I recently spoke with a family member about the hospital care of his wife. He was disgusted with the “quality of care” she received. The bedside table was broken, the pillow was uncomfortable, the nurses did not bring her medicine on time, the sheets were not changed for 2 days, no one helped her to wash her face – the list went on.
In all fairness, I cannot say I was impressed with the place either. I was present as the evening nursing assessment consisted of the nurse introducing herself, explaining the planned activity for the morning (remove catheter and change her surgical dressing), inquiring about pain level, and checking the patient’s IV bag and rate. There was no checking of the IV or surgical site, no listening to her chest or abdomen, no inquiry about intake or output, no advising to turn, cough, and deep breathe, no checks of circulation or movement of lower extremities – in fact there was no hands on touching of the patient at all. Nonetheless, my family member was very impressed with how nice the nurse was.
I found our differences in the concept of quality to be very interesting. He and his wife knew nothing about any checklist used in the operating room or telephone orders read back. They had no concept of the extensive bar coding system and process for medication administration. They were blind to pathways, guidelines, performance measures, and peer review. Their entire perception of quality was only what was in front of them and how it compared to personal and business experience. It was the purest form of customer service – only.
His wife was moved to a rehabilitation facility the next day. My family member raved about the change in environment. Not only is there a garden there, they offered him a sandwich! Despite the fact that his wife arrived on a Sunday, and there is no therapy provided on that day, he could not stop telling everyone about the wonderful care at the rehab facility.
Perhaps there needs to be a better distinction between what healthcare professions call quality versus what patients call quality because, right now we are not talking about the same thing. While I find it unfair that all of healthcare quality can be judged on the comfort level of a pillow or the smile upon the face of a nurse, I also understand that perspective – and I cannot deny its importance.