Couch Sessions: "Checks"

Last week proved to be a hubbub of activity at the hospital where I worked at; back-to-back meetings (for which I got props for  traveling 2 hours to get to), general clean-ups, and heck, even manual reviews.

Naturally…

The PhilHealth team and Department of Health were paying a visit to hospitals and health establishments in the region. Now, this is an important visit, as it is an evaluation which determines accreditations for hospitals. Usually, it is a time a stressful time, especially for chiefs of hospital because they are under pressure to make sure that their institutions are following guidelines and keeping up with standards.

This week, the teams came on subsequent days…both of which I was at the hospital, on-duty. The teams had different concerns, PhilHealth was mostly focused on paperwork and the putting up of info posters on the walls, statistics, etc. The Department of Health’s checklist was more on the facilities and equipment the hospital had.

Now, I didn’t really expect us to get a high mark for the materials and equipment part, because it is common knowledge that hospitals and health care do not get the most shares in the national [apple] pie chart budget. They try to make do with what they have, our hospital included. The bureaucratic red tape does not help, too.

Getting Asked

I didn’t get to see any of the Philhealth team, although I was told that they were going around the OPD section, asking the nurses and some patients, questions. The nurses did pretty well, but the patient they asked was kind of irate because he said that he was waiting there since 8AM, but didn’t get seen until 9. (Another reason why we should put posters up to say that OPD consults don’t start until 9AM…LOL. Sometimes, people need to “know” certain things first, otherwise they get very emotional and start getting all antsy, which is totally unnecessary. Let me stress on Totally.)

Peeved

It is a peeve, actually, because it happens at the OPD on many occasions. Some patients would get irate at not being seen right away, when most of them, once you see them, say that they have been sick for the past 6 days but have only decided to come because their “home remedies (a.k.a. mumbo-jumbo herbal)” haven’t worked. And by these mumbo jumbo, I mean kerosene rubs, “bitters (decoctions of a plethora of leaves and whatnot”, and a lot of other stuff (including amulets worn at their waists) they were told were effective. Gee thanks.

(I am reminded of a patient who had his open fracture “massaged” by the local massage therapist (in our dialect, the hilot). Ugh.

In-patients have to be top priority, so in case anything happens (and unless the OPD patients aren’t emergency cases, but are stable and ambulatory) then they’re the ones who get my full attention first, as with all the other doctors.

I’ve digressed completely.

(But yes, honestly, these things happen occasionally, and they require a lot of patience. As a doctor, it is your role to give people options, and to help them decide which course of treatment is the best for them, but when you’re up against the local customs and traditional medicine, you’ll realize that their beliefs, and what their local albularyo (medicine man) says would take precedence.)

This is mostly because my target patient population because I work in a rural area and other hospitals are like maybe an hour away, so it is the closest they can get to. It is a daunting task, in that aspect, to be perfectly honest.

To try to change people’s minds about how they do things, and how to take care of themselves is no easy job, so you really have to find a compromise.

Where was I, again?

:-p

Checks/Evaluations Part II

Anyway, about the PhilHealth thing, it went ok. They felt we needed to put more health statistics posters up. Another doctor asked me if they asked me/interviewed me. I shook my head to say no, but I wouldn’t have minded. I never shirked away from interviews (I love them, actually. J), but what I don’t like is having to feel like I have to recite the hospital’s vision-mission statement, verbatim.

The Department of Health people came in when I was examining a patient in the outpatient department (OPD), she was quite friendly, but the first thing she did was whip out her checklist and ask if I had a Neuro hammer, a diagnostic set, etc etc, which I had in my medical bag, which I lug around (because it is chock full of things I might need when I’m examining a patient) with me. Heck, it even had a BMI calculator in it. :-p But that’s like, not very important, with regards to how they were evaluating the hospital, I know I made a good impression on her, but in the end, it’s all about how much effort the whole hospital puts in with their delivery of services.

These evaluations should be taken as what they should be,  “checks”, and in no way are they personal. I’ve heard some employees grumble about how these people were just looking for flaws, or that if they weren’t examining hospitals, they were just clerks. I found this sour grape-ing utterly hilarious. It was beside the point, really. Their job was to see if people in hospitals were following guidelines, and not to get them fired, or lay them off. Of course they would be concerned (and would note down, and comment) if so and so manual isn’t found in the wards, when it should be, or if waste segregation wasn’t followed to the letter…you know, random things like that.

Although, I have to admit, one of the examining personnel wasn’t too impressive herself. She didn’t seem to know how a childproof bottle of paracetamol anti-pyretic worked. You know how they are, right? The cap seems loose, but to open it, you really have to press down before you twist… So anyway, she went, “Aha, so it’s not properly capped, and is still open!”

(wait for it, wait for it…)

Duh…

:-p

And so, all’s well that ends well. The bottom line is, everyone needs a “tune-up” once in a while. These evaluations should be taken for what they are…as a means to know our deficiencies and strong points, so we can work on them.

In a setting as delicate as health care…it is always important to stay abreast with standards.

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Ok, that was my two cents’ worth.

Did you miss me?

(It seems the longer I’m gone, the more long (winded) my entries seem to be.haha)

~ Sonia.