I recently had the misfortune of having to take a family member to an A&E department in a local hospital. What I encountered confirmed all the bad news stories I had heard about the health system and its over crowding. Yes, cut backs have caused many problems in the health system but there are other underlying problems. The lack of customer service skills and proper systems for utilizing services to their best capacity were two of the first problems I recognised.
When we entered A&E we were seen by a Triage nurse within 15 mins, great I thought. She told the patient what was probably wrong and that they would have to see a doctor. She also said they would need a X-ray and various tests. Patient was told to re-join queue in general area.I enquired where we not meant to be queuing for the x-ray and tests that were mentioned. Told, in a very surly and unfriendly manner, no and to go back to queue and wait our turn. Waited for nearly 7 hours, with a person in extreme pain. Made numerous enquiries about how long we would be waiting, only to receive rude, non committal answers practically spat back at me. Finally we were called in by a doctor, who after a 2 minute examination told patient to….yes you guessed it, go queue for a x-ray. Now x-ray only took 20 mins and blood tests another 10mins, then 20 min wait on results for doctor to check. Why, oh why couldn’t we have had all these tests, x-rays etc done during our 7 hour wait. All patients could then present themselves to doctor with all the necessary info. This would create a steady flow and use the expensive doctors time more efficiently. I estimate over 30 mins of the doctors contact time with us was spent waiting on info, results etc. A fully collapsed lung was diagnosed as the problem and the first procedure needed was the inserting of a chest drain tube, again delays while waiting on equipment and qualified assistance to be found. A nurse who had just gone on their break had to be called back to assist as there were not enough on duty to assist each doctor. Then we had a 12 hour wait on a bed, well thats due to cut backs and ward closures I thought. Well when we finally got a bed on a ward I observed one bed empty for 16 hours due to a lack of communication between ward & A&E.
My relation was visited by numerous doctors, specialists and a professor, who all spent about 10-15 mins with them. ALL wasted the first 5 mins asking the exact same questions as the previous doctor but where each set of notes with answers went I don’t know. Another waste of expensive time due to simple lack of communication and record sharing.
Next the actual quality of the staff and the level of their competence to operate in an efficient manner. I wouldn’t normally consider myself knowledgeable enough to rate medical professionals but when you see patients wrongly connected to vital machines for 4-5 days and no-one noticing, despite filling out check lists for machine function 3 times a day, you have to wonder. Time after time hours were wasted waiting on reports, information and for staff to find even basic supplies like a suture set. Once a doctor waited so long for a nurse to return with second suture set (he had made a mess stitching patient with first) that he asked me to go and find her. By the time she returned local anaesthetic had worn off (doctor tried to stitch wound anyway until I physically stopped him) and a second dose had to be administered. Another waste of time, materials etc and extra suffering for patient.
These are just a few examples of bad management I encountered, be it operation, supply or staff management. My relation is still in hospital but in a private area of a different hospital. Guess what? Good management at all levels, and it works!
726courtown 