Hola a tod@s, my dear friends.
A very interesting reflection was initiated yesterday from Colombia. Arturo Arias raised the following:
“It is true that humanising is an spreading strategy throughout the world, but there are certain details that appear and we had not calculated. And in this era post vacuum, called liquid modernity, this details are very important and more in our very ‘brain-underdeveloped’ countries.
While it is true, open the ICU doors it is very beneficial for relatives and patients… also has a cost: two relatives came into the ICU just twice a day and washing their hands before… Now, four to ten family members come into and all of them wash their hands over and over again…
The manager calculated the new cost of soap, paper, water and light and obviusly, it had increased in a significant way… In our country there is a real crisis in health due to the rotten corruption of the Health promoting companies.. They don’t pay to the hospitals… etc. What can we do?
1. Should we close the ICU again?
2. Should hands not be washed?
3. Should people bring their soap, papers and towels?
4. Should they bring only soap?
Have you had thought about this? Not me, but who pays the fees, for sure…”
And, indeed, this is one of the side effects of humanising healthcare: the use of resources. And for sure, many costs will appear: the need to adapt the structures to make them more comfortable (intraICU or in the living room); the creation of follow-up post-ICU síndrome consultations; ratios of ICU team adjusted to the needs, or the inclusion of psychologists, physiotherapists and speech therapists in teams…
Thinking (or let us try to think) that humanizing health care DO NOT CARRIES A COST or as it has been said repeatedly from some political instances THIS IS ZERO COST, is a great lie.
But, on the other hand, we can turn the discourse and measure the humanising economy in positive:
- A patient emotionally cared could stay less time in the ICU, and much less time in the hospital.
- An accompanied patient could have less chance of delirium, disorientation, requiring less medication for the control of agitation or physical restraints, and thus we could avoid many complications.
- A patient with short stay and minor complications would have less probability of having sequels post-ICU.
- A family satisfied and involved in care would not have why claim or report in according to some situations.
- A family emotinally cared would give the adequate support for a patient who might return to work as soon as possible.
- A motivated, encouraged and cared team by its own institution would have less absenteeism from work and would be more productive.
- When a team had an adequate ratio to their needs, patients recover before; therefore they are discharged sooner.
An architecture and structure humanised would bring benefit to everyone and facilitate the workflows.
And I think that I could follow this list forever…
Having said this, we have to measure and demonstrate it. Perhaps doint this, we would get the investment that is needed for the humanisation, to realizing those who manage budgets the amount of money that would be save looking at things from another point of view: the Dignity of human being. Meanwhile, we keep making visible the invisible: no one can put doors to the sea.