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Better Care Through HCIT 101: Part 6 - The Children Are Our Future

August 27, 2009
by Joe Bormel
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We walked into the Children's Hospital and Clinic. We were told where to go and when to be there:
“Just come in the main entrance, turn left at the McQueuen/Hardy sign, straight past the Seymour-Thomas Nephropaleontology Center, right at the Hoddes Chickeldorf Dobbs Imaging Center, then simply go to the end of the hall with the double glass doors. Just before those doors, turn left again and you'll find us, the Van Ders Neurocardiopedics Pavillion."

Better Care Through HCIT 101: Part 6 - The Children Are Our Future
Culturally adopted vision, values, and continuous improvement require continued focus

Everyone is familiar with the challenge of finding one's way through a hospital. Wayfinding often takes the form of clear signage and guiding lines on the floor and walls. It reflects a true patient-centered facility design. The picture above comes from a pre-eminent children's hospital in Delaware that I recently visited with my family. My initial healthcare access challenges are covered in my Relativity and Relativity post. This was a routine follow-up visit, and all was well on this visit.

The hospital and clinic are gorgeous and clean. More importantly, of course, is that the staff was highly talented, professional and attentive. Per my post, the care is objectively the best that's available within a several hundred mile radius of home.

I was reminded of a few lessons from this experience:

1) What we call things and how we find them is so instrumental. It's ease to lose focus on that.

2) Visioning is not enough. Clearly, from the picture above, the wayfinding design was well thought out and executed. Of course, I'd prefer that the Blue Module above had a background color of blue rather than green, but let's give them credit for getting it right in two out of three signs shown. The fourth and fifth signs, not shown, completely lost the vision. They had those McQueuen/Hardy/Seymour/Thomas/Hoddes/Chickenldorf names (fictitious examples) and the same, non-informational background color. Putting in a systematic process to maintain the vision through all relevant projects is important. That's what was clearly missing.

3) It's not about us [the care provider]. It's about the patient and their care. Using names of people we want to memorialize is fine, but not for something critical to our patients like wayfinding.

4) There's always room for improvement; often those ideas come from visitors, customers, patients and their families, employees, etc. I did clearly communicate my concern about the wayfinding to our physician. I will follow that up with a second email containing a link to this post and it's comments.

5) The standards for children's hospitals need to be higher than that for adult hospitals. Aside from being a recognized, vulnerable population, children are less cognitively and experientially developed. Their parents and caretakers have additional burdens, physically and emotionally, compared to adults presenting for self-care. It's not my intent to be proposing a "shame" strategy, common to what's often done to adult and children's hospitals and clinics. This hospital is a strong, positive exemplar. In my work, I've been to and toured easily a dozen children's hospitals within the last 2 years. This hospital is clearly in the top decile. Part of what got them there and keeps them there is attention to detail. There are more details in a children's hospital.

I'll report back to let you know whether this hospital is improving, or whether its existing, high value investments (as evidenced in this text and the photo) is devolving. Continuous improvement and a culturally adopted vision are critical components of our institutions.

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