An Emphasis On ‘Quality Care’

Larry Price
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Wednesday - December 31, 2008
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I thought it was interesting that a new rating system was released at the beginning of the holiday season for Hawaii’s nursing homes. It was one of those good-news, bad-news stories. Six of the nearly 50 nursing homes in the state received the lowest possible ranking: one star out of five.

The Federal Centers for Medicare and Medicaid Services created the rating system. It assigns one to five stars for quality of care, staffing and state health inspections, and an overall score.

It’s all a little confusing, because the five-star rating idea is how the hotel industry determines who’s who in the business.


If there is a relationship between hotels and nursing homes it is pretty shallow, because stars have nothing to do with the care and custody of people.

You would think quality of care was the most important star, not state health inspections. One popular rationalization is no one wants to put a family member in a one-star facility.

A silly notions is to seek out a five-star facility when the family can only afford a one-star residence. It’s also confusing because, unlike the hotel industry, just finding a nursing home with space available for patients is a welcome circumstance. After all, the other aspects of the rating system don’t really matter if you can’t find a bed in a nursing home.

Maybe that’s why we have so many homeless people sleeping on sidewalks, under freeways and on park benches - they can’t afford a zero-star facility.

If you ever have to spend a holiday season in a hospital, you will never forget it. Most hospitals are busier during the holidays than any other time of the year. It sets a good example of what quality care should be. The big secret is that you can’t deliver quality care without quality staff.

I had the good fortune of spending such a season in the Queen’s Heart Center. It’s one of my most treasured “forced vacations” ever.

Not only did the doctors and nurses save my life, they reminded me what quality care was all about - not just when someone is watching, but 24 hours a day, seven days a week.

It’s kind of comical, in a way, because after you have open-heart surgery, you don’t really feel like walking around and singing Christmas songs in the hallways. You just want to lie down and try to sleep - the last thing on your mind is helping decorate the Christmas tree in the lobby. The nurses know that, but that doesn’t stop them from making you get up out of the comfortable bed and participate.

To be truthful, I was scared to death when I checked in to the hospital for my “holiday” vacation. Just a couple of months earlier the nurses had a lengthy stay on the picket line negotiating for better wages and working conditions. The nurses and staff work long hours and in a physically, mentally and at times emotionally exhausting circumstance.


The last thing I remember as I was being wheeled into the operating room was a very serious nurse leaning over me asking me what my name is. I thought that was odd and asked her where she was from, because she had a thick Southern accent. When she said Arkansas, I realized she was a replacement nurse who had been flown in, with room and board, to pick up the slack of the nurses on the picket line. I remember saying, “Oh, wow! I picked a bad time to need a tune up.”

When I woke up in the recovery ward, I was pleasantly surprised I was awake and the nurses were so nice and caring.

Let’s face it, under the circumstances they had every reason to not be so caring and professional. One of the first things they give you when you come out of open-heart surgery is a red pillow to hug when you cough. If you don’t hug that pillow, the pain will knock you out. When you check out of the hospital, all the nurses who brought you back from the brink autograph your pillow. I keep my pillow, with all the autographs and well wishes, next to my desk at work and always say a little prayer of thanks every day for their quality care. It’s a tough occupation, especially during the holidays, but when all is said and done, they offer probably better treatment than any five-star rated hotel in town.

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