I am completing an outpatient placement that is focussed on treating older patients who are at risk of further injury after history of falls. The nature of the challenges that these patients face with everyday life was highlighted to me with a treatment session last week.
During our morning meeting I was allocated Mr A to treat and informed that he has mobility issues, a history of falls and is considered a ‘wanderer’ due to his short term memory loss. Given this situation it had been arranged that his wife assists him into a taxi and then phones us to let us know he is coming so we can meet him and assist him to the treatment gym.
On this particular day Mr A was booked in for an 11am appointment but the taxis regularly drop patients early so I had to ensure I was free to treat Mr A from 10:30. Mr A arrived at 11am and we completed a productive session that lasted approximately 40 minutes. 15 minutes prior to the end of the session I phoned the taxi so that we could minimise the wait at the end of the session.
However the taxi was running late and did not arrive until 12:20. Given that Mr A was not safe to be left on his own I was needed to stay with him to ensure that he did not wander from the pick up point.
The timing of this treatment session meant I spent longer organising to see the patient than I actually did treating, which is quite a change from my recent musculo outpatients clinic. However I had plenty of paper work to do and was able to spend my time efficiently while waiting for the taxi. In that time Mr A explained to me that he had been ready from 9am waiting for the taxi and found it frustrating he spent so much time waiting with control over what he can and can’t do.
Given that patients like Mr A can sometimes have three visits a week to the hospital for various appointments, the inefficiencies in the system mean that so much of the patients time is spent in transit compared to the actual reason of their visit. In our clinic we try to be flexible with our treatment times and dates so that we minimise the amount of trips a patient has to make but sometimes this is unavoidable.
This experience had highlighted to me the need for us as health professionals to be an advocate for the patient so that delivery of services through appointments can be better managed for the patient and those who are responsible for their transport.
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This is very true. I guess because we spend so much time with patients we tend to find out these little bits of info. I think that within reason and where possible it can only serve to build rapport by acting on them.eg changing appt time etc
On my rural placement I was amazed by how many home visits were conducted, especially in paeds. There would be a lot of organisation involved in bringing a child with a disablity to the hospital, especially if it had to be via public transport, whereas the therapist could jump in the car and be treating them at home within minutes, so it made much more sense. Often the children were much happier at home as well. This obviously isn't a viable solution in this situation, especially in a metropolitan area, but is just an example of how we can make the lives of others so much simpler, just by doing something so little.
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