A few years ago, someone I’m close to went into hospital on a Sunday for an urgent (vs an emergency) outpatient procedure. From what I could tell, the quality of care he received was high, and the nurses who watched over him while he was recovering from the general anaesthesia did so with skill, empathy, and even a bit of humour.
And while his partner was stranded in the waiting room for several hours before and during the procedure, having discovered to her dismay that the coffee shop and other food outlets were all closed, a nurse who was passing by quickly recognized the partner’s plight and offered to bring her a sandwich. (When you’re in what feels like an unfamiliar and even unwelcoming place, worried about a loved one, it’s hard to explain the comfort such small kindnesses can provide.)
But what transpired next was far less than ideal. It hadn’t occurred to the patient, or the person accompanying him to ask for detailed instructions about connecting with the agency that was supposed to provide instructions on how to care for the catheter that had to be left in place for 10 days after surgery, or even signs or symptoms that should prompt a return to hospital.
Perhaps if his surgery had taken place on a weekday, that might have been different. There’s no way to know. What I do know? Because of that lack of a proper hand-off, the patient and his family suffered a lot of anxiety, and ended up in the Emergency Department not just once, but twice, for problems that it might well have been possible to handle at home, had they been given the appropriate information.
That kind of disconnect is the source of one of the most common types of complaints that are received by Ontario’s office the ombudsman.
Thankfully, some organizations and researchers are working on ways of helping hospitals adopt a more patient-centred approach to hospital discharge.
In the meantime, however, there are things that you can do to help reduce the chances that you’ll have an experience like the one described above when you or a loved one is released from hospital.
My heartfelt thanks to the interviewees who so kindly shared their time, stories and expertise:
- Beth Campbell Duke, a science educator and transplant family caregiver in Victoria, BC, who operates navigatinghealthcare.ca
- Carol Fancott, director of Patient Engagement and Partnerships at Healthcare Excellence Canada (formerly the Canadian Foundation for Healthcare Improvement) in Ottawa.
- Dr. Shoshanna Hahn-Goldberg, scientist and project lead at the University Health Network’s OpenLab, and an assistant professor in the Leslie Dan Faculty of Pharmacy at the University of Toronto.
- Dr. David Kaplan, a Toronto family physician and vice-president of Clinical Institutes and Quality Programs at Ontario Health.
- Dr. Jasmine Mah, an internal medicine resident at Dalhousie University in Halifax, NS.
- Jason Oliver, formerly a senior specialist at the office of Ontario’s Patient Ombudsman.
- Carolyn Thomas of Victoria, BC, author of A Woman’s Guide to Living With Heart Disease, who works tirelessly to raise awareness about women’s heart health partly through her blog at MyHeartSisters.org