Week of Sept. 14, 2020

Did you miss a blog post? Here is a list of the popular posts over the last week!

Week of Sept. 14, 2020https://respiratory.blog/week-of-sept-14-2020/
Patient Experience in Patient Carehttps://respiratory.blog/sept182020/
Simple Hacks https://respiratory.blog/sept162020/
The Forgotten Piecehttps://respiratory.blog/sept152020/
Anxious Coming To The Hospitalhttps://respiratory.blog/sept142020/
Look after yourselfhttps://respiratory.blog/sept112020/
Organizedhttps://respiratory.blog/sept092020/

Farzad Refahi
Sept. 20, 2020

Patient Experience in Patient Care

A lady on headset pointing to a clipboard and stethoscope.

In my opinion, patient care and patient experience are closely intertwined, especially in highly structured, organized and timed clinical settings such as Pulmonary Function Testing (PFT) labs.  I must emphasize that even at PFT labs, patient-focused care is still at the core. 

There are a few simple ways that I try to improve the patient experience at the lab.  

  • I keep my work station neat and clean.  
  • I anticipate the patient’s needs beforehand.  For example, I have the mouthpiece, nose clips, pen, spacer, requisition, PPE ready before calling the patient in. 
  • If the patient has previously been in the lab, I review the previous comments to be better informed.  For example, if the patient is on home O2, I have the wall O2 extension tubing and nasal prongs ready.  Another example is having the forehead probe ready if the previous 6MWT indicated that forehead probe was used during the walk.
  • I try to be on time, if not a little bit earlier.  This gives me the buffer time just in case the patient requires a little bit more time.  If I start the test early and the testing goes smoothly, at least I get a few minutes for a break until the next person arrives.
  • Working in the Greater Toronto Area exposes me to different languages and different cultures.  To better pronounce people’s last names I Google pronunciations.  I know how silly that may sound.  Search “pronounce [insert last name]” and in most cases, you find some useful resources.  I am not particular with the pronunciation of my first or last name, but this may not be the same with others so I put in a minute to optimize customer service for patient care.


What are some of the ways that you optimize customer service in your patient care?

Farzad Refahi

Sept. 18 2020

https://respiratory.blog/Sept182020/

Simple Hacks

From the conversations initiated by yesterday’s post, a few points came to surface. If you want to check out yesterday’s post, click on the following link: https://respiratory.blog/sept152020/
Firstly, we do many things to keep our equipment and clothing clean that we don’t even realize. For example, we use pens all the time and we tend to subconsciously clean them between patients rooms but not even realize it.


Secondly, there are always little and simple steps and hacks that we can adopt to help us along the way. For example, when I was deployed to the ICU, some of my responsibilities, besides patient care, included the preparation and cleaning of some equipment. Here is one simple trick: put a few cleaning wipes in a sample bag and place it beside the intubation kit/glidescope, or even inside/outside of the “procedure” room. This way, the bag is ready to go, and by closing the sample bag, the wipes will not dry out. I recall the number of times I had walked in the isolation room and I use the LAST cleaning wipe in the container! By taking the required items with me, life became more efficient and safe.

Here is an example for the PFT lab setting: I have left a little marker on the countertop so I can easily identify the ‘clean’ and ‘dirt’y side. After using the equipment I put them on the dirty side and that way I don’t have to ever doubt if the item has been wiped clean or not. I have noticed that patients also feel more comfortable and safe knowing that there is a clear cleaning system in place. Yes, a very simple step but on a busy day, it can go a long way.
What are some of the easy step, systems, or tricks that have helped you along the way?

A piece of paper with dirty and clean written on each side of the page.  On the right side of the image is a sample bag with a few cleaning wipes.

Farzad Refahi
Sept. 16, 2020
https://respiratory.blog/sept162020/

The Forgotten Piece

Image of my hospital lanyard as it gets cleaned and hung to dry.

When I think about my routines… Hands are washed frequently throughout the shift. Gloves are thrown out. Gowns are deposited in the basket.  Scrubs are returned to the scrubs-unit.  The shield is returned to the soiled utility room.  “Hospital” shoes are changed and left in the locker room. The rest of the clothing is changed and washed at home.  Cellphone screen is wiped clean.   One item that I tend to forget about is the lanyard! I need to remind myself to wash the lanyard more frequently. This started a whole list of questions…

How often you wash your lanyard? How frequently do wipe the outside of your bags, including the lunch bag?  Any other items I have forgotten about?

Farzad Refahi

September 15th 2020
https://respiratory.blog/sept152020/

Anxious Coming To The Hospital

Image of the pulmonary function testing lab with circular red boarders.

“I am surprised you are doing breathing tests!”

“Is it safe to do this test?”

“It must be very difficult for you to work at this time!”

“Is this clean?”

“Do you reprocess those?”

Roughly once a week, I have a patient who has shown up for their pulmonary function testing (PFT) despite their anxiety about being inside a hospital. They tend to register early in the hospital however won’t come to the waiting area until a minute or two before the required time. They also prefer to stand as they don’t want to sit in a ‘hospital’ chair.
When I guide them to the PFT lab, they seem anxious and need to ask a few questions before they are comfortable enough to do the test.

I know that I wouldn’t be able to start the test until they have the answers and they feel okay to start. Also, it is more difficult to establish rapport with someone who is tense. Performance, accuracy and reproducibility of values are also greatly influenced by an anxious mindset. What I have tried to do is listen and answer as many of their questions as possible. I spend a few minutes talking about the transition of our hospital’s PFT lab, which includes how our hospital shut down the lab until the local rates were low. I also explain that the hospital actively books fewer tests per day so waiting areas don’t get busy and that there would be more time between the tests for cleaning. Inside the body box and all the surfaces that people have touched or been near have been wiped with appropriate solutions. Mouthpieces are not reprocessed and are tossed out after each use.

I understand that we all get busy with our schedules and there is always lots to do. But we need to put in the time and effort to slow down and to actively listen. It is important to not take things personally. The patient is not questioning your care and ability to clean. They are worried about their health and need honest answers and reassurance. Although we spend a lot of time cleaning, the patient doesn’t see that.

I really hope that ordering physicians and clinicians take the time to explain the test, the reasoning, the cleaning process that hospitals and labs perform, and to answer any questions the patients may have. If the ordering clinician is unsure or unfamiliar, I strongly recommend that they contact the PFT labs for more information. I would be more than happy to have clinicians visit the lab so they better understand the process.

What are your thoughts? What steps do you take to make your patients feel more at ease?

Farzad Refahi
Sept. 14, 2020