In March of this year, Dr. Harlan Krumholz, a cardiologist at Yale School of Medicine, asked this question on Twitter.
I am curious to know from patients…esp those recently in the hospital…what do you wish we did better? What were the most obvious ways that quality could be improved. Throughout hospitalization & in the transition home. We should all really want to know. What should we improve?
— Harlan Krumholz (@hmkyale) March 7, 2019
Forty-four tweets later, people had posted a number of great suggestions. For example,
Be respectful of nighttime hours even though you have to be awake. Loud chat about your weekend or personal lives in/right outside patient rooms while patient is going through what are rough times for us is extremely rude and frustrating.
— Bray Patrick-Lake (@BrayPatrickLake) March 8, 2019
Anyone who has been in the hospital has experienced loud discussions between staff that interrupt sleep. One patient tweeted that she wanted patients to be provided with earplugs and sleep masks and asked for doors to be closed.
Here are a few more insights from patients who have been hospitalized.
Unsanitary Conditions
Patients worried about the lack of cleanliness of hospitals. Staff including physicians are not washing their hands.
You would be shocked at the number of doctors that don’t wash their hands between rooms. Not the nurses. DOCTORS. When called on it they said they were too busy. Or they only needed to between SICK patients. This was on the cancer ward. Twice… with each of my parents.
— Christine Im🍑 🍊🤡 (@spottedTB) March 8, 2019
Having to ask professionals to wash their hands is embarrassing and stressful.
Wash hands! Our hospital tells the patients that everyone should wash their hands after they enter the patient’s room, and then NO ONE washes their hands when they enter the room. I’m the patient’s spouse, and it is awkward to ask people to wash their hands.
— Rantidote (@jkornack) March 8, 2019
Another pointed out the filthy mops that are used to clean.
Don’t have someone bring a disgusting mop into every room spreading germs from room to room. Better to not clean the room at all!
— Carla Ulbrich (@singingpatient) March 8, 2019
Lack of Staff Knowledge
Extremely dangerous situations were described. For example, hospital staff did not know the difference between Type 1 and Type 2 diabetes and were using the protocols for someone with Type 2 diabetes on a patient with Type 1 diabetes.
Example: https://t.co/hg82RwcYOa
— Dr. Holly Witteman (@hwitteman) March 9, 2019
Example 2: https://t.co/u2IHw43W1e
— Dr. Holly Witteman (@hwitteman) March 9, 2019
And data: (This is from the UK. I’m not familiar with any similar analysis in the US but based on my experiences there, I’d expect similar or worse rates.) https://t.co/rpLznuZPSj
— Dr. Holly Witteman (@hwitteman) March 9, 2019
No Way to Remember Who is Who
Patients and caregivers noted that physicians and others enter the room and talk to them but don’t introduce themselves or have name tags that are too small to read. They described feeling overwhelmed and wishing for a way to keep up with all the people. Not having any idea when their healthcare providers will come to visit is another difficulty in hospitals. In my personal experience as a caregiver, I didn’t feel I could leave the my family member’s room to get a meal because I might miss the physician doing rounds and possibly miss vital information.
Give me access to a schedule that will tell me approximate times for rounds, vitals, meals, etc. The disruption to familiar routine is incredibly stressful. Knowing what to anticipate and when will allay fears and provide comfort
— Erin Moore (@ekeeleymoore) March 8, 2019
This caregiver came up with a solution for her father/patient.
I made a sign for my Dad that said please introduce yourself because without his glasses he couldn’t read name tags, most docs and RNs did but…everyone’s so busy you just want to do what they say, not bother them for their role…
— Betsy (@wildwestannie) March 7, 2019
Patients Coordinating Care Rather Than HCPs
Patients (and caregivers if they are available) seem to be required to coordinate their care even though they are seriously ill because of a lack of communication between healthcare providers.
It would be invaluable if all the docs treating the same patient knew what was going on with their mutual patient and actually coordinated their care. I see one PCP and two specialists and instead of them coordinating my care, I have to tell each what the others are doing!
— MedKaz® (@mymedkaz) March 7, 2019
Preventable Trauma
Several patients told of traumatic experiences in the hospital.
When a fire alarm sounds at midnight, the doors to my ICU room auto-close, and the words “Code Red” reverberate hauntingly for 20 mins on the PA system, don’t wait 4 hours to tell me, “Oh, it was nothing. A nurse burnt toast.” The nightmares for a vulnerable patient last years.
— Steven DeMaio (@stevedemaio) March 8, 2019
Agreed. When my daughter had her transplant she was placed in ICU w 4 other children. One had a crisis. Parents hurried out and separated from their kids so crisis could be attended to. Once over, nothing. Business as unusual but daughter traumatized as well as is
— MamaBear (@esteckler2) March 9, 2019
Being Ignored
Patients and caregivers described not being listened.
Listen to the patient, don’t wake me up all night and never show up during the day. Treat me like I have a brain. Don’t act like you are doing me a favor by showing up.
— @OdeToOm (@OdeToOm) March 8, 2019
Problems Around Discharge
Discharge from the hospital appears to be a problem for many. Lack of preparation time to discuss discharge was one complaint. Another was that patients were discharged to home with no support.
Post-MI, no written discharge plan. Nobody asked if I had anybody at home who could help me, or if I had anybody at home I’d need to take care of, or if I could take time off work to recover, or if I could afford the fistful of new cardiac meds I now needed to take. #Scary
— Carolyn Thomas (@HeartSisters) March 8, 2019
How Can Hospitals Do Better?
What do you wish would change in hospital care? Please share your experiences with us in the comments section.
