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"Are patients getting sick or cured in hospitals?''

I am willing to write a magazine article about this topic:
"Are patients getting sick or cured in hospitals?''
This is mostly about the hospital environment where the patient stays for days weeks and even months. Here in my country, patients are left as objects where health professionals visit them for a short period of time, do their job in minutes and then disappear! Patients spend the rest of their time with pain, listening and watching other sufferers , and waiting for death.
They are isolated from the world.
When we visit relative patients in minutes, we feel the bad conditions they live in, talk for minutes and then forget about it. But they, patients, are the ones who have to stay there and try to cope with it.
Obviously, this is not right and must be changed.
Please help me by 'donating' ideas!!
What are the bad things you notice in hospitals?
What are the good things that you notice in hospitals and is done somewhere in the world?
What are the good things that you notice(from your ideas and imagination)?
If we had to make a non-profit organization to deal with this, then what will it have to do?
This is mostly about fixing the hospital's environment and making a better place where patients can enjoy their stay!

social workers, clowns, magicians....anything,, I respect all ideas!


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    Feb 24 2012: Another TED poster once described patients as being 'transients in the system' and that says a great deal. The system is elevated above the patient. The patient will depart, either alive or dead, but the system will remain, and the focus is on operating the system, not the wellbeing of the patient.

    Look at how hospitals are run - bureaucracies with lots of administrators and boxes to tick and technology to look at. Then try and find which individuals have direct personal responsibility for patient wellbeing. You will find that the system is designed to protect the individual from any accountability. That's the fundamental flaw in how healthcare is delivered - health has no priority and it's no-one's job to care.
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      Feb 24 2012: I agree with you Anne- I believe it is the system structure (hospital hierarchy and vertical department silo model) that is one of the core problems. Add to this that the individual physician practice model is just as outdated as the hospital system structure and you end up with what we currently have in health care today. We can design a new system structure for care, but it is not easy because the current large organizations that dominate health care today are benefiting from the status quo.

      We have recently started a new academic medical center in a new system structure for health care (it is a start-up, only five divisions so far). Physicians are part of teams that work with definable groups of patients (and patients and family members are part of the team). With the help of a new professional, the patient care manager, each team evolves care communities that work together to help each other develop caring, loving relationships. It is through these relationships that care can be compassionate as well as high quality and efficient. Although there is an increased cost initially to implement this model, we are seeing that the efficiency and quality that can be gained in care, and the lack of bureaucracy, can potentially lead to a system that is actually much lower cost, while providing better and more compassionate care. In our new model, it's everyone's job on the team to care and there is never a hand-off. We start a new residency training program in July, so soon we will be training physicians in this model.

      As far as the original question, the answer is both- patients get sicker and are cured in hospitals. But, we should and we can do much better. We need to change our thinking (from reductionist to complexity science thinking) and change our models (from hierarchy and vertical silos to small teams and care communities).
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        Feb 25 2012: Bruce
        I am interested in this model. Do you have a reference?
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          Feb 25 2012: We don't have a publication yet, but if you would like to email me (bramshaw98@yahoo.com) I could send you some of our business plan- most recently summarized for a CMS grant application. Thanks for your interest, Bruce
      • Feb 26 2012: Bruce, this sounds great, I am also interested in learning about the model you created!

        It is interesting the many names patient-centered care has- some people call it relationship centered and some patient/family centered (I believe family is implied and does not need to be in the name)

        I think the way I would combine both relationship centered and patient centered programs is to call it a participatory health care program. . . I know it seems silly to care about a name, but with so many names it seems more fragmented, therefore less seen

        What I'm interested in is how you are measuring outcomes . . . I've seen research that looks at objective measures (survival rate 1 year post MI) was higher with a higher patient perception of patient-centered care (participatory care)

        Participatory Care as Starfish Organizations:
        I read a fantastic book by Ori Brafman and Rod A. Beckstrom The Starfish and the Spider, rather than considering what you are doing as bottom up, it sounds more like the starfish metaphor, you can read it here:

        Healthcare is more complex than people realize, and the impact of how we manage health is more preverse, reaching all facets of daily life, even if you are alive and well as an individual- the excessive money the nation needs to spend alone impacts the education our children recieve: http://www.ted.com/talks/lang/en/bill_gates_how_state_budgets_are_breaking_us_schools.html
        • Feb 27 2012: Agree wih the above. Having spent some time in healthcare, I have discussed with hospital boards how hospitals organisation should be switched from speciality-centric to patient centric. Hospitals do recognise the importance of care pathways but performace (especially financial performance) is seldom linked to care pathways. Typically a hospital will measure it's performance al the level of specialty departments and quality performance is either measured at the same level (which is useless) or at the level of care pathways wich is disjointed with financial performance i.e. the patient's results have nothing to do with financial results. In sept 2011 in the harvard business review, you'll find a similar argument made by Robert Kaplan and Michael Porter who then get into a detailed description of how performance could be tracked at a deep level of detail. I am not so convinced in the necessity of deep granularity of data to manage performance but the point about patient centric org of hospitals by care pathways is spot on

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