In this MedPage Today’s post, Alan Canto, MD gives a clear case from a medical professional’s standpoint regarding nursing home quality of care.
Citing this New England Journal of Medicine (NEJM) article about burdensome healthcare transitions, Dr. Canto goes on to state that the observations made in the article are not even mildly surprising to those who work in the field.
Dr. Canto goes on to relate some of his personal experience:
My personal real-world experience suggests that nursing home residents’ medical interventions begin with phone tag with the attending MD, progress to phone consultation with the attending MD, proceed to trialed phone orders from the MD and, inevitably, end up with the order: “Ship by ambulance to the ER.” It differs from physician to physician, as to how many calls from the nursing home nurse will be required, before the “Ship by ambulance to the ER order comes, but come it will.
What almost never comes, however, is the doctor to the nursing home—for evaluating the patient, documenting his evaluation and treatment plan within the chart—and, by so doing, sharing with the nursing home nurse the responsibility for the outcome of the patient. And so, within our nursing homes, almost any acute or subacute change in a patient’s medical condition—especially if occurring on the eleven to seven shift—generates “the perfect storm” for blowing the patient out of their familiar and secure environment, into the frenzied milieu of the nearest hospital ER.
The article is interesting reading for the insider view that is provided by Dr. Canto and certainly helps to forward the dialogue of Right Care’s mission.