Monday, January 11, 2010

Three clicks and you're dead

There is a maxim in website design--"three clicks and you're dead." This design rule means that if any user has to navigate through more than three different links, you are likely to lose them.

It's time to apply this to health care.

My 80-year-old father was taken by ambulance to Yarmouth Regional Hospital (45 minutes away from his home) a week before Christmas. The problem--gall bladder--was diagnosed very quickly, and a surgical remedy agreed to on the spot. Then Dad reminded them that he has had clotting problems during most surgeries. In their patient-centered way, they did all the blood work and sent it off but, since it was one week until Christmas, it never came back. He was "stabilized" and sent home on Boxing Day...click one.

On January 4th, he suffered a second attack at home and was rushed back to Yarmouth. Again, they stabilized him and, since the blood work results still weren't available, decided to send him to Halifax for  surgery.  Four hours by ambulance and he was into an admitting crisis at Capital Health. He was given a bed eventually, dog-tired from the trip and hours of waiting...click two.

After several futile trips to the operating room--and several days of no solid food--he finally had surgery on Friday and, despite the haphazard care of the past two weeks, it went well. He was sent back to his bed at the Halifax Infirmary site. The challenge then became how to get him up and moving. The moving part was solved Sunday, when he was shipped across the city to the old Victoria General site...click three.

Now, more than a little confused by being moved time and time again, Dad found himself in a bed that may or may not be his for a few days and was finally faced with the challenge of cooperating in a regime that might get him home again. Except, being of full mental faculties, he is understandably sceptical about any advice his health care team might offer and therefore no longer fully cooperating in his care.

This is a fiercely independent man, who worked as a minister, teacher and union activist. He and his partner--now living in an institution in the last phases of Alzheimer Syndrome--raised four children who all went on to university and successful professional careers. He is as mentally acute as he was at age 30, looks after himself and has a wonderful private care-giver who will care for him if and when he ever escapes our health care system.

His family awaits click four and hopes that, unlike websites, 80-year-old humans can survive the poor design of our health care system.