Monday, December 31, 2012

Patient Satisfaction Survey

When PediNP wrote about "Customer Service" in relationship to her clinic, it was something that most practitioners, from the techs to doctors, understand. We are the ones who actually touch the patients and talk to the patients and families on a daily basis.  
Most health care facilities around the country now provide some sort of “Patient Satisfaction Survey” after the patient has had their care. Hospitals, clinics and other healthcare services rely heavily on these surveys. Some information can be beneficial, but most of it is for the administrative bean counters and managers who never touch a patient.   

Facilities tailor these questions to their specific needs, but here is a generic form from the Department of Health and Human Services. See the flaws, sometimes these surveys look like something you would fill out after staying at the Embassy Suites or Days Inn.  When was the last time someone had a hip replaced, heart valve surgery or got a cast at a hotel or restaurant. We who touch the patients provide a different service. OK, sometimes we provide you a blanket and some mediocre food. (That is another post topic).

These hospital scores are posted online through a National database (No not Yelp). How does a survey compare a hospital or clinic that treats the under served and homeless versus one in the gated upscale suburbs? New hospital additions have private rooms and flat screen TVs, while the community hospital still has two and three beds to a room. Do you think the satisfaction score might be lower, if the patient on the other side of the curtain is on the commode all night doing his GoLytely bowel prep. Patients will provide positive or negative feedback depending on the amount narcotics given out or refused at a clinic or ER.   

Wednesday, December 19, 2012

Clostridium difficile and the dog

Really. This WebMD article says researchers in the Netherland taught a dog to sniff out C. difficile. Poor dog.  The dog was a 2-yer-old beagle named Cliff. Come on Cliff and C. diff, researchers are not very cleaver with word play. Anyway, when other dogs are taught to sniff out drugs and bombs, they are rewarded with tasty treats. What do you give a dog that is taught to sniff out C. diff.  I’m thinking maybe a bath.

Seriously did they spend a lot on this research, because I bet 75% of nurses with some experience at the bedside can tell you if a patient has C. diff. Even from the hallway at that particular time, nurses can make an educated guess as to whether someone has C. diff.

If fact nurses are so good we can tell the difference between the smells of a GI bleed bowel movement, C. diff diarrhea and hospital cafeteria food flatus.  Don’t try to impress your friends or family with this fact during Christmas vacation.  

Another good way to know if a patient has C. diff.  When you are floated to a new floor, look at your assignment. Yes, your patient in isolation will be the one with C. diff.   

You want me to spend my life doing what? Pick him, no pick him.

Friday, December 7, 2012


Just need a break.

One more week and finals will be over. Tests are stressful, but not as much as when your instructor comes out to your primary care site to evaluate you. That is stressful. They come and sit in the corner of the exam room and say just ignore me. The patients don’t have a problem with it, but the students are a wreck. Did I diagnose it right, did I come up with the appropriate differential diagnosis and did I order the right meds and consults.

I would love to be out in the woods breathing fresh air and walking a Labrador. That is the best way to beat stress. Until then I just need to keep the goal in mind for six more months, then I can get a job and dog.