Hospitals in need of change?

Every once in a while, our department’s hospitalist suffers me helping out on our inpatient service. And amidst the intricacies of inferior vena cava filters and community-acquired MRSA, I get to reflect on the health of our hospitals. Without further fanfare, here are my current top ten gripes:

1. I wish they would get rid of the ads, billboards, and marketing. Do you really pick your “heart hospital” on the basis of a catchy jingle or being in the top 100 in Mad magazine’s survey of area health care facilities? Maybe if the gruel that was served was edible (go to number 10).
2. No rooms or amenities for families. I really feel sorry for patients from out of town.
3. Patients are scattered throughout the facility, and places never meant to house inpatients are being used for “overflow.” And we haven’t even hit influenza season. The gift shop will be pressed into service next.
4. Patients get discharged too early (we had one patient allegedly discharged directly from a local ICU before being admitted). And discharge planning is still haphazard and rehabilitation guidelines too restrictive. I guess you just can’t charge enough for social services and physical therapy.
5. Want the records from a primary clinician’s office—tough luck. Critical information barriers remain the rule, not the exception.
6. Despite the promise of informatics, it’s almost impossible to get health care information at the bedside—I either traipse out to the computer or pray that the latest wireless “solution” doesn’t decimate my PDA.
7. Have you ever tried to get anything done on a weekend, let alone a long holiday weekend?
8. You ever ask a nurse about a patient and get a blank stare? Nurses no longer have time for patients; they are too busy slaving on their documentation.
9. Why should patients and family pay for the privilege of parking? Don’t they get enough revenue from those $10 aspirin?
10. Does anyone actually eat hospital food? The phrase is an oxymoron.

While I am sure there are more innovative hospitals, and solutions to these issues, I doubt my experience is unique. Guess I’ll saunter down to the doctor’s lounge and indulge in a cup of coffee and a sweet roll: despite the increasing competition, changing health system networks, and focus on patient safety, “Plus ça change, plus c’est la même chose.”