In response to poor HCHAPS scores and declining revenue, St John’s in the Valley has become the first hospital in the nation to trial a revolutionary concept in healthcare, the “All You Can Eat/Shoot Narcotics Buffet.”
“It’s a game changer,” said hospital administrator Richard Holder. “Our patient satisfaction scores shot through the roof. It seems patients don’t care about medication education, cleanliness, quietness, or communication with doctors and nurses when their access to Dilaudid is unlimited.”
The first drug buffet was opened last Monday on 4SW, the Med Surg Unit. According to Holder they selected 4SW for the test of change because an audit of the EMR revealed that the lowest acuity patients usually have the highest pain scores. The buffet is next to the nurses station, manned by a single nurse who scans ID bracelets to make sure patients have the requisite ‘Drug Buffet’ MD order. “Most of the patients administer the IV medications themselves,” said Holder. “They prefer to control how fast the Dilaudid is pushed. Which is usually really fast. To be honest, it’s amazing how well these patients know their own veins.”
Almost immediately, they knew they were onto a winner. “The patients are all just so much nicer now,” said Holder. “Especially since we decided to stock the buffet with IV Benadryl too. We get a lot of great feedback about that. Plus, it encourages ambulation. Patients literally leap out of bed in the morning, even those whose pain scores are always 11/10. It’s remarkable.”
“It’s fantastic,” said Brenda Alvarez, a nurse at St Johns for 18 years. “We finally have time for other things, like patient safety. Before the buffet we were all just running around in circles pushing Dilaudid all day. We never had time to do anything else like monitor drain outputs, hang STAT blood orders, change dressings, or respond to monitor alarms.”
Doctors at the hospital are equally thrilled. “I was getting so sick of negotiating Dilaudid doses with my patients,” said Dr. Lisa Hornby, hospitalist. “Even patients with an opioid induced ileus. I tried to explain that narcotics exacerbate these situations and make the pain worse, but none of my patients seemed to care.”
When asked if she was concerned about the alarming rise in the incidence of respiratory distress, intractable constipation, and opioid addiction, Dr. Hornby laughed. “Not at all,” she said. “We are not in the business of healthcare anymore. We are a service industry now.”
Administrators are so thrilled with the success of the drug buffet that they are already working on several other customer service initiatives. “Next month we plan to scrap NPO diets,” said Holder. “We think that will be very popular with our patients too.”
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