Monday, February 8, 2016

Pulling the Health Care Andon, part 2

Pulling the Health Care Andon, part 2

I few months back I pulled the andon (Japanese for ‘Help Chain’) on a major Toronto hospital where my mom had suffered a number of indignities.

Thought I’d let you know what happened.

Quick overview: Mama went in for lower back surgery to treat a very painful spinal stenosis. The operation was a success and her orthopedic surgeon and OR staff, superb.

Convalescent care was another story. Here’s a key point summary:
  1. No target discharge date or discharge plan

  2. No standard discharge process. Everybody we spoke to had a different opinion.

  3. Poor communication. Key staff members repeatedly failed to return phone calls or provide clear information on Mama’s condition, treatment and support plan

  4. Poor hand-off with community chronic care system

  5. A rogue ‘case manager’ who tried to hustle an 82 year-old patient, who was in great pain from an 8 inch incision in her back, out of the hospital after 2 days – and declined to attend agreed upon patient conferences or respond to calls.
The events could easily have taken place in an American, British, or Australian hospital.

The Rest of the Story
I sent letters to the hospital CEO and the Minister of Health. No response from the latter – and no surprise. Ontario’s vast Ministry of Health has 32 Deputy Ministers. Guess how many are focused on patient experience?

To be fair, Ontario has belatedly acknowledged the problem and appointed a ‘patient ombudsman’

We did receive a letter from the hospital’s ‘Director of Patient Experience’. Sorry to say, it’s full of howlers
  1. Everything is just great at our hospital – we have no problems at all

  2. Your mom was walking around and was ready to leave on the second day – (??)

  3. Any problems are all your family’s fault
Denial, deflection and disrespect for patients.

“No problem is a big problem,” my Toyota senseis used to say.

How can they possibly improve their processes and outcomes? How can patient experience be anything by a crapshoot?

I’ll forward all this to Ontario’s new ‘patient ombudsman’, and send another note to the hospital CEO. I’m not expecting anything, but you have to give feedback.

Let me salute again the growing number of hospitals around the world that are in the midst of heartfelt process and cultural transformations.

I’m lucky enough to work with some of you. You’re fighting the good fight, and though it’ll take a long time, you’re going to win.

Best wishes,


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