He stressed over and over again that Safety and Quality are the two sides of a coin, but not the same thing. He said that Safety should always be the first focus of any hospital rather than Quality. Safety should be defined and measured, and everyone in the organization should know that it is the number one priority. The other term that came up over and over again was Reliability as in the probability that a system, structure, component, process, person will successfully provide the intended functions. The number one priority for Children’s Hospital should be Reliability and Safety.
He had this excellent PowerPoint slide that showed what patients prioritize every time they use a hospital:
1. Don’t harm me.
2. Heal me.
3. Be nice to me.It always comes in this order.
That slide really hit home with me. I often focus on number 2 and 3 in my writing. The customer satisfaction experience that we cherish with Children’s Hospital, and the excellent quality care that we receive for Jacob. The times that Jacob has been healed and can go home again.
But reality is that number 1 comes first for me every time. This is why it is so exhausting to be in the hospital. That is the reason why I feel that I have been run over by a truck every time we are finally home again. Don’t get me wrong, we have had an excellent experience and track record with Children’s Hospital, but number 1 is what drives me every time Jacob is in the hospital. That is the reason why we have never left Jacob alone in the hospital. Somewhere deep, deep inside of me I am afraid that Jacob might be harmed. Not intentionally. I strongly believe that anyone who makes a mistake in the hospital didn’t plan that in the morning when they left for work. They were not thinking that today might be the day they would make a mistake. Things happen when you have humans involved.
Number 1 “don’t harm my child” is what drives me from asking tons of questions in every round each day. Number 1 is what drives me to double-check each and every medication going in to Jacob’s body despite medication barcoding. Number 1 is what drives me at night when I start to feel a knot deep in my stomach, and I know something is not quite alright. Number 1 is what makes me feel like a hawk in the hospital. Just ask Joakim. He knows what I am talking about here. He feels that I am completely micro-managing Jacob and his care, but I am just so afraid that that one little mistake will happen on somebody’s shift when they are with my son. It is always easier after the fact to understand what went wrong, to see all the warning signs, and to see that no one communicated effectively. During our last stay, the ICU nurse actually told me the following: “some parents think it is a vacation when their child is in the ICU (in terms of the nurse now doing all the care, not necessarily referring to your sick child), and some parents can’t let go. You belong to the second category, and you should just take a break”. Well, I wish I had listened to Kerry Johnson when he told me that because I would have told him that more important than Jacob getting well and you being nice to me is that you “don’t harm my child”.
This also brought me back to the early Jacob years. Jacob was going in for 4 surgical procedures with multiple surgeons involved. The main surgeon was Jacob’s ENT doctor. I had worked way into the morning hours in order to take this day off for Jacob’s surgery. I had cancelled all my meetings for the day of Jacob’s surgery. I was ready. We went through admission, and all surgical preparation work. We were ready to take Jacob into surgery. But not so quick…Suddenly Jacob’s ENT doctor shows up, and sits down with us, and wonders how our day is going. Well, it will all depend on how this surgery will go…I just have never liked to put Jacob under anesthesia. Well, the ENT doctor was really sorry that they hadn’t discovered this earlier, but they couldn’t do Jacob’s surgical procedures today. There was no open bed in the ICU, and in the event that Jacob would need that, there would be none. I was furious. I was tired. I was anxious and stressed. My first thought was actually work. I would have to work my butt off again to find another day I could clear off my calendar. I would have lost this day as a work day. My week was screwed. And the ENT doctor couldn’t even tell us what day we would be rescheduled for! I was not a happy camper. Thinking back on this day, I am thinking that this doctor is an excellent doctor who puts safety and reliability before healing and being nice. More important than an upset mom was the fact that he could guarantee Jacob safety, even if it meant that we would have to go through this all over again.
If you do work with patients, never forget what drives patients foremost, what is their number one priority. Make that your mantra each and every day. And if you are a patient or a parent of a child who spends lots of time in the hospital, see if the order of priorities matches yours.