Connecting the dots – or not!

Connecting the dotsFrom the very beginning of my (ongoing) journey, I have felt that nobody was ‘connecting the dots’. I mentioned in earlier posts the feeling that I was being seen as a sequence/collection of symptoms rather than a whole entity presenting with a single syndrome. Well, recent experiences reinforce that feeling.

Loyal readers will recall that my operation, originally scheduled for 8th April was postponed (for very understandable and acceptable reasons) and has now been rescheduled for 24th June. On the day, and during a conversation with ‘my’ surgeon (actually one of them as I understand there may be as many as three finally involved!) we agreed the new date and he said “I will dictate a letter this afternoon confirming the date”. So the letter arrived on 25th (?) April. It was a helpful and informative letter, but with header details of ‘Dictated 08 Apr  … Typed 21 Apr’. Does it really take nearly 2 weeks to get a letter typed up?!

Anyway, it didn’t actually matter – at least in terms of the medical process – although I had been left wondering for over a week about whether or not the situation might have changed.

Next, in early May, I get a letter inviting me to an Endocrinology Outpatient appointment on 28th June. If you are observant you may have noticed that this is only four days after the surgery, for which I expect to be in hospital for at least three days! Puzzled, I rang the Referral and Booking Service Cluster 5 as suggested. After the usual security clearance and explaining my puzzlement that I was being invited for an outpatients appointment on a day when I might conceivably actually be an inpatient, I was informed that this was an appointment that should have happened last December, being a routine follow-up 3-4 months after my initial appointment. Yes, you read it right, it should have happened 15 weeks ago! I hope the recording of the phone call shows that I was polite!

Clearly the booker (or whatever her job title is) was not going to be able to resolve the puzzle and credit to her for giving me the phone number of Dr Murray’s Secretary and transferring me there and then. I explained that I had been referred for surgery that had yet to happen and wondered if this was a post-surgery appointment. I remain unclear about what had actually happened, suffice it to say that she volunteered to cancel this appointment and send another out. All that after a 2-minute wait while I hear her very clearly explaining how to do something unrelated to my call to a colleague in her office.

So yet again we appear to have disconnected dots – the Endocrinology Team not being aware of, or not acting on, the information that my surgery had yet to happen. And what happened to the appointment that should have been arranged for December?

It’s got to the stage that first I laugh at it and then I get on sorting things out myself – I am left wondering what someone less stress-resilient and less organisationally-aware would do.

On a more positive note, I went along to spend an hour or so in front of the cameras for the Patient Experience Team last week. Having contacted them and offered my experience as both a patient and change leadership wallah, they have been working away seeking opportunities to use my experience to reinforce the case for and help them improve their administrative systems, most especially appointments. I am delighted to be able to help in any way I can, I suspect that others might have found this journey much more traumatic than I and I reinforced my key message that the admin processes are as important as the medical processes in the overall care of patients. After all, the letter is for many people their first contact with the hospital and it is the ongoing route through which long-term patients are kept informed of appointments etc. Organisations who rely on good customer service, and the NHS must surely be one of those:

  • have  easy and transparent ways for customers to contact them,
  • they respond quickly to any changes in either the patient’s or the organisation’s situation,
  • they explain very clearly what the customer can expect,
  • they find out what the customer wants and do their best to meet those wants,
  • they constantly check how their customers are.

Some way to go here, but to hear that they will be looking at Kaizen/Lean/Toyota methodologies (and that I will be involved) is reassuring and a future partnership with Virginia Mason Medical Center in Seattle, who have radically improved their systems using these methodologies is encouraging. The journey will be challenging, tough and rewarding and I look forward to being part of it.

One response to “Connecting the dots – or not!

  1. Jon Toulson

    You really are exposing a flawed system Geoff, or to be more precise, are personally experiencing the negative effects of a flawed system!
    Well written, and informative, and I am very glad that you are resilient and appear to be making progress!

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