Thursday, February 12, 2015

Hospitals make you better - don't they?

"Pyotr Petrovich admitted that he'd been a fool--but only to himself, of course.” 
― Fyodor DostoyevskyCrime and Punishment

There’s a good chance that you went to primary school with someone who ended up at Med School and is now a Specialist at something-or-other. You probably played together, got into trouble together or maybe you did/didn’t like him/her for any number of reasons. Then High School came along with different sports, activities, first dates, broken romances all the things that go with that decade of confusion.

The reason that I mention all this is because Docs are just like you and me - they’re human. At least I hope most of us still are! And being human we’re subject to good days and bad days, being brilliant one day and making mistakes the next. The only trouble is that when Doc’s make mistakes, it’s the rest of us who can end up in trouble!

In a  Swedish study from 2007, 12.3% of the studied population suffered an “Adverse Event” whilst staying in Hospital.  “Fifty-five percent of the preventable events led to impairment or disability, which was resolved during the admission or within 1 month from discharge, another 33% were resolved within 1 year, 9% of the preventable events led to permanent disability and 3% of the adverse events contributed to patient death. Preventable adverse events led to a mean increased length of stay of 6 days…. When extrapolated to the 1.2 million annual admissions, the results correspond to 105 000 preventable adverse events and 630 000 days of hospitalization".

Their conclusion: “This study confirms that preventable adverse events were common, and that they caused extensive human suffering and consumed a significant amount of the available hospital resources.

Another study in Italy reviewed the case notes of 1501 patients who had been discharged from hospital. A part of their discharge summary recorded Adverse Events in 3.3% of those cases. Significantly less than the Swedish study, but still a huge number when extrapolated to the entire population of hospital patients over one year.

In Australia, the Australian Institute of Health and Welfare defines Adverse Events as “ Incidents in which harm resulted to a person receiving health care. They include infections, falls resulting in injuries, and problems with medication and medical devices. Some of these adverse events may be preventable”.

In 2011–12, 5.3% of separations (Discharge from Hospital) reported an ICD-10-AM code indicating an adverse event.

These figures are from our Health Care and Hospital systems where “Best Practice” is constantly being reviewed and updated, and where there are procedures for every conceivable situation. 

 Far from scaring people off from going into Hospitals, the message I am promoting today is:

 Never be afraid to ask questions of your Doctor or treating Medical team.

If you’re a bit overwhelmed by visiting your Doc or by being a patient in a hospital, then get someone to act as an advocate for you.

One final comment about my medical colleagues. We’ve all met those people who are arrogant and think they know everything. Or perhaps those who treat their fellow citizens with arrogant disdain. Well the bad news is that some of those went on to become Docs too! Thankfully, I’ve only met a few over my long career, but believe me, they are still out there. If you believe that your Doc has treated you badly, ignored your questions, not informed you of your treatment options or has just been plain rude - you are not powerless. Write a letter to the relevant Medical Board who are there to protect your interests. They are on your side and will not ignore your complaint.

The Caring Profession should be just that - The Caring Profession. Sometimes it doesn’t work to our advantage through no ones fault, but sometimes the Medical team can “drop the ball”. We are all part of the solution: we all need to make sure that we are responsible for our own health and that means daring to seek out information that will be beneficial to our long term health.

There should be no one on this planet more vigilant about your good health than YOU. In the case of those who need an Advocate, then take that responsibility seriously. Believe me, when Docs are patients, they are never afraid to ask questions of their treating team - because they know that things don’t always run as smoothly as the Hollywood image of Hospitals would have us believe.

95% of Medical stories have positive outcomes. But that’s not good enough. We are all a part of the solution.
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