I guess we left compassion off the checklist

Dr. Dena Rifkin, a nephrologist at UC--San Diego, has a piece in this morning's New York Times that reminds us that there's more to good hospital care than appropriate documentation and following the myriad rules promulgated by regulatory agencies. She describes the hospitalization of a relative whose care met all the standards but was characterized by inattentive doctors and nurses. As she puts it, we've gone from treating patients to satisfying the system.

She writes:  "As we bustle from one well-documented chart to the next, no one is counting whether we are still paying attention to the human beings. No one is counting whether we admit that the best source of information, the best protection from medical error, the best opportunity to make a difference — that all of these things have been here all along. The answers are with the patients, and we must remember the unquantifiable value of asking the right questions."

This essay is important for those of us who work to improve the quality of health care. As a hospital epidemiologist who has spent an entire career trying to prevent healthcare associated infections, I think it is important to acknowledge that an infection-free hospital stay is not necessarily the be-all, end-all. Infection control is only one component of a successful patient care encounter, and yes, sometimes infection control is trumped by something more important to the patient.

Thanks to Dr. Rifkin for reminding us that even when every box on the checklist is ticked, it's not enough. In 1925, long before The Joint Commission came along, Francis Peabody taught that "the secret of the care of the patient is in caring for the patient." And so it was. And so it is.


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