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The 7th Attribute - Navigation Assistance

“Health literate health care organizations design health care facilities with
features that help people find their way.”
 
So says the Institute of Medicine’s Ten Attributes of Health Literate Health
 
My Dad  -he’s 86 - was admitted to the hospital last Thursday with chest
pains. My mother and sister sat with him that night. He woke often, agitated
and not knowing where he was,  determined to get out of bed. Friday morning,
mom was exhausted, so I took over the vigil. Dad had another difficult night
that he will not remember, but I will. On one of his many awakenings, he had
removed his gown and ripped off all the electrodes in the seconds it took me
to get to his side. It was a total role reversal with me telling my father he had
to stay in bed.
 
About 4AM, he finally settled into a sound sleep. At 5AM, I let the nurses know
I was going to get some air and would be back shortly.  I exited the main entrance,
breathed deeply, walked across the icy parking lot and back to the door. It was locked.
 
Seeking the Emergency entrance
A sign board visible only from outside read “Exit Only - Enter at Emergency Department”.
But there was no indication where the Emergency entrance is located. I walked more than
a block in one direction until I reached what looked like the the maintenance buildings,
thinking, “It can’t be this far; there must be lights.”  I retraced my steps back to the main
entrance starting to feel the below-freezing temperature and to worry about my safety. I
proceeded in the other direction.  I found another entrance, with the same sign.  I kept
going and found a third entrance, with the same sign. This one had an arrow, but it pointed
into a dark space between buildings - no ER in sight.
 
The locked doors seemed an obvious and important security measure.
But my security was at risk wandering around in the dark and cold. I could easily read and
understand the sign. But it was not an aid to navigation.  I decided to wait it out in my car,
but the keys were in the building.
 
 Lucky for me, before long, I  encountered two nurses coming in for early morning surgeries.
They had a card key and let me in the third door. when I promised not to tell.  They said,
“The ER is waaaay down that way”. One of them started to lead me there. It took a bit to
explain I did not want to go there, I only needed to get in the building. 
 
Easy to be more health literate
This hospital would easily become a more health literate organization by improving its signage
to include ‘navigation assistance”. And by making the Exit only”  signs visible from inside so
they can be seen on the way out.  Then the nurses would not have had to take surgery-prep
time to help me.  And there would be less risk of incidents that no one wants to happen. As
a former hospital public relations officer, I know all sorts of untoward events might have
occurred out there in the parking lot.
 
This hospital would score well on most of the Ten Attributes.  Perhaps this is a case of assuming
that “everyone knows” where the Emergency entrance is, and that  all other doors are locked
during certain hours.  But everyone does not know. And the ED needs to be easy to find. I checked
again in daylight and still saw no signs for the ED, except from the road.
 
Pretend you are from Mars, and go look at your signage. Can you see it where  you might need it.
Does it tell you how to get where you need to be?
 
 PS Dad is home, recovering well. I am grateful for good care. Nurses rock.
 
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