Thursday, September 13, 2007

Something in their water?

Should I install a new filter in the water supply system serving our IS department? Notwithstanding the picture below of our CIO, John Halamka, I had been able to push back any worries of unorthodox or risky behavior on behalf of our IS staff. Now, John reports the following news and sends the pictures above: "One of my IS Managers, Bill Gillis, just set the new world record for the land speed record on a motorcycle (250cc class) of 214.775 miles per hour at Bonneville Salt Flats!" Here's more information.


Anonymous said...

The link to Bill Gillis news is not working. Error bX-454fh1

Anonymous said...

Hmm, works for me.

Rob said...

Ok. I really DO hope you have a good succession plan because, wow.

Good thing that translates into creative risk-taking in the "real" world.

Anonymous said...

Rob, I had EXACTLY the same reactions.

Anonymous said...

Hi, this is not a response to your last post. Instead, it is a suggestion.
I believe that you are interested in "best practices," which I understand to mean:
standardizing what is believed to be the best care in various medical situations.

I suggest that low tech "best practices" might save hospitals huge amounts of money and patients enormous amounts of grief.
Here is my example:
Last month my husband was scheduled for elective BPH laser surgery on a Wednesday. He was prescribed Cipro as a prophylactic measure for 10 days preceding surgery.
His surgery was cancelled because he became arrhythmic; we hoped that it could be re-scheduled for the following Friday, when the surgeon was operating again. We had driven for two days to this large, well-regarded hospital, and were hopeful that somehow the surgery could proceed.
Unfortunately, Friday the surgeon's operating schedule was fully booked. That afternoon, I contacted the Urology department and asked that the surgeon or his P.A. renew my husband's Cipro prescription at the hospital pharmacy, in hopes that my husband could be worked in the following week. The secretary told me that she could find no record that he had ever been prescribed Cipro, but that she would pass along the message.
On Saturday morning, I called the hospital pharmacy. They had no knowledge of the renewal, and of course the Urology department was closed.
I then called the hospital's general number, explained the situation, and asked her what I should do. She advised me that if the doctor wasn't available, I should go to the Emergency Room and ask them for the prescription.
I did so. The admitting desk person there told me that the ER had a practice of never giving out such prescriptions.
I went to the Pharmacy. I showed the empty Cipro bottle, and asked if they could call in for a renewal. They said No, that unfortunately they could not do that.
The pharmacist suggested that I use the wall phone landline in the hall and dial O. "You mean just call the Hospital Operator? Like on my cell phone?" I asked. No, he said, that won't work. I should use the phone in the hall.
I did so, pressed O, and explained the situation. She asked, "Is this an emergency?" I said, Well, nobody was bleeding, but that this was important, explained the situation, and asked if she could help. She asked if she could call me back at that number; I said that the phone was labelled "Outgoing Calls Only," so I doubted it, but I would certainly wait right there if she thought she could call me back there. She said No, that I was right; that wouldn't work. So I asked if I could hold while she contacted someone on duty, so that I could speak with them, and she said No. So I asked if she could call the Pharmacy, and she agreed.
I hung up, went back into the Pharmacy, and told them to expect a call. The pharmacist asked, "Did you tell her the Outpatient Pharmacy?" I said No, I just said the pharmacy. "Oh, well," he said, "if it goes there, they'll just transfer it over." I hoped he was right. I sat down and waited.
Presently the phone rang. The pharmacy tech spoke with the caller, whom I later learned was the P.A., and turned to me. "For how many days?" she asked me.
I told her that we didn't yet have a definite time; that I understood that the surgeon was operating the following Thursday, and we hoped the surgery could take place then. She and the caller, the P.A, agreed on 7 days' worth.
She told me it would be about 10 minutes, and it was. I paid her, picked up the pills, and thanked her very gratefully.
Then I went back to the ER desk, and told the person I'd spoken to before what had happened, and how it had worked out. He told me that he really appreciated knowing the details, and said something to the effect that it was good when the system worked.
The surgeon was fully booked for the following Thursday, but generously came in early Friday so that my husband could have his surgery.
And I was relieved that my husband had been able to continue his Cipro for that week.

So it took the lady in Urology, the hospital operator, the ER person, the pharmacist, the operator on the landline, the pharmacy tech, and the P.A. to arrange for the Cipro. Each one heard the full story.
Seven people.
My husband cannot have been the first person in the situation, and surely he is not the last.
Wouldn't it make sense for there to be a policy in such situations? (I assume that I was correct in asking for the renewal, or the P.A. would have refused the request.)
Maybe the policy should be "Here is how to reach the P.A. on a weekend."
Maybe the policy should be, "Here is a renewal prescription. Fill it if you plan to stay around and hope for a re-scheduled surgery."
Maybe the policy should be to tell the patient, "If you have been on Cipro for X days, and you are re-scheduled within Y days, you will not need more Cipro; don't worry."
Maybe the policy should be that the general operator is better informed, so the the ER's time is not wasted.
I don't know what the policy should be, but I am convinced that patients' and patients' family members' anxiety could be reduced with the existence of a policy.
I am convinced that patients and their families shouldn't have to figure out what medicines should or should not be given.
And I am convinced that the absence of such a policy needlessly wastes hospital personnel's time.

Anonymous said...

Dear anon 11:25:
Wow, in my 25 yrs of working in hospitals, how many times have I heard stories like that. Perhaps we should start putting the actual hospital names in our comments to provide incentive for improvement.
In my humble opinion, the responsibility rested with whomever cancelled your surgery to ensure that everything on the "pre-op checklist" was renewed. To the other hospital people, you were someone outside the existing system (e.g. there was no policy for you) and therefore someone to be avoided. Kudos to the hospital operator who didn't blow you off.

Elliott said...

Congratulations to Bill Gillis unreservedly so, but in a "Ceasar's wife" extreme of caution, he might want to consider his sponsor.