Drinking from the Fire Hose

I am not sure exactly what is going on in the world to have caused the major increase in emergency visits and hospitalizations at Henry Ford Hospital over the last several days (or weeks or months). 

Maybe it’s solar winds, sun spots, loss of insurance, inadequate access to primary care, excessive co-pays or the leap year effect? It’s probably a combination of all of the above.

Maintaining high volumes of admissions by and large is good for the hospital. Better than the opposite. 

It’s a bit like: drinking water is good, while drinking water through a fire hose has its problems.

I do know that the teams of nurses, doctor, and all other employees at Henry Ford Hospital have been working at levels that have not been present for almost a decade. 

In the last few months, we’ve had the highest admissions of any January in 11 years, the greatest number of admissions (over 180) and the greatest number of discharges in our recorded history. 

It doesn’t matter if you are working on the front, middle or back end of hospitalization; you are experiencing high work loads, significant stress and strained processes.

Thank you for being here.

I was walking in the emergency department with Ronnie Hall, our COO, who I have worked with for over 25 years. Patients in CAT 1 were very sick, and triage patients, to our surprise, looked even sicker.  

Patients and their families were patient, but weary. Being sick and feeling poorly, waiting in a wheelchair or stretcher to be seen, is no way to spend a beautiful March afternoon.

In the midst of a sea of patients in triage, one of the patients wanted to leave before service could be provided. She was tired and just wanted to go home. Continue reading

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The Henry Ford Family

As we move to a new vision statement for Henry Ford, the essential value remains from our prior vision statement:

Providing each patient the quality of care and comfort we want for our families and ourselves.

This letter from Karen Davis – one of our hospital’s administrative nurse managers whose daughter was recently a patient in Henry Ford Hospital’s Emergency Department – exemplifies what that is about:

I couldn’t fall asleep until I wrote this note. First of all, I am happy to say that in my almost 6.5 years as a Henry Ford Hospital employee, no one in my family has had to utilize our emergency facilities.

The Davis Family

From the second we arrived, the Emergency Department staff was unbelievable!

Everyone came out of the woodwork to help Jennifer: Cindy helped start her IV, and the short, blond-haired triage nurse (I’m sorry, I didn’t get her name) and Jeff, the charge nurse, got her medicated, comfortable and whisked us back to the pediatric area.

There, we were met by Sarah, another charge nurse, staff nurses Mark and Ebony, and the PA, Jackie.

What terrific staff!

All of a sudden, my family was their family too!

What a great feeling that my “nursing hat” was off and my “mom hat” could be worn comfortably. Talk about being able to feel relaxed during a stressful situation.

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Reducing Door to Balloon Times

I recently attended a celebration for door-to-balloon time at Henry Ford Hospital.

It is a quality measure in the treatment of heart attacks, specifically an ST segment elevation myocardial infarction.

This particular form of heart attack has a high probability of destroying heart muscle, and leads to some of the direst of acute and chronic heart conditions.

Henry Ford Hospital Door to Balloon Team

The time interval measure starts when the patient arrives in the emergency department and ends when a cardiac catheterization wire, placed from the patient’s artery, crosses the blockage in the coronary artery.

This all sounds very technical, but it is easy to understand.

You are having a heart attack. The treatment is to quickly open the artery that is blocked. The technique used is by a heart catheter.

The longer it takes to open the artery, the more heart damage (“time is muscle”). And the more heart damage, the worse the patient does (“muscle is function”).

This measure is adopted as a core quality measure of how good a hospital performs in caring for heart patients.

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Midnight Rounds: Bridging the Aloneness

PART 2:

There’s an entirely different feel to the afternoon and midnight shifts in a hospital.

During the “normal” working hours of the day shift, much of the activity in a hospital centers on patient diagnosis and therapy (the processes of care).

And doctors are in abundance in the halls and the procedure rooms. 

For the most part, there’s a shift after hours to the on-going maintenance and care of the patients through the hospitalization process: fewer doctors and people, but still a lot of ongoing processes of care.

There is an “aloneness” that one feels in the halls of a hospital, especially after normal visiting hours are over. 

Being removed from the usual day-to-day communication and involvement of management, off-hours staff are curiously more interactive, more social, and much more eager to talk with the management about quality, safety, pay and even rumors.

Some areas of the hospital actually are more bustling in the off hours. 

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