Wednesday, October 7, 2015

Do We Get Better Health Care? ...Yes we do.

This has been another fun filled week of working the health care system.  To explain all of the events that have happened in the last couple of days I have to back up a few months.

On May 20th we had a scheduled visit to the Emergency Room at Children's Hospital in Winnipeg.  To make a long story short we ended up waiting 5 hours for what ended up being a simple injection.  To say we were ticked off is an understatement.  The lack of communication and pure incompetence of a broken health care system was on full display.  It was a case study in silo mentality where various players in the system failed to coordinate a fairly simple task.  As a project manager this drove me nuts.

As I tweeted some of the events of that morning, the Health Critic for the Progressive Conservative Party, Myrna Driedger, picked up on some of my tweets.  She discussed a few details of our experience; as scheduled appointments to Manitoba's ERs have been a long standing issue as these numbers have increased despite numerous promises from our provincial NDP government to curtail the practice.  She invited me to come to question period where she brought the issue of scheduled visits to our health minister Sharon Blady.

As I was referred to (by name) in question period I drew immediate attention from the Health Minister's staff.  I was immediately contacted.  I had a very pleasant conversation with one of the Minister's assistants.  They asked if they could investigate the issue on our behalf.  I agreed, but later had second thoughts.  I contacted the Minister's office later that week and decided this was something I wanted to tackle on my own.  I know many people at Children's Hospital and I am a parent rep on the Child Health Quality Committee (CHQC).  With Russell's Doctors I had at my disposal all of the people I needed to investigate this issue on my own.  This was going to be fun!

Russell's Cardiologist is great and she did a ton of work on my behalf.  We were able to identify several problems, that we encountered that morning, and we rectified them.  I think there were several people who learned something as a result.  I prepared a brief report for the CHQC and got some mixed responses but overall it was a good discussion.  As promised, I sent a copy of my report and a history of our experiences in health care to the Minister of Health.   I received an response from the Minister last week.  I would comment on the content of the letter from the Minister but I am not accustomed to providing gratuitous profane outbursts.

This brings me to the events of this week.  Early Tuesday morning Russell woke us up and was obviously in some significant discomfort.  He was reaching for his belly and was writhing on the floor.  There wasn't any discussion, we were off for another adventure in the Children's Emergency Room.

Russell examining Jake the Giraffe:
Waiting for an ER Doc to yell at me for letting
my son play with expensive hospital equipment
Unlike our visit in May, we waited for absolutely nothing.  We arrived at about 5 am.   We were taken into treatment room almost immediately.  We saw a Doctor with about 15 minutes.  This was awesome.  Seeing how much discomfort Russell was in, they got an IV in him very quickly.  They were able to take blood and gave him some much needed morphine.  That settled the boy done very nicely.  After a few more questions and discussion we were off to get chest x rays and an abdominal x ray.  This visit was totally unlike our experience in May.  The situation we consistently run into when we talk to the staff is the fact Russell has a heart transplant and he gets special attention.  He is complex and everyone starts to pay attention when he rolls into any clinic or ER.  This was certainly the case on this trip.  Our initial ER Doctor has seen us before.  He remembered us.  After shift change we met our new Doctor.  She happened to be the Doctor who was on service when Russell crashed in Emerg 7 years ago.  A point I reminded her about.  Our new nurse also popped in to do vitals and check in with us.  She also spent a shift with us on one of our previous visits to the Emerg.  At about this time the unit manager showed up.  I know her from our CHQC.  Do you see a pattern?  What is the old American Express commercial tagline "Membership Has Its Privileges."

Our entire experience on Tuesday was positive.  Good communication.  We knew what was going on and what the game plan was.  When we waited we knew why we were waiting and what we were waiting for.  When the Drs were guessing; they admitted it and explained why.  Textbook care.  The interesting part came when we were planning on leaving the ER.  The Doctors arranged for Russell to keep his IV in place and we planned to do an IV dose of antibiotic the next day.  We were planning for a scheduled visit to the Emergency Room for the next day.  I couldn't help but laugh.  This was exactly the issue that brought me to the Manitoba Legislature and received media attention in May.  I was committing an unpardonable sin in the ER.  A scheduled visit.

My fear on coming back to Emerg this morning was that instruction were not passed on to the staff who were on service when we came in.  If we got triaged that would be a disaster.  By policy we should go through the triage process.  We were circumventing the rules.  When we arrived this morning i got a little bit of resistance until one of our nurses recognized us and brought us right into a treatment room.  We talked to the Dr on service, got the IV treatment, and left the hospital in less than 90 minutes.  We were likely in and out before many patients would have been seen by a Doctor.  We are going back tomorrow morning for another IV dose.

So why did this trip work out so much better than our trip in May.  Very simple.  It wasn't busy.  5:00 AM is a great time to go to an ER.  Also. from beginning to end the ER was in charge of this trip.  There was very limited interaction with other specialties.  When any hospital department has control over resources to get a job done they will do fine.  It is when you get numerous specialties and departments involved it all breaks down.  This is certainly the case when we deal with Cardiology.  Our appointments their go so smoothly because they control the whole process internally.  Hospital organizations do not play well with each other. The other major component to a successful trip was us.  At a basic level we know how the hospital works.  We know where to find things.  We know some of the terminology.  We also know that we can't leave things to chance.  We ask questions.  Add all of these factors together and you get a very efficient trip to the ER.  It doesn't happen often so we are enjoying the moment.  It is experiences like that convinces me that we can do so much better and do it more consistently.

So, my questions is; Do we get preferential treatment in the hospital?  Yes and No.  There are things we don't have control over and hospitals are huge.  We don't have connections everywhere.  Where we have a huge advantage is that we are able to converse and communicate very differently with staff who know us because we have credibility with them.  Relationships that we have taken great care to cultivate.  Even when we had our messy trip to Emergency in May our experience was made a lot less horrific because we had people we could phone (and complain to).  I'm able to text our cardiologist and get answers to question in mere minutes.  Not many people have our level of access.  In that sense we have a huge advantage.  It is that level of access that probably saved Russell's life 7 years ago.

That is what frightens me.  Not everyone can advocate for themselves.  If you haven't been in a hospital in 30 years it is like being in a foreign country where you don't speak the language.  In addition,  we have trusted care providers who actively advocate on our behalf.  We are very fortunate and...yes...probably a little spoiled.  I don't know where we would be without the resources we have.  Does everyone have access to these resources.  Definitely Not.


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