Patients want the truth about tough choices
A study by Press, Ganey Associates of South Bend, IN, shows that people appreciate candor from their providers about life support options and organ donation decisions. "By bringing patients into the reality of health care, we’re serving and satisfying them — not intimidating them," states Irwin Press, PhD, president of Press, Ganey Associates.
The findings come from data compiled from 250,000 patient surveys in 476 hospitals. Ques-tionnaires asked patients if the facility provided information on organ donation and options and choices for continuing life.
The good news, according to Press, is that discussing life and death issues does not add negative stress to a patient’s life. On the contrary, he says, "it creates an environment that contributes to patient satisfaction." Such findings should reassure health care providers who hesitate to discuss bad outcomes, for fear of dashing patients’ hope of leaving the hospital cured.
Such communication can get everyone on the same page about care goals. It also can strengthen trust and confidence between the patient and his or her caregivers. Press notes, "Why should we be surprised that people respond positively to being empowered?
"These results should further remind us that the care of patients involves not only dealing with their illness and their condition, but also embracing them as a person and recognizing their authority. Patients can handle the truth."
To learn more, contact Press, Ganey Inc., specialists in health care satisfaction measurement, 404 Columbia Place, South Bend, IN 46601. Telephone: (800) 232-8032 or (219) 232-3387. Web site: www. pressganey.com.
Glove offers safety in surgical procedures
Over the past decade, 60,000 nurses and physicians have contracted HIV or hepatitis from needlesticks, reports Craig Maron, president of Gimbel Glove, based in Phoenix.
To protect health care workers from this job hazard, the company recently introduced a puncture-resistant glove. Invented by Neal Gimbel, MD, a Phoenix-based orthopedic surgeon, the glove retains most of the flexibility and sensitivity required for delicate surgery. The latex gloves have special pads built into the fingers and thumb. "For years doctors have been doubling up their regular gloves or wearing cut-resistant liners to help prevent punctures," he says.
"This not only reduces sensitivity, but does little to prevent needlesticks," Maron says. The patented Gimbel Glove was FDA-authorized in 1994 for marketing as "puncture-resistant." It also complies with the Occupational Safety and Health Administration’s bloodborne pathogen regulations. While the cost exceeds that of standard nonprotective latex gloves, the company says it is lower than the commonly used multiuse glove liners used by many clinicians.
For information about price and product availability, contact Gimbel Glove Company, 10640 N. 28th Drive, A-200, Phoenix, AZ 85029. Telephone: (888) 667-8425. Web site: www.gimbelglove.com.
AHA to address interest in alternative medicine
The Chicago-based American Hospital Association (AHA) will address the growing consumer and practitioner interest in complementary or alternative therapies. Therapies including acupuncture and herbal medicine are gaining credibility, particularly among consumers.
The AHA (www.aha.org) has signed a memorandum of understanding with the University Hospital and Medical Center at Stony Brook/ State University of New York to help hospitals and health care institutions learn about and develop programs to meet the interest.
An AHA survey from 1998 reports that roughly 9% of the nation’s hospitals offered complementary medicine. Larger institutions are more likely to offer the option than smaller ones. "I believe as we enter the new millennium, we will see a dramatic move toward complementary medicine because patients are asking for it," notes Jonathan T. Lord, MD, AHA’s chief operating officer and quality expert.
Stony Brook is the home of the University Center for Complementary and Alternative Medicine. The goal of the joint venture is to develop services to enable hospitals to engage in responsible complementary or alternative medical services. That includes methods of quality assurance and record keeping, reimbursement issues, and professional education offerings.
Grass Roots QI
When a ward coordinator in the child and adolescent psychiatric division of St. Francis Hospital computerized a paper patient census sheet, she saved resources and scored big points with internal customers. Julia Downey, CQI team coordinator for the 292-bed facility in Columbus, GA, reports a time savings of 45 minutes a day.
- IMPROVEMENT OPPORTUNITY
Daily census sheets document statistics — numbers of admissions/discharges, patients’ names, admitting physicians, and attendance at therapeutic activities. Some data affect charges and billing, for example, whether the admission is for a half day, a full day, or longer. In the old system, the ward coordinator provided handwritten data from staff files and made copies for the intake, utilization review, pharmacy, and dietary departments. "Often the forms were delayed in the interoffice mail system or stayed in mail boxes, delaying the timely receipt of vital information," she says.
The ward coordinator designed an electronic census sheet, or "e-sheet," for e-mail distribution and other efficiencies. A one-week pilot involved:
1. dissemination of the proposed e-sheet to the regular recipients;
2. request for suggested improvements on the form and dissemination procedure.
• Time savings — more than 34 staff days per year. "This gave the ward coordinator time for other duties such as devising an electronic census sheet for the adult program," says Downey.
• Internal customer satisfaction — high.
• Resource savings — elimination of hard copy filing supplies and space because e-sheets are processed and saved on disks.
• Spinoffs — adoption of the process and design of e-sheets by other units in St. Francis’ psychiatric division.
- Keys to success
"By empowering employees to make individual improvements, they feel a sense of ownership in what they do. Employees at St. Francis feel encouraged to make changes using the CQI principles," Downey says.
Julia Downey, CQI Team Coordinator, St. Francis Hospital, P.O. Box 7000, Columbus, GA 31908-7000. Telephone: (706) 660-6020. E-mail: downeyj @sfhga.com.