A letter sent by a friend to the CEO of a hospital outside of Boston. While this was not here at BIDMC or at a place where you might work, let's all look at each of her complaints and answer honestly: "Could this have happened at my place? What will I do to make sure it doesn't?"
I feel you need to know about some significant problems I experienced at your hospital. My ninety-four year old mother was a patient there from Nov 28th through Dec 4th, having fallen and broken her leg. Beginning with the nine hours she spent largely unattended by anyone but me in the emergency room and ending with her discharge a week later, the one constant was a lack of any useful communication, particularly given her age and degree of memory loss.
She was logged in to the emergency room an 2:00 in the afternoon on the 28th and finally given a room at 11:00 that evening. During that time she was in a great deal of pain, left without food or drink (in case she was going to be scheduled for surgery, even though it was clear hours earlier that no orthopedic surgeon was going to be available … she had the surgery late Monday afternoon), and although she is incontinent, not given any help or comfort until I intervened.
During her stay, I never heard from her own physician, and when I called him the day she was discharged, he told me that he had never been informed by the hospital that she had been admitted. He told me that he had recently received a letter saying that because he uses a hospitalist there, he no longer had hospital privileges. This may well be a useful policy for streamlining patient care (although my experience does not bear that out), but it needs to be shared with the patient’s family. I assumed, incorrectly, that her doctor had been called and his advice solicited.
I neither met, nor heard from the hospitalist, so I can only guess that he or she exists. The only calls I received from physicians were “witnessed” pro forma calls asking for consent for surgery and anesthesia. If the hospitalist policy precludes keeping family physicians informed, then some form of organized communication with the responsible family member needs to be instituted, particularly when the patient is elderly and mentally impaired. Her own family doctor could have given useful information on her medical history and mental state. The staff seemed generally unaware of her memory loss, her impaired hearing, and that the pain medications were causing her to hallucinate.
It was, all in all, a depressing, disorganized, and generally disillusioning experience. I will be happy to provide any further details about her hospital experience that might help you find ways to remedy these breakdowns in communication.
I look forward to hearing from you.