[capecoralbill]

I was in a semi private room after my 'outpatient' surgery in December 2017 , but I had to wait 4 hours to be discharged by the admitting physician. They do have bottlenecks over there.

[Bonny]

I was admitted to the hospital twice in the last couple of weeks.
People need to realize that everything, including discharge is a process involving many different medical personnel in the hospital.
"Dillywho" pretty well hit the nail on the head, so I won't repeat any of that.
The ER was packed and it did take a bit to get a room, however, in the meantime, I had very good care in the room I had in the ER & wonderful care, as always, while in the hospital.

[billethkid]

All descriptions of "process" are reasonable explanations.

However, there is no doubt the archaic, multi level approval....when available, does lack efficiency.

I personally believe current communications technology already residing within the hospital systems could easily accommodate improvement in the discharge process.

Further, I suspect the approval redundancy has much to do with litigation avoidance and billing and not much to do with efficiency.

The process for sure could stand to be improved.

[MrGolf]

I had the same issue with discharging so I signed an AMA (against medical advise) and checked myself out. That was after waiting almost 5 hours for the hospitalist to return from Leesburg to sign me out

Originally Posted by billethkid

All descriptions of "process" are reasonable explanations.

However, there is no doubt the archaic, multi level approval....when available, does lack efficiency.

I personally believe current communications technology already residing within the hospital systems could easily accommodate improvement in the discharge process.

Further, I suspect the approval redundancy has much to do with litigation avoidance and billing and not much to do with efficiency.

The process for sure could stand to be improved.

Couldn't have said it better

[dbussone]

Originally Posted by MrGolf

I had the same issue with discharging so I signed an AMA (against medical advise) and checked myself out. That was after waiting almost 5 hours for the hospitalist to return from Leesburg to sign me out

If the Hospitalist is NOT your attending MD (he/she is not the primary determinant of your care) his/her orders are subservient to the physician who admitted you. The admitting physicians discharge orders take precedence and you have no need to wait around. The Hospitalists are agents of the hospital and are not ultimately responsible for your care unless your admitting doc gives them that authority.

The hospitalist is primarily there to make sure that your care has met the standards required for reimbursement.

Learn to become your own advocate. SPEAK UP!

Another bottleneck in the care provided locally that is easily fixed.


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[Hancle704]

What if the admitting doctor was the ER doctor?

[CFrance]

Originally Posted by dbussone

If the Hospitalist is NOT your attending MD (he/she is not the primary determinant of your care) his/her orders are subservient to the physician who admitted you. The admitting physicians discharge orders take precedence and you have no need to wait around. The Hospitalists are agents of the hospital and are not ultimately responsible for your care unless your admitting doc gives them that authority.

The hospitalist is primarily there to make sure that your care has met the standards required for reimbursement.

Learn to become your own advocate. SPEAK UP!

Another bottleneck in the care provided locally that is easily fixed.


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And good to know this information, db. We had a similar problem two summers ago. But where does one go (besides you, and thank you) to get such information? It could have saved us a few hours. Plus I'm wondering what else we don't know that could speed things along.

[dillywho]

Bottom line is, patients not going home take precedence. You have probably been there at least one day, possibly more, so what is a few more hours?

As for the physician not showing up until after he had seen all his office patients, would you be a happy patient in his office if he didn't? People here already scream loud enough at the doctors office about taking too long to be seen. Medicine is not fast food nor should it be handled as such. Every patient is important to the doctors, nurses, ER, first responders, etc. Otherwise, none of them would be in the business of putting up with the abuses they endure on an almost daily basis. They know you don't feel well and would most certainly prefer to be elsewhere and cut you some slack. How about doing the same for them? Until the day comes that all phases of medicine can be one on one, then we just have to live within what we have. I certainly cannot fathom ever having that day, but who knows. People once thought of travel to the moon and back impossible.

[billethkid]

Originally Posted by dillywho

Bottom line is, patients not going home take precedence. You have probably been there at least one day, possibly more, so what is a few more hours?

As for the physician not showing up until after he had seen all his office patients, would you be a happy patient in his office if he didn't? People here already scream loud enough at the doctors office about taking too long to be seen. Medicine is not fast food nor should it be handled as such. Every patient is important to the doctors, nurses, ER, first responders, etc. Otherwise, none of them would be in the business of putting up with the abuses they endure on an almost daily basis. They know you don't feel well and would most certainly prefer to be elsewhere and cut you some slack. How about doing the same for them? Until the day comes that all phases of medicine can be one on one, then we just have to live within what we have. I certainly cannot fathom ever having that day, but who knows. People once thought of travel to the moon and back impossible.

Yes there are issues/problems/etc/etc.
However to "...we just have to live within what we have..."
Such a statement can only be valid with the assumption that what we have is the best it can be under the current capabilities/schedules/circumstances/etc.

Many of us KNOW from experience, that is not the case.

[graciegirl]

Originally Posted by billethkid

Yes there are issues/problems/etc/etc.
However to "...we just have to live within what we have..."
Such a statement can only be valid with the assumption that what we have is the best it can be under the current capabilities/schedules/circumstances/etc.

Many of us KNOW from experience, that is not the case.

I thought Dillywho's post was the best and most valid.

Our youngest daughter, now 52 was first diagnosed at the Cleveland Clinic when she was 18 months old and she began frequent hospitalizations for issues related to her congenital heart problems that slowed down when she had open heart surgery at 16. (That was the dawn of the heart lung machine and skill that brought her living through that kind of surgery to better than 50-50 odds. ) Every time it was time for release was a wait. I remember it well, she was a little munchkin and wanted to get out of there and there was still (I now see) procedures that made us have to wait. This happened time and time again

The reason we consult the medical community and rely on them is because they are experts at what they do. We don't know if our electrolytes are stable or if our last lab tests have been looked at. We don't know how long we need to be breathing "room air" before we can exit stage right. Etc. etc. etc.

I know that some lags at being released are avoidable but ............sometimes we just have to exercise Patience Grasshopper. The world does NOT revolve around us. There are sicker people there who are probably holding up the works. I can't tell you how many code blues I heard when I was recently hospitalized.

[graciegirl]

Originally Posted by dillywho

Bottom line is, patients not going home take precedence. You have probably been there at least one day, possibly more, so what is a few more hours?

As for the physician not showing up until after he had seen all his office patients, would you be a happy patient in his office if he didn't? People here already scream loud enough at the doctors office about taking too long to be seen. Medicine is not fast food nor should it be handled as such. Every patient is important to the doctors, nurses, ER, first responders, etc. Otherwise, none of them would be in the business of putting up with the abuses they endure on an almost daily basis. They know you don't feel well and would most certainly prefer to be elsewhere and cut you some slack. How about doing the same for them? Until the day comes that all phases of medicine can be one on one, then we just have to live within what we have. I certainly cannot fathom ever having that day, but who knows. People once thought of travel to the moon and back impossible.

Bumping Dilly's post. She has much reason to know of what she speaks.

Originally Posted by dillywho

Bottom line is, patients not going home take precedence. You have probably been there at least one day, possibly more, so what is a few more hours?

As for the physician not showing up until after he had seen all his office patients, would you be a happy patient in his office if he didn't? People here already scream loud enough at the doctors office about taking too long to be seen. Medicine is not fast food nor should it be handled as such. Every patient is important to the doctors, nurses, ER, first responders, etc. Otherwise, none of them would be in the business of putting up with the abuses they endure on an almost daily basis. They know you don't feel well and would most certainly prefer to be elsewhere and cut you some slack. How about doing the same for them? Until the day comes that all phases of medicine can be one on one, then we just have to live within what we have. I certainly cannot fathom ever having that day, but who knows. People once thought of travel to the moon and back impossible.

The issue for me is not having to wait a few more hours but patients in the ER waiting for a bed and patients waiting to get in the ER because of the backup. As was said there has to be a better way.

[graciegirl]

Originally Posted by fw102807

The issue for me is not having to wait a few more hours but patients in the ER waiting for a bed and patients waiting to get in the ER because of the backup. As was said there has to be a better way.

Patients in the ER have a bed and a small room once they are seen at TVRH.... But it is a room and you are constantly watched. ER's all over the country are clogged and there are waits due to the severe flu and here it is worse because people get sicker because they are away from their primary care physician and end up in emergency. It is still Triage. Breathing emergencies are number one...Cardiac and severe bleeding next. Pain is awful but not always life threatening. Sometimes we have to try and see outside the awfulness that is happening to us.

Emergency rooms are jammed everywhere and some of it is because people do not consult a physician when they aren't THAT sick.

long waits in emergency room. - Bing

Originally Posted by graciegirl

Patients in the ER have a bed and a small room once they are seen at TVRH.... But it is a room and you are constantly watched. ER's all over the country are clogged and there are waits due to the severe flu and here it is worse because people get sicker because they are away from their primary care physician and end up in emergency. It is still Triage. Breathing emergencies are number one...Cardiac and severe bleeding next. Pain is awful but not always life threatening. Sometimes we have to try and see outside the awfulness that is happening to us.

Emergency rooms are jammed everywhere and some of it is because people do not consult a physician when they aren't THAT sick.

long waits in emergency room. - Bing

That does not mean that there isn't a better way. If everyone just accepted things as the way it is then we would still be getting around in a horse and buggy. There is always a better way it just takes someone to discover it.