Change in the air at BMH?
I have not yet met Steve Gordon, the new CEO of Brattleboro Memorial Hospital, but after I wrote to him about a problem I had experienced at a BMH physician's practice, the problem got resolved.
This was refreshing. It was the first time since the Reformer ran my Oct. 5, 2007 op-ed, "Hospital's complaint process needs reform," that I felt a glimmer of hope. In that piece, I had written:
"Patients are naturally vulnerable, and rely on the hospital staff and administration for kindness and protection. To prevent lapses, there must be a trustworthy complaint procedure."
The BMH written complaint policy expresses a similar sentiment, but there were times when I had to question the actual reality. Recently, despite a previous unsatisfactory experience with the hospital's complaint process, when a BMH physician improperly discarded medical records in his care and would not discuss it other than to claim that he had done nothing wrong, I filed a complaint.
As had happened before, my complaint was quickly rebuffed. I appealed to Mr. Gordon. This time the result was different. Mr. Gordon reassigned the complaint to Practice Manager Kate McGinn, who made an appointment to speak with me.
My wife and I arrived at the appointment, hopeful, but somewhat apprehensive. Ms. McGinn, assisted by Gwen Mousin, practice director, greeted us. McGinn's sincerity put me at ease. She treated us with genuine respect, by which I mean she confronted the facts with complete honesty.
In the end, McGinn apologized for BMH, went to great lengths to locate and duplicate copies of the destroyed records at no cost to us, and thanked me for making the complaint. She explained that BMH had recently taken over a number of medical practices and needed to establish uniform procedures. She said that as a result of my bringing the problem to their attention, BMH was working to improve guidelines for the handling of medical records.
Was I dreaming? BMH was thanking me for filing a complaint?
Recent press releases reveal that the hospital has made changes to their complaint procedure, and is working to improve quality of care. There is now a patient experience coordinator to serve as liaison to assist patients "with unresolved complaints or grievances that have not been satisfactorily addressed by the provider or staff involved."
BMH has announced that they have hired a director of organizational improvement and announced that he will work on, "developing quality improvement teams for specific 'service lines' within the hospital." It took courage for BMH to embark on an improvement campaign, even though such a campaign is an implicit admission that there are serious problems.
The improvement campaign has focused on the new Emergency Department, and the quality of care that people experience there will be of critical importance in determining whether or not BMH is able to improve public confidence.
When I had a heart attack 10 years ago, the ER quickly got me stabilized. The physician's communications skills were a bit unpolished, but he kept me alive, so no complaint.
On another occasion five years ago, I had to go to the ER with an acute problem, facing emergency surgery.
Dr. Thomas Lewis left a family picnic on this beautiful Sunday afternoon, driving 40 minutes to come help me. Thanks to his skill, he was able to execute a tricky maneuver which got me stabilized, thus allowing me to schedule the operation as elective surgery. Dr. Lewis is a mensch. In his hands, exceptional care was not a public relations slogan: It was a reality.
Exceptional care does occur at BMH because there is a high proportion of wonderful physicians, nurses and staff. But consistency requires proper training and procedures.
In addition to training and procedures, senior leadership must safeguard the complaint process so that patients understand that recourse is fair, and that they have a responsibility to help the hospital make improvements by bringing problems to the attention of hospital officials.
When people grumble but do not seek redress, the reasons are usually that they do not expect their complaint to be listened to and addressed seriously, and they fear stigmatization. Retaliation is not always visible.
If the value and integrity of our hospital's complaint process is to be guaranteed, it is essential that senior leadership show zero-tolerance for "water-cooler" gossip about any patient. No physician or staff member should have any notion that senior leadership will respond to such behavior with a wink and a nod.
It is encouraging that the current leadership at BMH is taking concrete measures, striving for excellence rather than merely using "excellence" as a public relations slogan. It is important that people feel confidence in the hospital and know that it is safe to raise concerns.
The CEO cannot be present at every bedside and examination room, but he does make policy and set the tone. Steve Gordon seems to work quietly and intelligently. So far I am cautiously optimistic.
Steven K-Brooks writes from Brattleboro.
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