“Time passed with no relief”

Karyn Temte Lloyd RN, BSN
Quality Management Coordinator

Feb. 19, 2014

Before I give you this month’s accreditation update, let me share a personal story.

The patient is a fragile 83-year-old woman whose health is failing due to multiple myeloma. She’s close to the end of her life, but not ready to die.

One afternoon while at home in Minnesota with her husband – her constant caregiver and lifelong partner – the unexpected happened: She stumbled and fell, severely lacerating her lower leg. Bleeding profusely, she was taken to the local Emergency Department, where she was stabilized then hospitalized in a busy cancer unit. 

For seven hours she screamed and moaned in unrelenting pain. Her husband and family members who had gathered at her bedside were growing distressed. They pleaded with the busy staff to do something more to control her pain. A nurse assured the family that she’d “spoken to the doctor several times.”

Still, time passed with no relief. A family member calling from out of state finally reached a nurse to request a different intervention for pain control, patient-controlled analgesia. The PCA was ordered and later changed to continuous infusion for comfort.

The following day the patient – my mother – passed away with our family at her bedside. Though her death was peaceful, my father’s memory of her final days is scarred by a deep anguish over seeing his wife in unrelenting, terrible, uncontrolled pain.

It goes without saying that this hospital experience could have been handled better.

For all hospitals, the goal of quality, patient-centered care is to integrate compassion, critical thinking and evidence-based clinical expertise. But even more important, patient-centered care recognizes that we’re not just treating an illness; we’re treating a person and by extension the people who love that person.

Providence’s Loyalty Index (patient satisfaction) scores, which include pain management, are important metrics for highly reliable and exemplary health care and process improvement. Pain scores are meaningful because managing comfort creates a lasting impression of the hospital experience for the patient and family. 

Pain and comfort management can be a challenge on busy days. It requires constant communication with the provider, staff, patient and family with active intervention if the patient is still uncomfortable. But it’s also part of a larger commitment to provide what our patients and families deserve: our best every day. The care delivered by Providence providers, nurses and ancillary staff creates lasting memories, positive or negative. What patient memory will you create?

Accreditation update

  • To ease the way for licensed independent providers and provide access to required education for Providence Oregon’s LIPs, our region is standardizing initial and annual education required by accreditation bodies and governmental agencies. This new process will be rolled out within the next few months and will provide timely access for busy providers.
  • Patient harm and death associated with medical device alarm management and alarm fatigue among staff has prompted a new National Patient Safety Goal for alarms. In Oregon, Sandra Maddux, regional director of nursing practice, will work with an interdisciplinary team to review current processes and develop practice guidelines for patient safety. Watch for update on this important matter in future editions of Pulse.
  • All Providence Oregon Region laboratories will move from the current accreditation body – the College of American Pathologists, or CAP – to Joint Commission accreditation by the end of the 2014. Providence Milwaukie and Providence Willamette Falls had their first Joint Commission survey last month. PPMC, PSVMC, PMMC and PNMC are expected to be surveyed later this year. Providence Core Laboratory in Portland will continue with CAP accreditation.