Metaphor : how 'nesting ecology' can inspire great patient centric hospital design
Continuing on the theme of our last blog and building from the Commonwealth survey results as reported by the C.D. Howe Institute, the reality of Canadian ‘healthcare’ is that it is more akin to ‘sickcare’ with a system that focuses its limited resources on reactively handling ‘emergencies’.
While the system’s focus on ‘collision coverage’ has become an accepted metaphor for its’ emergency orientation, patient stories illustrate a darker reality. A ‘collision coverage’ focus means ‘urgent care’ will also take second place to ‘emergency care’. In other words doctors will need to prioritize between ‘collisions’ based on how immediately life threatening the damage to the ‘vehicle’ is. This has the ‘urgent care ‘ patient, unlike the emergency patient, experiencing healthcare as ‘a waiting game’.
To help illustrate what this can mean from a patient experience standpoint, here is a story from a recent patient self-ethnography study. Ted, a previously healthy adult runner comes down with pneumonia and experiences complications that damage one of his lungs. Laparoscopic lung surgery is needed to restore function to the lung and to rule out a possible life threatening malignancy. Ted is admitted into hospital where the only bed is on a surgical ward of older male patients suffering from dementia. Once in the ward, the ‘waiting game’ begins for Ted. Each day he is told surgery will likely happen only to be bumped by more ‘life threatening’ collisions. Ted, eager to avoid contracting more germs and in need of restorative sleep asks if he can play ‘the waiting game’ from home. The answer is no for if he leaves the hospital he loses his place in the queue. Waiting time in the queue can be anywhere from one day to seven. In Ted’s case he waits three full days for ‘urgent’ surgery.
Both ‘collision coverage’ and ‘waiting games’ represent potential ‘holes’ in the healthcare ‘net’ rendering it unsafe. Attaching real life scenarios to the metaphors from patient ethnography bring clarity to the problems being solved and make solutions work tangible.