Valley Voices

In search of hospitable hospitals

John G. Taylor
John G. Taylor

Catering to and fostering people who want to be healthy. That’s the health care environment we’re evolving toward. That’s not yet the propelling force behind many hospitals.

Once you’re in the hospital door, you’re often regarded – from security screening, to triage station to patient financial services – as another clot in an already sclerotic system.

You encounter warnings and scrutiny – not hospitality, education and encouragement. Leave your valuables at home. Prepare to provide a copay on admission. Bring a designated care advocate – with legally binding permissions – to stand up for your rights.

There may be valet parking and a colorful folder explaining confidentiality, billing and patient care services, but there’s signage suggesting perdition – “perfusion lab … densitometry scans … interventional radiology.”

When fiscal or physical dilemmas arise, you are pointed where the nomenclature turns dark. Charge nurse. Case manager. Ombudsman. Administrator on duty.

You hear that sizable staff are assigned to quality/infection control, risk management – suggesting variability abounds and unpleasant experiences lurk. If you’re looking for the forward-thinking positivism of a chief imagination officer, try the Sundance Film Festival.

Patients receive arcane brands. “Non-compliant” means not following instructions (though if a caregiver can’t speak the patient’s language, that tag can be mistakenly applied). “Frequent flier” – that will get you bonus airline points, but in hospitals it’s attached to those who frequently and often needlessly use emergency services (often for lack of public social services like behavioral counseling). “LWBS” – left without being seen, as hours turn to days of waiting for non-emergent care.

Fortunately, the inherent cultural infirmities of hospitals are changing. More patients with insurance mean heightened demands as well as expectations.

Government reimbursement hinged on paying for quality and penalizing for lapses – faulty as it is, particularly for safety-net hospitals serving disproportionate numbers of chronically ill patients – is hastening improvements as well as sometimes-warranted closures.

Retirements and shortages of physicians and nurses will translate into extending scopes of practices for other providers, and a rocky hand-off that will be.

Most hospitals were not founded with the mandate of putting more feet on the street – sending out multilingual social workers and educators, creating transitional housing for the homeless, lobbying governments to increase green grocers and green space, safely accessible to the public. That was the presumed province of government agencies and community organizations.

But better care at lower costs means systemic reinvention.

Ultimately, more empty hospital beds are part of the success story. That was no more the benchmark college curriculum for most of today’s health care execs than experiencing rigorous interrogation by patients of treatment options was for physicians educated a decade ago.

The innovations and experiments needed for that reinvention are evident.

▪  The Mayo Clinic has created a staff burnout task force, recognizing that rested and rejuvenated caregivers provide better patient service.

▪  The University of Illinois is funding apartments for as many as 20 chronically homeless Chicagoans for a year, easing emergency department usage.

▪  Kaiser Permanente is testing patient “health hubs” in Southern California, described as a kind of “public square” where care mingles with yoga classes, cooking demonstrations and educational classes.

▪  And in Fresno, Community Conversations – a collaborative of health providers, community, government and other activists – has not only revived a county mental health system eviscerated by funding cuts but also established a one-stop entry point to a usually Byzantine network of behavioral, substance abuse and homeless resources in the region.

Ultimately, the hospitals that flourish will increasingly empower those they serve. And they certainly will be more hospitable.

John G. Taylor, a former Fresno Bee reporter and editor, is owner/operator of The JT Communications Co. LLC. Write to him at jtcommunicates@comcast.net.

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