Saturday, June 27, 2009

Empirical evidence: Safety is not a priority at Duke Hospital

The Duke University Hospital website claims to be concerned with patient safety. [See below] And, I am sure that conceptually, the staff and administration would indeed prefer that a patient did not slip on a banana peel in the hallway. But beyond the obvious, I have experienced the pre-hospitalists program model quality of care at DUH and I have experienced the post-hospitalist program model quality of care.

My life was saved at Duke University in 1985. The surgeon was Dr. William Peete. He recognized a condition that other surgeons and physicians throughout North Carolina had missed my entire life and, most dramatically, since a patched emergency surgery in Greensboro in 1982.

Dr. William Peete spent the time with me and my family to explain my condition. I was born in 1962 with entirely too much intestines and none of the intestines were attached to the wall of my abdominal cavity. I had been suffering my entire life with stomach aches and vomiting but my GP in small town Cary dismissed the problem as "nerves."

I almost died in 1982 when I was an undergraduate student at UNC-Greensboro. My abdominal cavity was swollen so badly that I literally could not stand up. I crawled to the UNC-G infirmary. The nurses placed me in a room and told me not to cry because I was bothering other patients. Two days later, a doctor said that I needed to go to the hospital. I was transported via UNC-G van to Moses Cone Hospital in Greensboro, NC. All I was wearing was a long tee shirt and socks.

The surgeons told me that the condition was too serious to wait for my parents to arrive from Cary. I was about 30 minutes away from dying.

I survived the emergency surgery in Greensboro but for the next 3 years I continued to suffer with nausea, vomiting, pain.

It was not until 1985 when my family got a referral to Duke University Medical that my life would be changed and saved. In 1985, Duke was a place of miracles. The surgeons and physicians were all remarkable. Duke did not accept every case. I could only been seen there with a referral.
Link

Now sadly Duke Medical has become as any other medical institute --- a place where patients too often come second to money.


http://www.dukehealth.org/AboutDuke/quality/initiatives/patient_education_and_feedback_initiatives
Patient education and feedback initiatives to improve patient care quality and safety at Duke include:

Heart attack-specific discharge instructions and patient education information are composed of a 30-minute discharge video, a resource guide given to patients to help them manage their care at home, and one-on-one instructions from nurses before patients leave the hospital. The information answers questions heart patients may have regarding medications, risk factors, signs and symptoms of problems, and resources available at Duke.

Heart failure-specific discharge instructions and patient education information are composed of a 30-minute discharge video, a resource guide given to patients to help them manage their care at home, and one-on-one instructions from nurses before patients leave the hospital. The information answers questions heart patients may have regarding medications, risk factors, signs and symptoms of problems, and resources available at Duke.

Innovative motivation tools encourage patients to aid in their own healing process. In one instance, patients are given laminated dogs to walk to the nurses’ station three times a day. While the activity is fun and playful, it encourages post-operative patients to get their blood moving after surgery and thus avoid major complications.

Patient advocacy and support groups encourage patients and families to participate as active members of the health care team. Local patient advocacy groups, such as the Cancer Support Group, provide support to families and patients with specialized needs and concerns. The Duke Patient Advocacy Council is a group of patient volunteers who meet with Duke leadership on a routine basis. The Council’s mission is to provide patient perspectives and voices to Duke Medicine with the goals of enhancing patient-centered care; respecting the needs of the human spirit; and bringing together patients and their caregivers as partners in healing, education, and research.

Patient communication boards in patient rooms tell patients who is assigned to their care on every shift and how to contact their caregivers for assistance. The boards may also show other information related to the patient’s care, such as daily procedures.

Patient education materials consist of pamphlets, videos, and other sources of information that help patients manage their care and live healthier lifestyles.For example, Duke HomeCare and Hospice provides take-home materials that empower families and caregivers when they must administer medications to patients in crisis symptom management situations. This education gives families confidence and helps reduce medical errors caused by anxiety.

Patient rounding calls for a hospital unit or department leader to visit each patient within the first 24 hours of admission or transfer. The visits give patients the opportunity to provide feedback and resolve any problems they may have with their treatment.

Patient satisfaction surveys are given to patients on discharge to help us understand what patients liked and didn’t like about their hospital experience.

Pneumonia-specific discharge instructions and patient education materials have been created by the Duke health care team for patients who are receiving treatment for pneumonia. Health care providers discuss these educational materials with patients and their families during their hospital stay and before they are discharged.

Smoking cessation programs and patient education materials make it easier for patients to quit their tobacco use. They may include resource materials, classes, counseling sessions, and/or nicotine replacement therapy.

Surgery-specific discharge instructions and patient education materials have been created by the Duke health care team for specific types of surgeries. Health care providers discuss these educational materials with patients and families during their hospital course and before they are discharged.

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