WHEN NO ONE IS DRIVING THE BUS, PATIENTS ARE UP THE CREEK WITHOUT A PADDLE:

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Veronica was  a very complex young lady. She was 32 and had type 1 diabetes. She had a serious motility (motor) disorder of her colon. Her gut did not move food contents along from top to bottom, in the way that it should. This lead to a number of serious complications including persistent vomiting and dehydration. She had many hospitalizations.

RCM was engaged by the family to complete a medical case review.

We were also engaged to create an expert panel to provide 2nd, 3rd and 4th opinions.

The opinions lead to some valuable suggestions.

When it came time to implement the recommendations at her hospital, we realized that NO ONE WAS DRIVING THE BUS.

Without a most responsible doctor, it was impossible to introduce these new ideas.

Veronica was experiencing a failure in CONTINUITY OF CARE.  The residents came and went. Her doctors were not seriously engaged in her care. No one was DRIVING THE BUS.

Our job became one of identifying a doctor who would take the role of the clinical lead. To do that we had to go to the CEO of the hospital to make the CEO aware of this management problem.

This was the start of getting clinical leadership of this complex case in order to introduce some valuable improvements in care for this young lady.