Despite the growing importance of IT, providing the proper care is still about staffing
LAS VEGAS — Sept. 1 — About six nights ago, I got a call from a nurse telling me that my father was going in for emergency surgery to repair a ruptured aortic aneurysm. In a kind voice, she said it was remarkable he had made it to the hospital, and doubtful he would make it out of surgery. Then she put me on the phone with him — presumably for the last time — and I told him he was the best father a son ever had.
I couldn't rush to a local hospital in northern New Jersey where we both live because the call came from Las Vegas, where he had been vacationing.
I scheduled the first flight out in the morning, my wife with a fear of flying bravely by my side. As the night passed, we waited for the phone to ring with news we had lost him; it didn't. In the morning, we got to the airport at 5 a.m., still fearing that phone call. Again, it didn't come. Fast forward five hours until the plane landed and I was allowed to check my messages. Again, no call. When we finally got to his room in the Desert Springs Hospital, I was relieved by what I found.
He was hanging in there.
And after five days in the ICU, on a breathing machine and at least 15 drips (now down to about eight), he still is. As I write this column, I don't know if he will develop pneumonia or some other infection that could turn things south in a hurry. Of course, being on his back for days on end, he could easily develop skin problems, pressure ulcers and the like. But he hasn't. You know why? It's because preventing those types of complications requires not copious amounts of cutting-edge IT (such as EHRs, CPOE, etc.), but rather the proper amount of staff.
Being one of the most critical patients in the hospital, my father has had almost one-to-one attention for most of his stay. He's been turned regularly, bathed (even shaved) and generally cared for like a family member of the staff. His skin is perfect, and I have the nurses to thank for it.
I'm not the only one who values this type of care and attention. CMS thinks this it's pretty important too, and the largest payer in the country is trying to reduce the number of preventable hospital-acquired conditions by refusing to pay for such post-admission ailments. One of the ways hospitals can reduce these conditions is not just through IT, but through proper staffing. Technology can help here too, as there are a number of vendors that provide staffing optimization software.
I know there are many caregivers who labor under less-than-optimal staffing conditions. Like waitresses with too many tables, nurses run from room to room as best they can for 12 to 15 hours, with almost no breaks. Imagine being on a vent, waiting for an overextended nurse to turn you. It's horrifying.
Certainly the nursing shortage is an issue that needs serious attention, but where a lack of staff is the result of budgeting constraints, shame on administration. In the portion of our cover story that deals with the best practices of medium and small hospital CIOs (page 32), Jim Stalder, CIO of 230-bed Mercy Health Services in Baltimore, says that when putting together a budget, it's important to realize IT isn't the only group with needs. "It's all about being fair and looking out for the organization and knowing that other people need that money too."
God knows, I'm not trying to say that hospitals don't need IT to give the best care (they better, or I won't have a job). But what I am saying is that, watching my father in bed and helpless, I don't give a damn if his information is kept on paper or in a computer. I just want someone to come into the room and turn him.