Healthcare Improvement (let the patients sleep)

Most hospitals could use a good comfortability expert (or if you prefer, a usability expert).


Let's see, it was about 9 o'clock at night when the nurse came into a semi-private hospital room where I was sitting with a patient I knew. The other patient, an elderly woman who was hard of hearing, was woken up so she could sign a consent form that would make it quicker for her doctor to review her records. That, by itself, wasn't much of a problem (although it probably annoyed the woman who was woken up). What was a problem was the fact that the elderly woman had a hearing problem so the conversation went something like this -


"I just need you to sign this form so your doctor can see your records."


"I just need you to sign this form so your doctor can see your records."



You get the picture. Now it just so happens that every patient in this hospital has a portable TV that they can swing around in front of them to watch. A comfortability expert would quickly see the usefulness of this and say hey, stick a keyboard on that thing and type what you want to say to patients who can't hear very good. That way the person in the next bed can get some sleep.


I'm sure there are a lot of other things he or she would recommend too, like providing a comfortable set of headphones to block out all of the rest of the background noise that can keep the patient awake, and an eyemask to block off the lights that keep getting switched on and off as visitors come by to see your roommate.


The profit motive could even work in favor of hospitals hiring someone like this. Take the conversation in my example. It probably took the nurse at least 3 minutes to get the patient to understand what she wanted her to do and then get the form signed. Conveying the same message on a screen could have cut that time in half. Since any task that can be accomplished faster translates into a cost savings (decreased labor expense), it wouldn't take long for a comfortability expert to have a positive impact on a hospital's cash flow. The brighter CFO's in the healthcare field will recognize this.


When I first mentioned this idea someone pointed out that since the elderly are often afflicted with poor sight as well as poor hearing showing them the form on a TV screen might not help. Since they brought it up I'd counter that this gives our comfortability expert another opportunity to improve things and earn their keep. If the patients can't read the screen then they can't really be giving their 'informed consent' when they sign the form we're asking them to read either (insert lawsuit here), still assuming they have a hearing problem too. Our expert would realize that in cases like this the form itself should be shown on the screen, magnified several times, and a flip-down attachment added beneath the TV so they could electronically sign it (the same way we sign for credit card purchases at a lot of stores now).


A couple might help show how this idea could result in a net savings instead of a net loss to the hospital.


At the hospital I was visiting each patient had their own phone, each one with a long line attaching it to the phone jack so it could be used just about anywhere. The defect in this convenience? There was no place to hook the phone

onto the bed. Because of this the patients either laid them on the bed or tried to tie them around the bed rails in an effort to keep them within easy reach, resulting in several collisions between the phones and the floor. Being plastic, the phones are going to break fairly often. Now weigh their replacement cost against the cost of a few pieces of velcro - one on the back of the handset and one on each of the railings. This would keep the phones off of the floor and within reach of whichever side of the bed that the patient felt like putting them on, making the patient more comfortable. The money saved by not having to replace broken phones could be put into the labor pool, increasing the percentage of successful treatments.


Another case in point. The respiratory mechanics of a difficult bowel movement are often overlooked. Ambulatory

patients using oxygen have a choice, disconnect their breathing tube and take their chances in the bathroom, or hang onto the tube (assuming it's long enough) and bring it in with them. I saw examples of both. Those who left the tube on the bed could sue the hospital for not providing them with a longer tube if they lost consciousness during their trip to the bathroom and suffered an injury (resulting in less money available for successful treatments due to court costs), and those who took it with them sometimes dropped it on the bathroom floor requiring a replacement tube to be supplied (again reducing the money available for successful treatments). So what would our comfortability expert suggest? I'm betting he'd say find the patient a convenient way to take the oxygen into the bathroom without risking the loss of the tube. It wouldn't be hard to find such a way either. Most of the time these same patients have to drag an IV stand with them into the bathroom too. The pole on that stand is hollow. Since we know how to make small, hand-sized cylinders that can hold about ten minutes worth of air (which we sell to people who don't want to risk smoke inhalation while trying to escape from a burning building) we could easily convert the hollow pole into a similar oxygen tank with maybe 15-20 minutes worth of air. The stand would have it's own tube too so when the patient wanted to go to the bathroom they'd just take off the air tube they were using on the bed and put on the one that came with their IV stand. Net result - no lawsuits and more comfort for the patient. This would also let patients who are now retricted to their beds due to their need for oxygen get up and walk around a little bit without having to cart around a heavy oxygen tank. (They do make tanks for the beds by the way, they just haven't thought to turn the IV stand poles into smaller versions of those tanks.)


It might be argued that these examples would only result in surplus pennies. With each new solution there would be

more pennies though and pretty soon the cost of our comfortability expert would be far less than the amount money those solutions would be contributing toward better patient care. If nothing else, give it to the nurses. They deserve it.



19 votes
Idea No. 1179