No room at the Inn

With patient volumes ever on the rise, hospitals in the downtown core are continually faced with the problem of bed space. We often have more patients, than we have beds. This leads to a number of issues; having to re-direct ambulances, having to temporarily place patients in hallways, Emergency departments overflowing with patients waiting for in-patient beds, and having to cancel surgeries. This is a well-known issue for the province of Ontario and its aging population.

As a result, we often hear from patients and families members who are understandably frustrated about the lack of hospital beds and the lack of private or semi-private accommodations.
Here are some helpful things to know:

  • If a patient comes to the Emergency department (ED) and is admitted to hospital, but there is no available bed on the unit to which the patient is assigned, then the patient will either 1) wait in an available bed in the ED, 2) be temporarily placed on another inpatient unit, or 3) be temporarily placed in the hallway on their assigned unit.  Though not ideal, each of these options are a temporary solution until an appropriate bed becomes available.
  • If a patient has requested private or semi-private accommodation, this is provided based on availability.  Patients requiring private rooms for clinical reasons (i.e. infection/isolation, imminent death, clinical equipment) take precedence over patients requesting private accommodation as their preference.  **It is important to note, that if a patient has been placed in a private room in accordance with their preference, they will be moved to another room if a patient later arrives to the unit who requires private accommodation for clinical reasons.

Without the ability to predict how many patients the hospital will receive, and without the ability to predict if/when inpatients will be medically safe for discharge, the issue of bed-space continues to require our attention and problem solving.  We will continue to work collaboratively with our patients and families to provide care to all who come through our doors.

Mixed Gender Hospital Rooms

The subject of mixed gender patient rooms is a hot topic for hospitals right now, especially given the ever increasing patient volumes in Ontario and the limited number of hospital beds available in acute care facilities.

This recent article out of the Sunnybrook hospital addresses the debate:

http://healthydebate.ca/2013/10/personal-health-navigator/would-you-share-a-hospital-room-with-opposite-sex

 

Please leave your valuables at home

This is just a reminder for our patients that when coming to the hospital, please do not bring the following items:

□ Valuables, such as watches or jewelry

□ Pieces of identification or credit cards

□ Large amounts of cash

If you brought any of these items with you when you arrive, ask a family member or friend to take them home.

Your money and valuables

The hospital does not assume responsibility for your money or valuables.

If you choose to bring money and valuables into the hospital, you do so at your own risk. If possible, please send all valuables home with a family member, friend or your substitute decision maker (SDM).

UHN will only assume responsibility for your valuables if:

1) You choose to have your small personal items locked in the hospital safe (such as your wallet, cash, credit cards or jewelry). These items will be collected for you in a valuables envelope. All the contents of the envelope will be written on the front and a claim check will be attached to your hospital chart. Security will lock these items in the hospital safe temporarily until you are ready to retrieve them.

2) You cannot take responsibility for your own valuables while in hospital. In this case, your healthcare team will be allowed to collect your valuables in the envelope, write down all items that went into the envelope and give it to Security for safekeeping on your behalf.

We know that you will have personal items such as clothing, medications, and personal support aids with you (for example, eyeglasses, contact lenses, dentures, hearing aids, mobility aids such as a cane, walker, prostheses or wheelchair, etc.). Please note the hospital will not assume responsibility for these items if they are damaged or go missing.

Thank you for your cooperation.

The Racist Patient

A recent feature broadcast on Brian Goldman’s CBC radio show ‘White Coat, Black Art’, tackled the controversial subject of racism from patients:

http://www.cbc.ca/whitecoat/blog/2013/09/16/racist-patients-an-enabling-medical-culture/

Unfortunately, this is not uncommon and we at Patient Relations get many patients/ family members expressing racist comments about all occupational groups when sharing their complaints. We also get requests from patients for healthcare providers of a specific culture, race or religion. 

The approach we take is that all of our personnel are fully qualified for their roles and we do not allow patients to choose their healthcare providers based on race or cultural backgrounds.  We encourage patients and providers to openly discuss issues/ concerns together and then make a joint decision as to whether each can continue the therapeutic relationship in a positive way.  If this is not possible, then perhaps another person can take over, if resources allow. The patient then has the opportunity to decide whether they wish to stay here or go elsewhere, where they might receive a healthcare provider of which they approve. 

When we are personally attacked without reason, the natural human response is defence or retaliation. As healthcare professionals, we cannot react this way, however we should certainly call the patient out on such behaviours and end the therapeutic relationship. This takes self-control and restraint.  Healthcare providers should feel empowered to draw the line with patients/ family members who behave inappropriately, however this needs to be done in a professional and respectful way, regardless of the behaviours with which we are faced.

What is Patient Engagement?

About five times a week I am asked what I think about the notion of patient engagement.

The answer is never easy since I think that people bandy around the term and it doesn’t mean the same thing to different people.

For example, at the clinical level of discussion between the patient and the healthcare provider, patient engagement to me means that ‘the healthcare provider is going to engage the patient in a discussion about the assessments required, the diagnosis, the treatments, the medications to be prescribed, the expected outcome of those treatments or medication, etc’ . Then there will be a discussion between the healthcare provider and the patient to ensure that the patient understands what is happening and so that the patient can make an informed decision about what is being proposed. This also means that the patient is encouraged to ask questions along the way to ensure understanding and that the healthcare provider will be willing to engage in giving responses.

On another level – perhaps at the provision of services - my response would be ‘of course patients need to be engaged in the dialogue’. An example might help here. Let us say we are designing a change to a particular treatment program. The patients are the ones using these services and to me, it Is necessary to find out from the patients what works and what doesn’t work and to try to develop the program in such a way so that it satisfies as many patients as possible. Of cours,e there will be some who will not be happy, but let us at least try to engage the patients (the user of the service)  in the discussion.

Sometimes people want to know whether patients should be engaged in program development. To me, this means that there is a decision to be made by a hospital as to which service will be offered and which service will not be offered. This is generally a management decision or a board governance decision, but engaging patients in this discussion might be helpful to increase understanding.

Sharon Rogers, Hospital Ombudsman

My First Appointment

At the Patient Relations office, we find that a large number of patient complaints are closely linked to a lack of information, or a lack of understanding as to how the hospital works.  Providing information to patients ahead of time can help to make their hospital visit run more smoothly.

Below are some helpful tips for preparing to come to the hospital:

My First Appointment:

Make a list of your medications.  Include prescription drugs, over the counter drugs, vitamins and herbal products.

Gather your medical information from your referring doctor, including medical history and any recent imaging.

Review directions to the hospital, and to the specific clinic you’ll be visiting, so that you feel confident about your trip before you leave for your appointment.

Think about what questions to ask and write them down.

Arrive early for your appointment, so you have time to visit registration and get your blue UHN card

What to Expect:

Your first visit to the hospital will be a consultation and could last several hours.  It is unusual to receive treatment during your first visit, but it sometimes happens.  Because UHN is a teaching hospital, you will be cared for by a team of health professionals, not just one doctor.

Each clinic at UHN is different, and may have its own specific instructions for your visit. Find your clinic here to learn more about what you can expect.

Helpful Tips:

Communicate. Tell your health care team about any concerns you have and ask questions if you want to know more.

Bring support. A friend or family member can give you emotional support and can help you make good choices. They can also help you gather information, take notes and ask questions.

Listen. You will hear lots of new information. Taking notes can help you absorb and understand what you hear.

Take names. Writing down the names of the members of your health care team can help you get to know and recognize the people you will be working with.

Try to be on time. Running late can be stressful, so make sure you leave yourself lots of time to get to your appointment.

For more details on your first appointment, visit:  My First Appointment