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Learning about challenges facing top-tier hospitals: part 2 of 2

My guide and I made our way down to the Diabetes education department and met the doctor and two patients she was in the process of instructing. In an old wooden bookcase with glass fronts, there was a display of plastic food on plates that showed suggested serving sizes of food – looking like they dated from about twenty years before. In her patient training, the doctor shows the patients how to check for complications, the proper way to inject insulin, how to check blood glucose level, shows them the right kinds and amounts of food to eat, and advises them on getting more exercise. When I asked her what else she needed to help her in her job of educating patients, the doctor remarked that she needed someone to evaluate the patient outcomes after going through patient education.

In the midst of the Sisyphean task of advising an endless stream of diabetic patients of how to manage their disease, she would like to know to what extent this training is actually changing patient behavior. With that, the doctor excused herself and returned to advising the patient in his striped pajamas who had been waiting patiently while we had interviewed her. As my guide and I made our way back out of the hospital, he pointed out some other barriers faced by the medical workers in delivering care to their patients. “Did you notice that when we finally met the head administrator, she was on a locked floor and we needed to be let in by a guard?” he asked. I had noticed that it was very difficult to find her and that we had been a bit late getting there because the many wrong directions given to us. “There are many instances of physical attacks on hospital staff and administrators from frustrated patients. The legal system in China tends to set up barriers against patients getting satisfaction when they perceive that they have received poor care. As a result, there is growing violence being directed toward staff as well as administrators of hospitals here in China.”  This visit revealed that these top hospitals are the thought leaders in educating physicians and patients and are working with other organizations like the Chinese Endocrinology Association. They can be the source of the best information for educating physicians down to the community health center level. Even so, at the best hospitals, there are no studies to show whether the patient education interventions work. They are hungry for validated educational interventions. The chief administrator’s observation that the working age population is probably best reached through workplace interventions validates the concept of workplace carnivals and their emphasis on getting entertaining educational information at the workplace followed by information via hotlines. These top hospitals have great credibility with physicians and patients and should be involved in any awareness and educational initiatives involving them. If possible, in shaping GBCHealth’s diabetes strategy, I need to incorporate methods to test the effectiveness of educational campaigns; this will guide future efforts to initiatives proven to change patient behavior.

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