Following is the text of a letter dated today and addressed to the CEO/President of the local health system constituted by three major hospitals and many other medical facilities. Certain information has been obscured for legal and privacy reasons. The letter is entered into ElderBlog because its content is part of the blog narrative.
I am writing as the primary caregiver for my elderly parents, 40-year residents of (this city) and often-enough patients at (your largest) hospitals. My specific intent is to make you aware of my last two experiences at (one of them) and, in-so-doing, illuminate a problem I believe exists there.
Last November 18th, I brought my father from his Assisted Living residence at (Piedmont Place) to Triage at (this hospital). His urologist ordered this, and cleared the path to entrance into the hospital. Triage/ER was full of H1N1 and other prospective patients at the time, and we wound up in the waiting room for almost eight hours before getting a room upstairs; far too long for a vulnerable adult, and for someone whose immune system is already compromised.
Last Friday, (Piedmont Place’s) medical staff found another in a series of high calcium readings in my father, and ordered him to (the same hospital) for further testing. We were specifically instructed to enter the hospital through Triage/ER. We arrived at 5pm. It was well over an hour before we were received inside the waiting room wall, and that’s where the problems began. I am not unaware of the challenges facing your ER staffs having spent my fair share of time in them with both my immediate family and with my parents. But what I’ve experienced at (this hospital’s) Triage/ER goes beyond the pale. Here’s what happened:
After initial entry testing, we waited for hours. We were then relocated to the hallway where the Red- and Blue-team desks are located. There we waited for hours. A decision was made to not perform an ultra sound but rather a CT scan. So my father was wheeled away for that, and returned to the hallway where we waited again for hours.
The triage doctor, who seemed woefully overworked, finally visited us and performed an examination right there in the hallway (no other room was available). He was baffled as to why my father had been brought here, and I found myself giving him medical instruction. All of this information, I said, was included in the orders I had brought from (Piedmont Place). Why wasn’t this considered by the doctor before the examination? Because he had never received the paperwork. It was all still in the preliminary ER exam room. It took someone forty-five minutes to find it.
This being a Friday night, you likely know the type and volume of cases needing to be processed. My father laid on a gurney, was covered with three blankets, provided a pillow, and made to wait in the chilly hallway as handcuffed gang suspects whizzed past with their police escorts, and others with all manner of illness and injury were processed.
Our ER doctor seemed hard-pressed to develop a course of care for my father, but ultimately did. And then we waited for yet more hours while the administrative aspects of admission were accomplished.
To recap: we arrived Friday at 5pm, and were admitted to (the hospital room) at 5am Saturday. Twelve hours. I don’t know how you keep score, but by any measurement I can conceive, this is well beyond reason. It also begs the question: Would my father have fared even worse had I not been there to advocate for him? Is this the way we should expect to be treated by your hospitals?
Let me say quite clearly that my unhappiness is entirely with your Triage/ER process; not necessarily with its hard-working operators (I watched them), and absolutely not with your staff on the hospital floors. These people are the best at what they do, and almost make it a pleasure to be admitted there.
But I think I’ve got a valid complaint here. How can I look forward to a hospital stay with your great medical staffs if I know I’ve got to first suffer the obstacle course that is your Triage/ER?
Update – 052510 — The hospital system CEO/President called me today, one business day after receiving my letter. He expressed his concern with our ordeal, apologized, and told me that his system has an application into the state to get permission for certain changes to the Triage/ER of the hospital. I was assured that my letter would trigger an investigation to discover specific causes, and that I would be apprised of any findings.
This, my friends, is how you run a business.
Update — from the June 4, 2010 issue of the Business Journal of the Greater Triad Area:
(The local hospital system) is adding another major construction project to its growing list of activity.
The Greensboro health system plans to build a new $20 million emergency department at (one of its largest hospitals).
(The hospital system) has filed a Certificate of Need — required by the state for most large-scale health care construction projects — seeking to move the (subject hospital’s) emergency department to the opposite side of its campus.
(The hospital president) said it will more than double the department’s size from 12,000 square feet to more than 25,000 square feet.