There is nothing more frustrating than having a very sick family member in a hospital and not being given an opportunity to talk to members of the care team in order to understand what is happening.
Here is a case study:
Virginia had been in the intensive care unit for 9 weeks in respiratory (lung) failure. The care team had tried many antibiotics to treat her infection(s). None of the medications had worked. She went into heart failure. She was unconscious and supported on a ventilator.
Her father-in-law grew frustrated in not having access to the care team and not understanding what was being done. He wrote a very strong letter to the hospital CEO and the chief of the medical staff. He was very angry. His daughter was a lawyer. They were ready to litigate in court.
That is when Rupert Case Management (RCM) was retained by the family to help.
After reviewing the medical records, our first action was to organize a conference call with all of the ICU doctors and the chief of the medical staff. This was not a trivial feat. We worked through the CEO’s office to accomplish this. There were seven doctors who rotated through the ICU on a one week on and seven weeks off schedule. Many of them were unaware of the changes in the patient’s status.
Once we got their attention, we worked with the family to organize and prioritize their interpretation of core issues and critical decisions. This was presented to the care team. This brought further appropriate attention to the patient.
Unfortunately, she passed. The family asked for an autopsy. They wanted answers. We were asked to organize a second opinion. The first pathologist had been selected by the hospital staff. They did not trust the first pathologist.
The second pathologist, who was a heart-lung pathology specialist, was selected by the family with our assistance.
The outcome was surprising to everyone. This patient had TB of her heart. This was confirmed by the two pathologists. During her hospital stay, she had been treated for TB.
The outcome was that the family felt satisfied with the answers. And costly and time consuming litigation was avoided.
This is an example of using design thinking to create a customer-facing process to help patients and families in extreme distress. In this process, a qualified third party such as Rupert Case Management (RCM), with experience in advocacy and in the management of complex cases, is introduced by the hospital to the patients and families as a value added service. This process provides the families with carefully managed “customer experience”, with seamless access to information that is made understandable to a lay person and with guided access to hospital staff.
If this process of increased transparency and responsiveness is employed pre-emptively, then many instances of litigation against hospitals might be avoided.
Virginia’s family was appreciative of the advocacy work that we undertook. There was also the realization that litigation against the hospital or the doctors was not warranted.
Design thinking can be used to develop and deliver a process of carefully managing the “customer experience” of angry and frustrated patients and their family members. This process provides increased transparency, improved comprehension of the core issues, empathic responsiveness and acknowledgement of the customer’s concerns.
RCM’s process is proving to be of marked value in preventing needless litigation and in maintaining and improving the long term relationship capital of hospitals in their communities.