So, as we start to implement BIDMC SPIRIT, here is a classic tale of a complaint and a solution that doesn't solve the root cause problem. Note that all people involved are very well intentioned, responsive, and caring of the patient , but how -- without a little prodding -- an underlying problem would have been left unsolved. By the end, we are headed in the right direction!
Note to me from a friend of a friend:
Hi. I am forwarding this to people here who can be helpful.
Reply to me from our CIO, with a copy to the right person in his place:
Happy to help. ABC, could you check on [this patient's] registration?
Note to the patient from ABC, with copy to me:
You are now registered for PatientSite. If you need further assistance, please do not hesitate to contact me.
Note to ABC from me:
Thanks. Now, I am curious as to why it didn't work for him. Can you explain? Is there anything we need to do to help others avoid this problem?
The IS person's reply to my query:
He sent two requests to register with Dr. X in the XYZ clinic. These requests typically go to office staff, and they did not respond to his requests.
My reply to administrative director in that clinic, with copies to others.
Well, let's pursue this and get to root cause and solve it, so it doesn't happen to future patients. (Pat and Jayne, also please note and offer BIDMC SPIRIT advice and assistance to [the AD] as needed.) Remember, no blame! Solve the problem.
Reply from AD, to me alone (!):
Thank you. Will follow-up with the admin staff.
Reply to the AD from me, again with copies to all others:
But, wait: There may be lessons for other clinics as well, so please do not do this in isolation. That is why I continue to copy others on this email thread....
Jayne, the VP who was copied, jumps in and says:
I will call a meeting to discuss the process for signing up for patient site. It would be good for everyone to understand the full process. Once we all know the full protocol and who is responsible for what portion of the process clearly without misunderstandings, then we can improve and re-document the process and roll this out to office assistants also as appropriate. Also, we need to ensure that the physicians also understand that they too need to approve their participation in patient site as I understand that has been a concern in the past.
ABC, can you bring a process flow of how IS and offices handle requests and timelines of the process for approval. Also, how is it fully communicated to the patient, etc. Then we can discuss other components that contribute to a less than optimal response to the patient and solve to root cause, then roll out to all, the improved system so that everyone understands their roles.