OT 25309 the NHS

[Geoff Parkstone]

When are you getting out then Ol' mucker? Get well soon!

Not sure - maybe end of week, maybe a bit longer

[ramAnag]

Reducing customers is an interesting option. Reducing care standards will deal with that one quickly enough but reducing time wasters at front end in A&E and educating customers that A&E is just that would ensure smooth flow. My experience is very limited but there seemed a lot of people with no clear reason to be there although I accept sight will not always be a reliable assessment

My overriding impression is that there are a huge number of very old virtual veggies staring into space in here (ok I've not been in pediatrics or maternity.) But a more Malthusian approach could ease overcrowding although may not be to my advantage...

I have only spent one night in hospital (aged about 7) in my entire life and (touch wood) hope it stays that way…but, about eleven years ago, my wife was seriously ill and spent 17 nights in the Derby Royal. Treatment at the sharp (operating theatre) end appeared brilliant…at the more routine (recovery) end, more mixed and actually quite poor on a Sunday - hope you’re out by then GP.

My abiding memory however is…it was December and there were a number of elderly people there who simply didn’t want to leave. I visited twice a day, every day…they had few visitors but were warm, safe, fed, watered and generally well cared for with company and no outgoings to worry about. Because there were misgivings about the circumstances they were returning to they stayed…taking up much needed bed space and there seemed little the hospital could do about it. It needs addressing.

[Andy_Faber]

Today's theme - IT.

As I said I've never been an inmate before today but on past visits to friends and family in wards, I remember big offices with patient records, treatment plans etc. Patient notes at the end of the bed, about 1-1 ratio of staff to patients.

Now that ratio is about 2-7 everyone is barcoded and all the readings are zapped onto laptop - bloods, blood sugar, blood pressure, temperature done and recorded in no time at all. A huge change in use of technology, shifting the administrative functions away from the care staff and letting them focus on what they're good at.

You constantly hear of IT issues in the NHS but the use of it at the coalface seems to be excellent. Move wards and everything automatically shifts.

There will always be improvements to make but for now it seems to work fine. The train drivers / rail companies could learn a lesson from IT related efficiencies here.

That (great IT/data integration) is a facet of our GP surgery including the seemingly seamless link with an unrelated pharmacy

[Trickytreesreds]

I have only spent one night in hospital (aged about 7) in my entire life and (touch wood) hope it stays that way…but, about eleven years ago, my wife was seriously ill and spent 17 nights in the Derby Royal. Treatment at the sharp (operating theatre) end appeared brilliant…at the more routine (recovery) end, more mixed and actually quite poor on a Sunday - hope you’re out by then GP.

My abiding memory however is…it was December and there were a number of elderly people there who simply didn’t want to leave. I visited twice a day, every day…they had few visitors but were warm, safe, fed, watered and generally well cared for with company and no outgoings to worry about. Because there were misgivings about the circumstances they were returning to they stayed…taking up much needed bed space and there seemed little the hospital could do about it. It needs addressing.

I quite agree.
In my long stint, there was 4 of us in a bay. The guy opposiite and I had had major gastro surgery and were on nil by mouth and morphine. To my left of me, was a guy in his mid 70's , suffering dementia and he'd been there 5 months, whilst they tried to find him suitable accomodation. The other guy was 93 and in there because his wife had been in 6 weeks and dying. No one to look after him. Pathetic situation.

[Geoff Parkstone]

So first the good news, I've been told the treatments are working and could be home next week. Touch wood.

So today's rant. Ward furniture. The beds - great: I want one at home - I'd never get up. So why is there a big chair next to it? I'd always assumed these were for visitors, but no.

It's all rather sad - patients get out of bed, move a few inches and sit staring into the middle distance. A bit like putting your houseplants into the sun for a few hours in summer. I've never felt an inclination to use the chair but to some it seems a highlight of the day. Maybe there is some psychological nuance to thinking "I'm not in bed so I'm not really in hospital?". Genuinely puzzled - the bed is so good it really makes the chair redundant. Take the chairs out and you could fit an extra patient in the ward.

Nurse workstations - see before re IT - trolley based laptop exceptional. Reduces numbers of fixed workstations and increases bed capacity. But there is a downside as I saw when travelling the hospital for MRI etc. - these work trolleys tend to end up blocking the corridors as staff seem to not be able to work on ward.

It's all about space management and bed maximization and I'm not sure they've got it spot on yet. If there was a fire it might be very difficult manoeuvering bed bound patients out through a labyrinth of work stations, wheelchairs and assorted parked equipment.

You can tell I'm getting bored here, doing amateur risk assessments!

[Trickytreesreds]

So first the good news, I've been told the treatments are working and could be home next week. Touch wood.

So today's rant. Ward furniture. The beds - great: I want one at home - I'd never get up. So why is there a big chair next to it? I'd always assumed these were for visitors, but no.

It's all rather sad - patients get out of bed, move a few inches and sit staring into the middle distance. A bit like putting your houseplants into the sun for a few hours in summer. I've never felt an inclination to use the chair but to some it seems a highlight of the day. Maybe there is some psychological nuance to thinking "I'm not in bed so I'm not really in hospital?". Genuinely puzzled - the bed is so good it really makes the chair redundant. Take the chairs out and you could fit an extra patient in the ward.

Nurse workstations - see before re IT - trolley based laptop exceptional. Reduces numbers of fixed workstations and increases bed capacity. But there is a downside as I saw when travelling the hospital for MRI etc. - these work trolleys tend to end up blocking the corridors as staff seem to not be able to work on ward.

It's all about space management and bed maximization and I'm not sure they've got it spot on yet. If there was a fire it might be very difficult manoeuvering bed bound patients out through a labyrinth of work stations, wheelchairs and assorted parked equipment.

You can tell I'm getting bored here, doing amateur risk assessments!

The chair I agree with. It would be more use if you had a foot rest. I understand the idea to get you moving again, but its really poor. I always found my biggest gripe, was the lack of tv. Especially if there was a match on. You don't even need the sound on.
Then we get to the bloody pay to watch tv's on the wall. Never has there been a more rip off system, playing on peoples misery than that. No every ward has them, but they leave a bitter taste in the mouth when you see them. They aren't even good quality pictures when you consider its the NHS not private, its a dig at the poor in society

[Geoff Parkstone]

I don't think there are any on ward TVs in this hospital, not even in communal areas. Many moons ago I recall my dad was in for something and we took in a 12 inch black and white portable for him. It was the day Wimbledon beat the scouse in the cup final. So that afternoon football was on both channels that he could get - with very grainy scratchiness. He hated football.

[Geoff Parkstone]

The chair I agree with. It would be more use if you had a foot rest. I understand the idea to get you moving again, but its really poor. I always found my biggest gripe, was the lack of tv. Especially if there was a match on. You don't even need the sound on.
Then we get to the bloody pay to watch tv's on the wall. Never has there been a more rip off system, playing on peoples misery than that. No every ward has them, but they leave a bitter taste in the mouth when you see them. They aren't even good quality pictures when you consider its the NHS not private, its a dig at the poor in society

They do really need to pander to the poor in society by having multiple 42" + screens all over the ward walls and in the toilets, instead of all the medical paraphernalia. Make them feel at home but would slow down recovery as there's no incentive to go home. A small branch of Wetherspoons instead of the X Ray room would be good too, next to the smoking area. Paddy Power outlet next to the coffeeshop perhaps

[MadAmster]

Stuff all this communal stuff. In Dutch hospitals, the ones I've stayed in anyway, each bed has its own personal TV/Radio setup.

[Geoff Parkstone]

The difference between easyJet and Singapore Airlines!