Looking for Continuity of Care.

LWW/JNCQ JNCQ-D-16-00190 February 3, 2017 J Nurs Care Qual Vol. 00, No. 00, pp. 1–2 c 2017 Wolters Kluwer Health, Inc. All rights reserved. Copyright Commentary In this commentary a patient describes his recent hospitalization and need for better continuity of care. Looking for Continuity of Care Steven P. Segal, PhD W HO is Dr Jason Lo? Dr Lo was listed as my physician on the whiteboard on the wall next to my hospital bed, but during the 2 1 / 2 days I was in the hospital, I never met him. While “all’s well that ends well,” there are aspects to my recent hospitalization regarding continuity of care that the health care system needs to address if my experience is at all representative. Day 1: I arrived at the emergency depart- ment (ED) at 4:00 PM and was admitted to the hospital at 11:00 PM , relieved to be finally going to a room. The nurse said the physi- cian listed on the whiteboard next to my bed would be in to see me in the morning. Nurses showed concern, were efficient, and shared important information. All seemed well de- spite the seriousness of what I was informed was a potentially life-threatening condition, a deep vein thrombosis and saddle pulmonary embolism. Day 2: Breakfast seemed surprisingly un- healthy, soggy hash browns. I had been up since 6:00 AM , but Dr Lo had yet to appear. The Author Affiliations: Mental Health and Social Welfare Research Group and The Mack Center on Mental Health and Social Conflict, School of Social Welfare, University for California, Berkeley. The author declares no conflicts of interest. Correspondence: Steven P. Segal, PhD, University for California, 120 Haviland Hall (MC# 7400), Berkeley, CA 94720 (spsegal@berkeley.edu). DOI: 10.1097/NCQ.0000000000000246 nurses indicated I needed to talk to him to find out my treatment plan. My blood pressure was higher than I ever remembered: it was 120/80 at my physician’s office before visiting the ED but now was 165/85 (“white coat” hyperten- sion, according to physician friends). At 10:00 AM , I met Dr R. He had read my file, had a treat- ment plan for me, but said I must first see the oncologist. I was surprised at that. I had never been told I had cancer. Did he mean a hema- tologist? He did and apologized, thanking me for the correction. Dr R, however, continued to refer to my impending meeting with the “oncologist” after lunch. He was apologetic when over again I said “hematologist.” Dr H., the hematologist, came in after dinner and outlined the treatment plan. He would put me on a new medication, Xarelto (rivaroxaban), although there could be some issue with in- surance approval. Day 3 begins early: A “masked-woman” turned on my room lights at 6:15 AM . “Wake up,” she said, “I have orders to draw blood.” She came around to the side of my bed and said: “William, how are you?” I told her “I’m not William.” She looked at my wristband and exited the room without another word. At 7:15 AM , another woman entered my room and awakened me, yet again. She said: “Good morning ma’am, I’m here to take vitals.” Upon seeing I was a man, she too left, saying “ex- cuse me.” My nurse came in later, took my vital signs, was quite thorough in checking me out, and was nice and conversational. She told me my Copyright © 2017 Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited. [AQ1]