Good learning from bad hospice

I strive to be positive in a field with where shortcomings are often hard to ignore. I’m very fortunate to work for a hospice with ethical and supportive leaders who empower us to do good work.

Interacting with the hospice that served my grandfather up to his death, unfortunately, reminded me of the importance of helping bring about some change in our field.

My grandfather was a truly forgiving man, but he knew forgiving didn’t mean forgetting. Instead, he valued learning from experiences. When things went wrong, he’d contemplate what approaches would promote a better or more just experience. Borrowing his attitude, I’ll refrain criticizing the hospice that served him, beyond acknowledging the errors as lessons.

Hospice failures remind me of two things. First, they remind me of what is important to do well. For example, the failure of the hospice serving my grandfather to communicate with my Aunt in a reasonably accurate or timely manner reminds me just how important it is for team members to communicate with families sooner than later. And when the team member who the family is expecting to hear from is overwhelmed with other tasks, then it’s important for other team members to cover down and contact the family, and even if we can’t answer the specific questions of the moment, we can reassure the family that we haven’t forgotten about them.

The second thing that hospice failures remind me to do is appreciate good teamwork and service. My team communicates at a high level, and since we are constantly communicating, it is easy to take it for granted. But the hospice that failed to serve my grandfather well (shall we call them Mortem Hospice instead of their real name so they don’t feel directly threatened by these articles?) reminds me to appreciate good team communication.

Learning #1: Importance of communication

My first contact with Mortem Hospice was an after-hours request for information. The person answering didn’t know the answer, but tried to change the subject, instead of direct me to someone who could answer. I didn’t get the info I was seeking until I called again the afternoon of the next day. My hospice would have had an on-call administrator call back right away to discuss the question.

Then, Mortem failed to communicate with my aunt about what to expect. Even after they admitted my grandfather, she had no idea when anyone would arrive or what his plan of care would be. Calling their main number didn’t get her the clarification she was seeking until I called them and complained. When they finally did tell us when someone would be showing up to provide my grandfather with care, the timing was grossly misrepresented. The receptionist told me the social worker would show up in 30 minutes, but a couple hours later she told me she never gave an estimated time of arrival.

Appreciating the good communication at my current agency

The hospice I work for routinely communicates quickly and reliably, and my experience with Mortem Hospice reinforces how important good communication is. Anyone calling the hospice I work gets a warm greeting and a credible response. The receptionists pledge to pass on the message being communicated or the request for information. Office staff always email field staff quickly with these messages. My supervisors and our RNCMs either take my calls or follow up with me when they can. I tell patients and their family members when they can expect me to show up or call, and if I need to adjust my schedule, I let them know. Noone is left hanging. Team members express appreciation for each other and make sure they have the information they need. And while there are imperfections, they are forgivable.

This kind of communication creates a better experience for patients, their family members, and team members. Good communication requires a trusting and respectful organizational climate, and it also helps keep the climate positive.

Quick and reliable communication is a prerequisite to good hospice service. If communication is lacking, as Mortem Hospice demonstrated, good service is impossible.

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Religious chauvinism in hospice

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Why hospice social workers should attend deaths