Being asked the same question 4 times, in 4 days by 4 different people

25 February 2015

A few years ago I went for a pre-admission assessment for planned surgery. The nurse took my blood, weight and blood pressure and asked me a series of questions. Four days later I was admitted. When I arrived, the next nurse came to do me admission assessment. At least half of the questions were the same. I asked why. My assumption was, either that they do not trust what their colleague had written, or they had lost the information. Neither were true, the nurse said that this is just what they had to ask. As a patient, the impact on me was strange – I felt unsafe.  Not just irritated at having to share the same information for a second time, but unsafe. I was trusting my health and body to people who needed to keep asking me the same questions.

On Wednesday I sat with my colleague Emily and we looked at the pre-assessment, assessment, care planning and discharge planning paperwork for a hospital. We have been asked to help streamline their paperwork and make it as person-centred as possible. I could see the same pattern. As we looked through the paperwork it was clear that you would be asked about your home situation (social assessment) at the pre-admission assessment, again at the assessment and then by the OT and the physio. All with slight variations, but essentially the same information. We started this process by asking the nurses and other professionals what is working and not working for them about the paperwork, to see how close we can get to a win-win, of improving it for both patients and staff.

I am pleased to have the opportunity to see if, at least in one hospital, we can change this. To see whether there could be one assessment that different professionals added to, rather than repeated, and one set of progress notes that all professionals added to. I wonder if we can go further than that, and make it something that uses the same language, or as close as possible, as we all use to talk about our health and life. We are looking at whether the discharge planning could include elements of care and support planning too. I am excited about what could be possible, and how this could link with care and support planning in health.

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