill

On-Liberty-Mill-John-Stuart-9780486421308We weaken Medicare by refusing to debate it.  When’s the last time you saw opposite opinions on healthcare presented fairly, without bias?  Silencing contrarians does not protect our system. Suppression of opinion creates thoughtless prejudice.

JS Mill gave 3 reasons to stop suppressing debate in, On Liberty, 1859.

1. Suppressed opinion might be true.

“The opinion which it is attempted to suppress by authority may possibly be true.”

“All silencing of discussion is an assumption of infallibility.”

2. Refuting contrary opinion reveals truth.

“Complete liberty of contradicting and disproving our opinion is the very condition which justifies us in assuming its truth for purposes of action…”

“Truth gains more even by the errors of one who, with due study and preparation, thinks for himself than by the true opinions of those who only hold them because they do not suffer themselves to think.”

“The fatal tendency of mankind to leave off thinking about a thing when it is no longer doubtful is the cause of half their errors.  A contemporary author has well spoken of ‘the deep slumber of a decided opinion.'”

3. All conflicting opinion holds some truth.

“…Conflicting doctrines, instead of being one true and the other false, share the truth between them, and the conforming opinion is needed to supply the remainder of the truth of which the received doctrine embodies only a part.”

“Truth, in the great practical concerns of life, is so much a question of the reconciling and combining of opposites that very few have minds sufficiently capacious and impartial to make the adjustment with an approach to correctness, and it has to be made by the rough process of a struggle between combatants fighting under hostile banners….”

“Not the violent conflict between parts of the truth, but the quiet suppression of half of it, is the formidable evil; there is always hope when people are forced to listen to both sides; it is when they attend only to one that errors harden into prejudices, and truth itself ceases to have the effect of truth by being exaggerated into falsehood.”

Mill makes a final point: “…truth; unless it is suffered to be, and actually is, vigorously and earnestly contested, it will, by most of those who receive it, be held in the manner of a prejudice, with little comprehension or feeling of its rational grounds.

Silence

Politicians fear losing votes, providers fear losing their jobs (or promotions), and voters fear losing medical insurance by allowing debate on Medicare.  With Medicare using 50% of tax dollars and growing at 6.5% per year, will this change before it’s too late?

 

(photo credit: images.betterworldbooks.com)

Grumpy Tech Meets Grumpy Customer – What Do Patients Want?

Virgin-Media-logoMedicare assumes fixing patient problems is crucial, and being nice, less so.  We prefer polite, but don’t believe it’s essential.

Jill Dean, CEO of Brand Biology, gave a presentation “Grumpy Tech Meets Grumpy Customer.  This Can’t End Well … Or Can It” at a recent customer experience conference. (Thank you, Bruce Palmer, for tipping me off to this!)

Check out the 30 min. presentation on YouTube.

Virgin Media sends out technicians to help customers with cable service problems.

Techs arrive at customer’s homes harried and edgy.  Customers call when they have problems; when they are frustrated. Like healthcare, both provider and customer are often frustrated long before they meet.

Virgin tried to figure out what drives client satisfaction:  technical skill or pleasant service.

They asked customers to score service on a scale from +100 (happy customer who would recommend to others) to -100 (unhappy, no recommendation).  They found that when technicians:

Fixed the problem and were friendly and polite, customers scored +74

Fixed the problem and were neutral in tone, customers scored +26

Fixed the problem and were rude, customers scored -44

Did not fix the problem and were friendly and polite, customers scored 0

Did not fix the problem and were neutral in tone, customers scored  -64

Did not fix the problem and were rude, customers scored -87

 Rudely fixing a problem was worse than being nice but not fixing the problem at all.  

No doubt, if “fixing the problem” equals saving life, people prefer having their problem fixed.  However, only a tiny percentage of people seek care for life-threatening problems.  Canadian emergency departments send 89% of patients home without life-threatening diagnoses.

We need to align system incentives so that everyone works to provide great customer service, not just fix problems.  We should aim for every patient to recommend us to their friends.