Welcome to Hospital - Here is your daily schedule

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.