The Michigan Daily-Wednesday, January 31, 1979-Page 7

STAFF SHOR TAGES, ANTIQUATED BUILDING CITED

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Patients suffer from hospital confusion

(Continued from Page 1) 1U

Fiddian-Green next went to the Bio-
chemcial Division where he found that
its staff had "not received" the
specimen, even though it had been sent
hours before. The doctor was then told
that the specimen had "just arrived"
and the short analysis was finally per-
formed - more than three hours after
the lumbar puncture had been taken.
"I cannot tell you in words how
strongly I feel about the total lack of ef-
ficiency and organization in the han-
dling of my child's spinal fluid," wrote
Fiddian-Green in the letter to David
Dickinson, the chief of clinical affairs,
and Jeptha Dalston, the hospital direc-
tor.
"I HAVE BEEN aware for some time
that there are many aspects of patient
care in the University Hospital which
are grossly inefficient and disorganized
and have had to pacify patients on
many occasions," the doctor continued.
"It is this aspect of care in our hospital
that has recently led me to advise my
family and friends to seek medical care
at St. Joes (St. Joseph Merch Hospital
in Ann Arbor). . ."
Director Dalston, said that problems
of this kind are, in part, inherent to an
institution like 'U' Hospital. "There are
hundreds of thousands of lab tests taken
every day, and we simply don't have
the modern systems that we need to
handle all of them," he said.
Dalston also said that the large size of
the hospital's staff and physical plant
often makes it difficult to coordinate his
workers and that morale is sometimes
low among employees.
IN THE Fiddian-Green case, a lack of
coordination was a major reason for the
delay. "In this particular instance, the
medical technologist did not recognize
that it was a priority specimen and con-
sequently, there was a substantial
delay," said Bruce Goldstrom, the
assistant to Dickinson in clinical af-
fairs.
Goldstrom explained that this is a
frequent problem among the tem-
porary weekend staff who are un-
familiar with the hospital's routine, but
that a system of "checks and balances"
has been employed to help alleviate the
problem.
According to Dalston, many of the
problems involved in the Fiddian-
Green case were a direct result of the
ancient hospital structure. By virtue of
design the new building will be more ef-
ficient, he added.
BUT DR. HARRY Colfer, the
president of the House Officers
Association (HOA) said that the new
hospital will in no way be a complete
cure for the numerous problems that
currently plague the hospital. HOA
represents interns and residents at the
medical center.
"The patient is the focus of the
hospital and that is where the ad-
ministration should be putting their
time and energy," Colfer said. "I don't
think they're doing this. They're
making plans for this grandiose new
hospital and we can't even get people
off the bed pans properly.
"There definitely is a need for a new
hospital," he added, "but it seems that
we ought to be taking care of the other
problems as well."
CONTINUOUS aggravation caused
by these "other problems" even led one
frustrated doctor to comment that 'U'
Hospital "is not a real hospital. The
system is terrible. The place is a
mess," he said.
The doctor, a two-year resident of the
hospital and spokesman for the HOA,
said that he spends an average of 120
hours a week at 'U' Hospital and that
50-60 per cent of that time is devoted to
"secretarial work."
To illustrate his point, the HOA

spokesman described the multi-stepped
process involved in getting an X-ray
taken:
THE DOCTOR must first write up a
special form for an X-ray and give it to
a clerk. The physician must then call
down to radiology to make sure the
department received the form. Next he
has to check to see if the X-ray was
scheduled, and finally, he must make
sure the patient got down to X-ray in
time.
"Either I wheel a patient down to get
an X-ray or it is scheduled for another
day," said the HOA official.
And a reporter's tour of the hospital
revealed that doctors are performing
tasks generally assigned to nurses or
other employees. One doctor, for in-
stance, was frequently involved in
tasks like drawing patient's blood.
COLFER SAID that performing jobs
like drawing blood and changing I.V.'s,
is common among doctors at 'U'
Hospital.

about the disease that could spread as a
result of all the filth. "The bathrooms
were a mess," said Haithman. "Old
patients who were given enemas often
couldn't control their bowels and the
results would make the situation even
more unpleasant."
And a walk through 'U' Hospital on
any given day supports these obser-
vations. The bathrooms are almost
always filthy - the sinks are un-
cleaned, toilets are often broken, and
toilet paper covers the floors, according
to a reporter's observations.
INSPECTIONS made regularly by
the State Department of Public Health
further confirm these maintenance
problems, The last inspection was per-
formed on November 17, 1978 and pin-
points the sixth and eighth floors of the
main hospital as being particularly
poorly maintained. The report said that
some of the major problems were that
patient rooms were blocked and that
floors and walls were unclean.
Tim Hurst, the assistant director of
facilities for the hospital,
acknowledged that there are some
housekeeping problems.
According to Hurst, the main hospital
is difficult to keep clean because it has
so many people gping through it every
day.
40
'When you are short of
staff, you are always be-
ing pushed, and, conse-
quently, you don't feel
like you're doing as good
a job as you could. So you
quit.' -a nurse
HURST ALSO said that when the
hospital contracted with a maintenance
firm called Service Master in the fall of
1977, there was a "considerable period
of getting used to each other. The main
hospital is still in that getting-used-to
period," he said.
Many of these maintenance problems
can, in part, be attributed to the out-
dated structure that houses the main,
hospital. The main hospital is over fifty
years old - 10 years older than the
normal maximum life for a hospital of
its kind - and, consequently is ham-
pered in providing relatively modern
comforts.
According to a University report, the
hospital still maintains huge obsolete

wards where 18 patients share two
toilets. Ventilation is poor, there is no
sprinkler system and no central air-
:onditioning. But these are problems
which have frequently been addressed
by the administration, in reports
detailing the need for a new facility.
THEY ARE problems which
presumably will be rectified by the new
hospital - scheduled to begin construe-
tion in 1980. But the question that still
remains in the minds of many doctors
and staff is whether the extreme inef-
ficiency currently hampering patient
care can be solved by a shiny new
hospital.
Memebers of the HOA feel that the
only remedy to the problem is direct ac-
tion by the administration. "It
shouldn't take a year and a thousand
pages of reports to solve these
problems," Colfer said. "It's something
that someone should apply their mind
to and change next month."
In an attempt to spur such action, the
HOA did threaten to strike earlier last
year over the issue of patient services.
This produced a "favorable, although
non-committal response" from the
University, the HOA president said.
Since then, however, little has hap-
pened, according to Colfer, and the
University has consistently been non-
committal on the problems addressed
by the HOA.

THIS WARD on the sixth floor of the hospital has, only two restrooms available,
according to a staff member. Below, a patient makes his way slowly down the
corridor with the aid of a walker.

Daily Photo by MAUREEN O'MALLEY
given complicated directions for get-
ting there. As a result, they seemed
totally confused as they set off to wheel
Hale through the maze-like corridors of
the hospital.
According to one nurse, the staff
shortage is the result of the hospital's
high turnover rate. The two main
reasons she cited for this high turnover
rate were that the hospital's wages are
not competitive with other hospitals in
the area and that the hospital's "tense"
atmosphere makes it an unpleasant
place to work.
"WHEN YOU ARE short of staff, you
are always being pushed, and, con-
sequently, you don't feel like you're
doing as good a job as you could. So you
quit," the nurse said.
She also said that the constant over-
crowded condition of the hospital also
contributes to the tension. It is not at all
uncommon for a patient to wait six to
eight hours for a bed, making the
situation for the patient and nurse all
the more frustrating, she said.
In an'effort to pinpoint the key areas
of patient dissatisfaction, patient at-
titude surveys have been conducted by
the hospital for the past four years.
THE SURVEYS are distributed four
times a year and generally receive a 30-
38 per cent response. One of the major
areas of patient complaints concerned
the long periods of time spent in the
hospital's admitting area.
In February 1976, the number of
patients who waited over a half hour to
be admitted reached a high of 43 per
cent. In February of last year it drop-
ped to 23 per cent, but as of last May
had risen to 28 per cent.
Another area of patient dissatisfac-
tion centered around the overall main-
tenance of the hospital. Patients
repeatedly shown concern over the lack
of cleanliness in the wards or rooms
and in the toilet and washing facilities.
DIANE HAITHMAN, a student
volunteer at the hospital last summer
who distributed patient attitude sur-
veys, said that patients were worried

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July 2-August 10
Prof. Sonia Lee
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changed every third day," said Colfer,
"but unfortunately, doctors are only
human. If a doctor has been working 80
hours one week, changing 'the I.V.
might get put off and the patient will
suffer. That is not optimal patient
care."
AND FOR ONE. patient, the
seemingly routine procedure of
changing her I.V., became a traumatic
experience:
Sue Johnson (not her real name)
remembers walking down the non-air-
conditioned wards of 'U' Hospital late
one night in the summer of 1978. She
was looking for help.
Johnson, a 'U' Hospital employee,
had entered the hospital for a hysterec-
tomy, but the pain that night was in her
grossly bloated arm where An I.V. had
been inserted incorrectly and had
caused her arm to swell two inches.
THE PROBLEMS began when the
changing of Johnson's I.V. had been
overlooked. As a result, her arm turned
black and blue, making insertion of the
I.V. difficult. After being gouged in the
arm five times by a nurse and once by.
an unsympathetic doctor, the I.V. was
finally in place.
Although the problems with the I.V.
were finally corrected, Johnson said
that she would never go to 'U' Hospital
for treatment again. "Having major
surgery is a traumatic enough ex-
perience. I shouldn't have had to go
through what I did," she said.
ACCORDING TO Colfer, such patient

by doctors and patients involves the
amount of time that patients spend
waiting around as a result of frequent
bureaucratic mix-ups.
WAITING AROUND for extended
periods of time is particularly
prevalent for patients moved for
testing, according to Colfer. "After the
test is completed, for some reason or
another, patients don't get back to the
ward for several hours.
"Imagine yourself being some sick
patient, lying out in some cart in some
god damn hallway for a couple of hours.
Every doctor can think of an instance in
which this kind of thing has happened,"
added Colfer.
In response, Dalston admits that
there are tremendous problems when it
comes to the transporting of patients.
"We move hundreds of people every
day in stretchers and wheel chairs, and
we simply don't have enough people to
move them all."
DALSTON SAID that the com-
bination of a shortage of personnel and
the enormous size of the hospital often
necessitates leaving one patient to
retrieve another. The hospital director
stated, however, that the Hospital
Replacement Project will solve some of
these difficulties. Because the new
hospital will be structurally more effi-
cient, it will be easier to reach patients,
he said.
In the meantime, however, the
hospital's obvious personnel shortages
have severely restricted the staff's

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