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    Monday, June 13, 2005

    British vs. American: An interesting first-hand account of surviving hospitals on both sides of the pond. I found this the most interesting:

    As for the caliber of medicine practiced at Queen's Square, we were quite impressed at the collegiality of the doctors and the tendency to make medical judgments based on group consultations. There is much better teamwork among doctors, nurses and physical therapists in Britain. In fact, once a week at Queen's Square, all the hospital's health workers--from high to low--would assemble for an open forum on each patient in the ward. That way each level knows what the other level is up to, something glaringly absent from U.S. hospital management. Also, British nurses have far more direct managerial control over how the hospital wards are run. This may somewhat compensate for their meager wages--which averaged about ?20,000 ($36,000) a year (in a city where almost everything costs twice as much as it does in Manhattan!).

    Once upon a time American hospitals worked that way, too. Now the care has grown increasingly fractured. Sometimes it's difficult just to get the various doctors caring for a patient to communicate with each other, let alone the nursing staff and ancillary staff. Part of the problem is that shift work and floor rotations has made it difficult to maintain continuinity of care among nurses and other staff members. A patient might have a different nurse or physical therapist every day, none of whom every knows him well.

    The other problem is that nursing duties have been increasingly farmed out to aides with minimal training in patient care. The aides answer all the patient call lights, give the baths, and take the vital signs - in short everything that involves patient contact. The end result is that too often the patient is just a series of notes on a clipboard as far as the nurse is concerned. I suspect there are some nurses who manage to work their entire shift without ever laying hands on a patient, except to pass them their medication.

    As for the doctors who don't communicate with one another - there's just no excuse for it.

    (via Medgadget who also has gads of cool new gadget posts.)


    posted by Sydney on 6/13/2005 08:52:00 PM 0 comments


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