Blog #4: Wild Card -Clinic to Hospital Affiliation

Many patients build trust with their provider. My organization (Cancer Institute of Florida) is affiliated with Florida Hospital. Our providers make hospital rounds at three of the Florida Hospital locations; South, East Orlando and Altamonte. Many of our patients were admitted to the hospital and our physicians saw them in the hospital and will continue with their follow up visits at the clinic. If during the office visit, they need to be admitted, we send them to Florida Hospital and if for any reason, such as insurance purposes, they are scheduled for radiology, outpatient chemotherapy or blood testing with Florida Hospital. We carry a close connection with Florida Hospital.

If a patient is sent out for testing, the clinic is able to pull the results from the internal software shared with the hospital. Sometimes records are not faxed over right away and can cause a delay, creating anxiety for the patient. Cancer patients tend to lose their memory due to the chemotherapy, some call it “chemo brain”. Many times patients will forget where their scheduled appointment is and will rely on the staff to find out for them. The interoffice software is also able to pull up other physician’s schedule who is affiliated with Florida Hospital. When a patient is scheduled within Florida Hospital and their name is input into the software, it pulls up the date, time, location and what doctor. A print can also be given to the patient in a list form; this reduces the many appointment cards they receive.

From my perspective, this is a transition toward electronic medical records and works efficiently and effectively. In addition, it is less time consuming when it comes to preparing patients charts for their visits and retrieving their results when ask upon.

Blog 3: Patient Perspective;Adverse event

When an adverse event occurs, the patient’s perspective is the not most important determinant. In most situations, when an adverse event occurs, the patient is at harm. As a manager, the first thing I would want to do is consult with the patient to make sure they are okay and listen to what they have to say. When a patient has been harmed, usually they look for someone to blame which is the staff. Emotions not only from the patient but family members tend to influence the negatively attitude towards the organization. The staff, managers and providers are then put under pressure because they do not want to face malpractice or a lawsuit. However, when a patient becomes harmed, it does not necessarily mean the providers and staff are at fault. In health care, there will always be a chance of complications and allergic reactions because every individual is made differently and not certain as to how the body will react to the medical attention received.

From my personal experience working in the oncology department where we perform chemotherapy, the risks are always presented to our patients before they begin the treatment. There are numerous encounters I have had with patients when they have had a reaction to infusion/treatment and have to be sent to ER. Even if the protocols and procedures are followed accordingly, there is always a chance an adverse event will occur and does not always mean it is the fault of practice. At the time of the adverse event, the patient and family members are most likely going to point fingers at the practice.

            The patient’s perspective should not be overlooked against other determinants but taken into consideration. If the patient’s perspective was to be the most important determinant whether an adverse event occurs, there would more cases of malpractice and law suit. When an adverse event occurs, it is important to evaluate all the factors at that given time. In all actuality, everyone's perspective should be taken into consideration.

Blog 2: Wild Card

I read this article about health care quality and how to know it when you see it. It provides as a guideline for patients to get the quality they deserve. It reminds me of our first blog where we had to write about what quality means to us. As we all know it varies from person to person.  The article makes a statement where many people would think the quality of care lays with how fast they get in to see the doctor or amount of time spent at their visit. Ideally, everyone would want to get their appointment time when it is convenient to them and be seen at that specific time as well as sufficient amount of time spend with the doctor.  The author makes a comparison of health care and a mechanic shop. “The people in the shop can be friendly and listen to your complaints, but the most important thing is whether they fix the problem with your car”. It gets the reader thinking and for myself, I realized that was true. There are times where I have gotten poor service by the staff members but got what I needed and was satisfied. At the time of poor service by the staff, I thought to myself I would never come back. Same goes for having a welcoming visit but issue was not corrected nor did I get the answer.

The author makes recommendations in taking an active role and being in charge of your health care. During doctor visits, the patient should ask as many questions, research symptoms and diagnoses. Being informed about labs, test and procedures is essential to one’s health and the healthcare system. Find out what needs to be done and exactly why. Many physicians order unnecessary tests which put the patients through hassle and in essence hurt our health care system. If a test is going to be done, inquire about when to expect the results. Many organizations allow patients to fall through the cracks resulting patients to go into anxiety mode because they are anxiously waiting to find out their results. Other questions needed to be ask pertaining to prescriptions and surgery.

Overall, it is important to learn about health care to receive quality healthcare. Without understanding, insurance companies and organizations will take advantage and give you the run around while they are benefiting from your health issues.  With the various health care plans, it is essential to choose a plan that fits the coverage, benefits, providers and services suitable for you. Research possible doctors you find interested and get their ratings and if possible hear different reviews from previous/current patients. I always do my research and read reviews even though it’s an individual’s personal experience; I do this for products, facilities and organizations. Sometimes it is best to do your own investigation to chose a physician, hospital, clinic, health plan and understand your diagnosis along with procedures, test and medications that comes along with it. 

Reference:

Agency for Health Care Research & Quality. (2005, September). Guide to health care quality. Retrieved from http://www.ahrq.gov/consumer/guidetoq/guidetoq.pdf

Blog 1: What quality means to me

Quality is something that is not measurable and is perceptual. It varies from person to person due to their own preference. Everyone wants to receive good quality whether it is in a service, product or even an individual’s personality.

What I would define as good quality would be beneficial to myself and gets the job done. If I have to put out I must say in the long run it was worth it. For example, with clothing, I would say good quality clothing would be one I can wash and dry more than three times and the color does not fade or become dingy and so I got my money worth.

Quality is valuable, effective, durability and gives me assurance to be worth giving up something, therefore I am pleased with the outcome I am seeking.

In the health care aspect, quality is judged from the patients based off of their experience from the moment they step foot within a facility. For many people, we have all visited a doctor’s office at least once in our lifetime. Everything counts and depending on the severity and importance there are some things I would chose over quality. When it is pertaining to my health, I would go to a physician’s office where I would wait in the waiting room for a long period of time. In the end, I would wait “x” amount of time because I know the physician will give me the best quality of care. However, when it comes to clothing, if the line to checkout is over 20 minutes I would rather put the clothes back no matter how good the quality is and come back another time because it is not worth the wait.

I have been going to a specialist for about two years and this particular physician tends to come in late because of rounds at the hospitals. On top of coming in late, he is usually double booked on majority of the visits I have been to. He tries to see as much patients as he can. Even though he is pressed on time, during my appointment time, that is my appointment time and takes the time to go over every question thoroughly and clarifies anything I need.  I have spent up to two hours waiting to be seen but I would not give him up for anything. When I schedule his appointment I know to expect a wait time so I try my best to clear my day just to see him because he is just that good and gives me the quality I need. The same does not go for his staff but nurturing my issues and concerns with him serves more importance.

Overall, quality to me depends on the importance and worth what I am giving up. Finding value and trust is essential when turning to quality. In healthcare, I think that is why many practices strive to give good quality and serves as a competition in the market field.