What Makes a Hospital Great

We are finally on the last day of the year and the decade too. This is usually a time for reflection and I too have been thinking about my good fortune in never having been admitted to a hospital so far. God has indeed been kind and merciful. However, while I have been able to avoid a visit to the hospital so far, I have spent most of my working life and almost all of the last 10 years roaming the corridors of hospitals all over the world. This has been a great privilege for someone who isn’t even a clinician. I have been a part of teams trying to create wonderful hospitals that patients would love to come to. This quest continues with the realization that patients do not love to go to any hospital, whatsoever. They go there under the force of circumstances and are keen to return home as soon as possible.

So, what would constitute a hospital that one wouldn’t mind going to if the situation so demanded? Here are some thoughts.

The first and foremost is the obvious. The hospital must have great clinical expertise. This essentially means that the hospital should have a great set of clinicians well trained and experienced in their areas of medicine. It should also be equipped with some of the best medical gadgetry to allow the medical wizards to treat patients safely and to the best of their ability. This is relatively easy to achieve. The really difficult part is to get the great clinicians and the nurses and everybody else who delivers care to work together in the best and abiding interest of each patient. It takes years for a team to tango together. Large, successful hospitals are busy places, filled with thousands of patients demanding attention and care round the clock. For most patients a hospital visit or a surgery is perhaps a once in a lifetime experience. For busy clinical teams, scores of patients everyday is the norm. In all this a great hospital would be one where care and attention is lavished on each patient as she is the only one under their care that day.

Apart from providing great medical care, I would truly treasure a hospital that talks to me as a partner and treats me as an equal stakeholder in my own care. Very often this is a neglected area in most of our hospitals. Rarely, clinicians take the trouble to explain to the patients the medical conditions they have been diagnosed with, the treatment plan, the prognosis and the complications that may arise. There are many reasons for this – doctors are extremely busy juggling multiple balls all the time, do not consider this conversation as very important one, believe that patients do not have adequate medical knowledge to benefit much from this discussion and some, dare I say, are just not trained to address all the queries the patient may have. In a great hospital, medical teams must spend time with each patient, explaining and answering their questions as best as they can and with candor, empathy and respect.

There is something else that as a patient I rarely get to see or know but is absolutely critical for my well-being. This is the effort and investment a hospital makes in ensuring patient safety. Hospitals are inherently dangerous places teeming with germs and instruments, which are used for jabbing, invading and cutting open patients. Of course, all this is done in a controlled and highly sanitized environment, yet chances of someone slipping somewhere, making a grave and maybe an inadvertent error is always round the corner. The trick is in trying to eliminate these errors as far as possible through technology and stringent process controls. Ultimately, patient safety is an organization wide effort to establish a culture, which looks at learning from mistakes all the time. Great hospitals are obsessive about patient safety and treat even the smallest transgressions with utmost seriousness. To them nothing is more important than ensuring that the patient comes to no harm in the hospital.

Everything else to me in a hospital is a given. I would expect the hospital to be clean, the food to be of decent quality and served on time, the air-conditioning to be working well, the nurses to be responsive and the staff pleasant. I would greatly value efficiency in a hospital and wouldn’t like to wait endlessly for things to get done. I do expect the hospital to transparently charge me for its services and make a reasonable profit for its share-holders. A great hospital is also one, which does all of this effortlessly and as a matter of course.

As the new decade begins, I would certainly hope not to land up in a hospital in the next 10 years too. Yet, if it becomes unavoidable, I would certainly want to be in a hospital, which does all of the above rather well.

Here is wishing all of you a wonderful new year, filled with good health, happiness and much joy.

The views expressed are personal

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