Sunday, October 08, 2006

Does anybody actually read this stuff?

We had occasion to have Kiddo in the hospital for a couple of days recently. Nothing really serious, an intestinal bug dehydrated him, scary for us as parents and very frustrating especially as S. and I were recovering from the same bug at exactly the same time that we were taking him in.

After the third visit to emergency and a visit to our own Dr. it became apparent that although everyone was making copious notes, no-one was actually reading the notes made by anyone else. We repeated the same answers to the same questions, apparently asked by rote with no care for previous answers. From a systems point of view this is a disaster - data entered repeatedly by different users in 'free form' entry styles - this is an error waiting to happen.

On top of all of that it became abundantly clear that none of the users actually read the details given by previous personnel, even between shift changes staff would boil Kiddo's condition down to 'intestinal bug' and read just the orders given by medical staff - we would then be asked the same series of questions (again) and we would re-tell the story in brief (again). At one point we actually stopped a procedure begin carried out and questioned the necessity of the procedure (we understood that it had been performed previously) and who issued the order. After the nurse actually went back and did some proper reading it was determined that the procedure had been done and the test results from it had been misfiled. Had we not been on hand and actively advocating for K. it would have been repeated.

Medical treatment in a hospital like this in Canada costs us nothing directly no co-payments no direct premiums nothing (It's paid for from every one's taxes). I'm coming to the conclusion that without a proper profit motive there is little or no incentive for structures like this to be improved. I don't want a direct pay system but if we had a private delivery public funded system of some sort (similar to the Swedish model) at least we would introduce an incentive to remove this kind of inefficiency.

Oh and by the way, everybody is back home and feeling much better!


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