Patient Access: 9 Things We should Be Measuring

I have enough everyday stress to keep me happy without having someone manufacture it for me. It’s not like I have anything against flying; I just have something about other people flying with me. My wife would argue that I have the same issues with driving. (She and I tend to work similar schedules but we don’t always arrive at the same place at the same time. Sometimes one of us takes too long to put on their makeup, and the other one gets impatient and leaves.) When I think about it I am at my best when I am locked in a room. There I have the luxury of talking to myself with the knowledge that I am talking to an intelligent person.

On this flight I am seated next to the plane’s water closet. The queue my fellow travelers formed in the aisle made me wonder if someone had discovered gold in the WC. The person closest to me was doing the “I need to go sooner rather than later dance,” and her motions made her look like a bear undergoing electro-shock therapy.  Naturally, the queue began to bother me, so I began to charge each person a toll to get by.  The flight attendant informed me that if I continued this behavior that I could kiss my bag of peanuts goodbye and that I would be sent to the US AIR re-education camp to atone for my sins.

Apparently Gilligan had just gotten off the island, and on this flight he was seated across the aisle from me. He snacked on something that looked like trail-mix, but I couldn’t tell what trail it came from. I, on the other hand was eating a croissant from Paris. I tried to convince him that if he held it to his ear that he could hear the sounds of a sidewalk café. He dressed with all of the fashion sense of an accordionist in a Wisconsin polka band. The look in his eyes suggested that he might be the type of person to walk into a Seven-Eleven and take down everyone because the Slurpee machine wasn’t working. 

One summer I was offered a job drawing caricatures in Ocean City, Maryland. I longed for my pad of paper as I scanned my fellow passengers many of whom looked like they had been plucked from the bar room scene in the Star Wars Cantina.

Enough about my day.

In 1958 a group of MIT seniors went about measuring the Mass. Avenue Bridge.  They didn’t have a ruler, but they had Smoot, Oliver Smoot.  The seniors made marks along the bridge, one for every smoot.  The length of the bridge is 386 smoots plus one ear.  Ever since that day, each time the bridge is repainted, the Smoot marks are repainted to ensure they will be around for future generations.

Healthcare seems to enjoy measuring, perhaps because the folks in Washington seem to like reading measurements.  Maybe the time has come to start to think about the cost of all of the things that are not measured.  After all, what are the chances that the people in DC hold the patent on what does and does not need measuring?

Here are a nine examples of what we do not measure that would tell us what people really think about their access experience:

  • The number of people who call the hospital whose calls are transferred because the person with whom they were speaking could not answer their question
  • The number of people who hung up because they grew tired of being on hold
  • The number of people who had to call time and time again to try to get an answer to their question
  • The number of people who were not able to schedule an appointment
  • The number of people who were not able to schedule an appointment in the timeframe they needed
  • The number of people who called another hospital to get an earlier appointment
  • The number of people who asked to speak to a nurse who were given a voice-mail saying that a nurse would get back to them within 48 hours.
  • The number of people who upon getting that voice-mail went to the emergency department


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