PATH ALONG Sedation Scope Missing Time

The patient has been sent to the hospital for a scheduled outpatient colonoscopy.  This procedure involves sedation and insertion of a flexible tube with a camera.  Pictures of the intestine wall are taken and small growths are tweezed and  placed in a container. 

The over identified pattern of similarity in all procedures (endoscopy, sigmoidoscopy, colonoscopy) using sedation is missing time.  The administered medication creates a state of amnesia so the patient does not remember the treatment visit.  The medication prevents the patient from remembering the past. 

A sheet of camera images are printed out to show the patient what the provider has spotted on the bowel wall.   The provider discusses their immediate findings. The patient views the camera images with the provider and the tweezed growths are shown as being on the way to the lab for further testing.   During this post procedural consultation the patient is in a state of light sleep and will not remember the experience.

The drowsey patient is transported by wheel chair from the out patient floor to the hospital exit.  Staff assure they will call the patient with the date and time of the scheduled primary provider visit.   An arranged ride is required as the patient would not be safe to drive.  The discharged patient is hungry.

The out patient hospital staff call to tell the patient her follow up appointment with the primary MD is in 4 days at 9am.  The hospital staff instruct the patient to write this information on a post it note immediately so as not to forget.

 The patient attends the scheduled primary provider visit.  The first question from the primary MD is please tell me in detail what was discussed after the test with the scope.  The patient responds, the last thing remembered was my ride pulling in to the subway parking lot to get a sub I could take home.  I was so hungry. 

Outpatient procedures have become proficient in strategies to move the patients through the process.  The value to information being presented to this patient population for the purpose of continued care is in question.  If the sedation inhibits memory  storage and recall, the communication has not been effective.

PATH ALONG staff are trained to compensate for the missing time and assure the patient is accessing the needed care.  PATH ALONG is an original Wisconsin model that connects inpatient providers with community staff who support the patient during health system transitions.  For more information check out the site below with free access
http://www.homecarepath.com/Pages/PRESSRELEASEOriginalWisconsinModelToReduceHospitalReadmissionRates.aspx