VIDUR MADHAV
The Hospital-Patient Interaction
The flowchart describes the broad journey of a patient of a small town in Bihar from the inception of a problem to its cure through a hospital. This is then further explored to extract relevant points of interaction in this journey.
Patient Journey:
The journey of the patient has a strong cultural influence of their experience. Each segment of the experience which is in control of the patient is adapted to suit cultural or religious dimensions. All other aspects of their journey which is controlled by the hospital is completed in a more rational and objective approach.
There is an attempt to mark specific areas in this journey where this cultural and rational approaches to the same experience collide with each other to create specific yet impactful hurdles in the journey.
Points of Intervention:
The impact of family in the patients experience is as large as the patient. The focus of the patients comfort seems to be more of a responsibility of the family than the hospital. From going through the formalities of the procurement of all the small requirements of the treatment, the family seems to play a larger role of interaction with the hospital space than the patient itself.
The two areas of interest chosen from this journey, both show this cultural aspect of the society to a large extent. The next steps are to explore both these areas in a deeper context and extract various interventions possible due to this clash.
Relavant observations:
Electricity Shortage in Hospitals
There are frequent power cuts in small towns and sub urban medical centers. There is power backup in some facilities while the others improvise with part time electrical connections. The backup is generally limited to the ICU, OT and path-lab facilities. Such issues are also faced by the disaster management industry, where there are power cuts after calamities. The instruments which are typically run on power are replaced by batteries and hand held tools. This improvisation is productive for first aid but doctors require enhanced tools for further medications.
Collectivistic culture of society
The families are close knit and generally live together. In terms of health crises in the family, most members travel with the patient to the hospital. When traveling for secondary and tertiary treatments to a bigger town or the nearest city, the family stays in or around the hospital while the patient in inside the ward. Due to expensive accommodation in a city and budget constraints in times of emergency, the accommodation of these members is a big part of hospital management.
Apart from this, the families are also involved in the process of looking after the patient, medicine procurements, interactions with the doctors and completing all the financial paperwork during the treatment. This makes them an integral part of the system, which theoretically does not accommodate these services in its design.
Expectations of patients
There is wide difference in the mentality of patients across cultures and demographics. While in a city, the hospital takes up the responsibility of the patient's well being, in smaller towns the healthcare system is not exclusively responsible for the patients well being. This creates a sense of fear and insecurity about resources, travel and procurement of needed commodities for the treatment. The families and the patient himself feel responsible for understanding the system and the requirement, which when mixed with other factors becomes very hard. Thus, there is less expectation from the system and it is easy to get away with workflow loopholes.