I worked in health care for 35 years and during that time firmly believed in the value of accreditation for hospitals. I worked hard to ensure the hospitals I was connected with over the years were accredited. I experienced the process from the point of view of a provider, but not a patient. When I look back, I realize that a large part of the process was looking at paper records and ensuring that certain standards were met. Recent experiences make me wonder whether accreditation puts enough emphasis on communication with patients. I also wonder why patients cannot see the results of their hospital’s accreditation review.
In July of 2011, I had prostate cancer surgery in an accredited teaching hospital and thus experienced the value of accreditation from the patient perspective. The nursing care was very good and certainly met standards. The surgery went well and I am happy to report that all the cancer was removed. However, the follow up medical treatment was non-existent.
The surgeon never spoke to me during rounds; never asked how I was or if I had any questions. Apparently there was a resident on the unit, but they never darkened the door of my room. The surgeon did make rounds and spoke to two of the patients in my room, but after speaking to one patient in a low voice, he said to me through the drawn curtain: “I trust you heard that because the same applies to you.” He did not hear my response that I had not heard what was said. One of the medical students who was with him did see me respond in the negative, but just shrugged his shoulders and smirked. Here I was in an accredited teaching hospital with the surgeon and two medical students in the room but, from my perspective, if had I had a cardiac arrest it would have gone unnoticed, as none of them came within three feet of my bed or seemed to care how I was.
After discharge, I got a copy of my health record. The surgical report no doubt met all the requirements of reporting on the standard procedure. On paper, I received excellent care. If an accreditor reviewed my file, he or she would not be able to tell how I was treated on that ward.
I know accreditors speak to some patients when they visit a hospital, but are they seeing enough to really get a sense of what the patient experience is like? If patient experience is bad, is that enough to tip the balance on whether or not a hospital gets accredited? If a patient has a problem, why do they speak to someone at the hospital and not the accreditation agency? And hospitals always know when they are going to be accredited, giving them the chance to gear up beforehand – are the standards maintained during the 2 to 3 years between accreditations?
Did the fact that the hospital was accredited ensure quality care? To me it did not. After the surgery I basically did not exist as far as the medical treatment team was concerned. While I continue to support the need to ensure our hospitals are providing quality care, I believe our accreditation process may not be putting enough emphasis on the most important thing in healthcare: the patient.