VA Patient Safety

Safety blog posts: Blog post Number 7
Patient Safety and the Veteran’s Administration

I have been silent with the blog in part because we are moving our office one block away to a new location and that has occupied quite a bit of our time. Additionally I had to give some thought to what was going on with the Veterans Administration issues that clearly involve elements of patient safety. There is no doubt that many of the patients in the the VA hospital system receive excellent care, oftentimes in spite of and not because of the system.

In previous posts on this blog I have referred to system errors and system problems. The VA places a burden on good healthcare workers forcing them to deliver excellent health care in a suboptimal or really terrible setting.

There is no end to the problems of this nature that occurred in the VA system. Many of the problems can be traced back to management of the VA healthcare system by bureaucrats. The VA healthcare system is plagued by civil servants who are out of control. The civl servants cannot be removed from their positions regardless of poor performance. Such a system of healthcare delivery appears to be designed to fail. Unfortunately the VA is the living model for Obamacare; big government controlling or providing medical care.

Off with their heads, really?

Making sacrificial lambs out of the hierarchy at the VA will not likely cause meaningful change to the way that patient care is delivered in the VA hospital system. The Veterans deserve better delivery of their care, care which when they are able to get care is often excellent. I by no means wish to denigrate the superb care given by some of the nurses, physicians, and other healthcare providers in the VA system. However they should not have to deliver the care at such great personal and emotional expense. There is a political group in the country simply believes that throwing more money at a problem will result in a solution to the problem. Throwing more money at this problem is not the solution. The VA system appears is hampered by the civil servants who rights and privileges far exceed those of all around them.

What to do?

What did not work was the fake management approach of the previous administration. Eight years of doing nothing other than meaningless public relations work did not work. Our current president has inherited the problematic VA organization from members of the opposing party. All party flavors of president have been unable to “fix” the VA. Something far more radical than a simple fix will be required to ensure durable positive impact on the VA. We can and will fix these problems and others in the VA.




Patient Involvement in the Surgical Safety Process: Blog post #6

I will address this topic of patient involvement in the surgical safety process more than once in this blog. One of my friends who has been reading these patient safety blog entries freely and intelligently comments on the blog and the apps that we at Single Point of Truth Medical software are building to aid patient safety. He tells me that the blog appears to him to be a bit frightening. My response to this rather knowledgeable critic is that knowledge empowers and that the truth can be rather frightening. So for those of you who would rather proceed through your surgical treatment with blind faith, little knowledge, and little or no concern for being involved with the safety of the process, read something else. If you are the squeamish or frightened type or you simply do not wish to know the details of what is going on with your personal safety in your surgical care process, then you best leave now before things get worse for you or I bore you to death.

Bringing a buddy

Many patients are thrust into the whole process of surgical care by necessity rather than by choice. Either way, adverse outcomes may occur. Some patients bring a friend, significant other, or relative with them for at least the initial and sometimes subsequent visit with a surgeon. Not a bad idea if you are not a seasoned surgical patient. Your buddy will hear and remember things that you forget, may take notes that will be useful to you, and may prompt you to ask questions that you had not thought about asking. Finding your surgeon with or without a referral from your doctor (if you even have a doctor) is really the beginning of the patient safety process. Our best referrals come from other satisfied patients. These satisfied customers become well informed about how they were treated and whether or not they could put their trust in the surgeon and the surgeons staff.

The office environment

The office staff has moved numerous patients through the surgical care process. It goes without saying that the front office staff can make or break patient satisfaction and confidence. Many of the office staff personnel are not medically trained. Asking them medical questions will likely not be wise, but they do know the rules of the patient road well.

Who should I ask about my surgeon?

When possible ask people you trust whether or not they are health care professionals about your selection of a surgeon. You may be lucky enough to know team members from the operating room of the facility where the surgeon operates. These surgical team members can be great sources of information. They see the surgeon in action at a time when most patients are sedated or anesthetized. Ask them how things go when the surgeon you are about to select is operating. Ask them if they had the same or similar condition who they would select for their operation or procedure.

Where else can I look?

While no health care professional can please or satisfy all of their patients, a bad on line reputation may be one of the warning signs that should get your attention. Always remember that the surgical patient is the most important person in the room. If you do not feel important, that’s a problem. Be alert and pay attention. If you are really lucky in your quest for surgeon performance information you may get information about how your surgeon handled a problem or complication. Anybody can deal with success but how they deal with a problem or failure can be quite revealing.

Back to Checklists

Patients commonly rely on a list of questions that they bring with them to ask their surgeon. This is sort of a patient generated checklist and perhaps I intend to author a general checklist for patients in this blog. The surgeon and the surgeons staff will likely rely on checklists to make sure that they attend to details of your care. These checklists should be viewed by the patient as signs of knowledge and organization, and not as signs of weakness or disorganization by the practice.

Thanks for reading this patient safety blog. We publish this blog for you and your surgical safety.