After
all of the holiday festivities, January is the time of year when many peoples’ thoughts
turn to planning their holidays for the next year. In the UK, the latest cruise industry figures estimate
that for 2013, almost 2 million Brits will take an ocean cruise, a growth of
more than 2% on 2012 (http://www.the-psa.co.uk/).
The attractions of spending a week or two on the ocean wave are multiple but
one important aspect is how slick everything is organised by the industry. Once
on board, ships such as the Queen Mary 2 (2,600 passengers and 1255 crew) publish
a daily schedule of activities providing a timetable of activities, events,
restaurant and bar times as well as an exhaustive list of contact telephone
numbers. There are also meetings scheduled for “Friends of Bill W” – onboard
alcoholic anonymous sessions as well as for “Friends of Dorothy” – to
accommodate gay and lesbian travellers.
Contrast the serine environment of a modern day
cruise liner gently ambling its way for 5 days from Southampton to New York
with the invariably chaotic nature of a stay in an NHS hospital for the same
length of time. Admission to hospital can be both lonely and disturbing as the
patient is expected to hand over much of their
personal autonomy to complete strangers, spending most of their time in their
nightwear within close proximity to people not of their choosing. Hospital patients
also have to interact and be dependant upon multiple and complex groups of
individuals often with unrecognisable uniforms and unpronounceable (and often
unreadable) labels ending in “therapist” or “ologist”. Most frustrating however is
the unpredictability of the experience - “the scan might be this afternoon or
tomorrow”. Similarly, despite the creation of the new managerial mantra of
discharge planning, the actual timing of release from hospital is often
elusive, last minute and as can be highlighted by the media, in the middle of
the night!
So for a 2013 new year’s resolution how about
creating a “Your Daily Schedule” for hospital inpatients? This would be
published the evening before and contain details of what is supposed to happen to
include meal times, doctors rounds, visits from occupational therapists,
physiotherapists and social workers, phlebotomy schedules and if linked to
radiology, the proposed timing of the scan or angiogram. It could also provide the name of the Consultant in charge and phone numbers for social
services, the patient liaison team and even the hospital shop so that the next
day’s Daily Mail can be pre-ordered.
This system could also allow patients and relatives
to email questions to the relevant department and book an appointment to see
the doctor, nurse or social worker to discuss discharge planning.
This would probably work best where patients
are admitted electively but would require NHS staff to improve scheduling and
planning and embrace access by patients and their families. To become more
widespread throughout NHS hospitals it would also need a significant cultural
shift with the system evolving for the benefit of the patient rather than the
organisation per se. The benefits might be (a) better communication and fewer
complaints, (b) an improved public profile for NHS hospitals and (c) efficiency
savings due to fewer cancelled investigations and enhanced discharge planning.
If not then the only similarity between the NHS and the Cruise Travel Industry
will remain the propensity of both to put people at risk of catching Norovirus.
