The small tools that make a difference…

Recently, one of my closer relatives was taken into hospital. She was admitted to the stroke ward at a hospital in Sweden, and I found myself being very much in charge of her well being. However, this turned out to be a much more difficult issue than it could have been had only the apropriate IT-support been installed at the hospital. This became even more clearly shown now, when the pandemic delimits personal visits at the ward.

So, what IT-support would have been useful then? Was it the “machine that goes bing” in the movie by Monty Python? Or was it some more elaborate type of measuring device or what was it. Well, none of that, actually. The IT-support I refer to is also often referred to as communication support. Although it did start with the phone, that is also not the problem per se, as we shall see. Let me give an example of the problem by relating what happened during the last week.

When I heard about my relative (let’s give her the name Sara, for convenience), Sara was taken into emergency reception on an ambulance, we were naturally very concerned about what had happened. Finding this out was not very easy, at all. She was in the emergency ward for quite some time, before being transferred to the stroke unit. During this time, it was tough to reach out and get any information about her status. I can understand that people are very busy at this place, often dealing with matters that are really about life and death. However, it was even difficult to get to know where she was.

Once she came to the ward and got the number and contact information the next day, it became a bit more difficult. Sara was conscious and awake, and she had her mobile phone with her. Luckily so, since the telephone to the ward was only open for calls after 11.30. So, I called her and we were talking about what had happened when I noticed that she was not connecting. What came out of her mouth was more or less gibberish. She had some kind of seisure or mental lapse. Still, it seemed that she could understand what I said to her to some (very limited) extent. So I tried to get her to press the alarm button and call for a nurse, to get help and talk to the nurse about what happened. To actually get her to push the button, which she really did, took the better of five minutes. When the nurse came, however, Sara turned off the phone and didn’t answer again.

After some twenty minutes when she did not answer, I naturally became very concerned. When she finally called, she was more or less her old self. But she had no idea about what had happened, and neither did she know why she had not answered the phone. So, I said I would call back later, and that she would get some rest. When I finally could contact the ward, they told me what had happened, and what treatment she was getting, as well as that she “was responding well to the medication.” They were very nice and helpful, so no shadow should fall on them.

Still a little worried I tried to call her the next morning again. Now the same thing happened. She becomes non-responsive and when she said anything at all, that did not make any sense. I could not even get her to use the emergency button this time. When she did not reply at all, I tried to call the direct number to the ward, in order to tell someone that she had this seisure again. Well, of course, the ward telephone was not in use before 11.30 and it was now about 9.

So, what do you do in such a case? I called the main telephone switch/reception. I told the person that I had to get in touch with someone at the ward, and described the situation. The telephone operator told me that “They don’t reply on the phone until 11.30!”. Fine with me, so I asked her if she could relay a simple message about that the patient, i.e., Sara, seemed to have a seisure while I was talking to her and that someone had to check in on her. What did she say in response to that?

“Sorry, I can’t get any message to them until they open the phone at the ward.”

That ends my story here, but actually, the story continued with communication problems throughout the week. Whenever I was connected to the personnel at the ward, it was a positive experience. But to get there? A real nightmare.

So, from this perspective, what is this critical piece of necessary software? It’s not the “machine that goes bing” or some other very advanced system. It is the possibility to actually send notes or messages around between different parts of the hospital. This was noted when I visited a ward at the Academic University Hospital in Uppsala, but then it was mentioned mostly as a problem of contacting personell at other hospitals. However, I could not in my dreams imagine that the telephone operator would be unable to even forward a real emergency message to a ward as long as they don’t have their telephones open.

In my perspective, this runs back to one of the things I noted during the visit at the ward I mentioned above, namely that the infrastructure lacks a dedicated communication/note-taking system that is explicitly designed for the hospital environment. Standard phones or tablets are not well designed the work in hospitals, and they lack many features that would make the work more seamless. In a way, it is possible to say that the small things that are often taken for granted may be just as important as the large expensive equipment that the person needs to handle. Simple dedicated communication systems would be such a supportive tool, that could enhance the hospital environment for both the personnel, patients and relatives.

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