Presentation on theme: "Host Nation Medical Care Lessons Learned Medical Director, TAO-P."— Presentation transcript:
Host Nation Medical Care Lessons Learned Medical Director, TAO-P
TRICARE Pacific 2 Hope is never a good plan.
TRICARE Pacific 3 Frequently Encountered Problems Patients The doctor wouldn’t explain things Doctor/Patient relationship & communication (The “Sensei”) The nurses wouldn’t listen or help Language barriers and the role of nursing The facility was old and dirty Sometimes old and, yes, sometimes dirty I couldn’t get pain medications readily Differing standards (the epidural) I couldn’t eat the food I couldn’t find the clinic I had to wait forever
TRICARE Pacific 4 Frequently Encountered Problems MTF Staff The standard of care is unacceptable Prolonged hospital stays Delay in interventional treatments Technology-Practice disconnect Diagnosis not shared with patient Medications disguised I can’t get timely or complete reports Lack of formal medical communication standard Language barriers
TRICARE Pacific 5 Frequently Encountered Problems Host Nation Providers We’re not always sure what the patient or MTF provider wants. What service is desired, in what time frame, etc.? We have a difficult time communicating in English. Fluency often better than willing to admit We don’t understand your insurance plans. We can’t get paid on time. They are not in our network and have no obligation to play by our rules. They expect payment on or near point of discharge.
TRICARE Pacific 6 Solutions Long Term Relationship Investments Communications Managing Expectations No One-Size-Fits-All Solution
TRICARE Pacific 7 Invest in Long Term Relationships It’s all about “Relationships” HN: In place for a lifetime, US: 2-3 years Who needs whom? Drinking Green Tea Build both professional and social relations Reciprocal medical rounds Publishing = legitimacy Nurse exchange programs Recognition (awards & the Base mystique) Social (Golf and the 19 th hole)
TRICARE Pacific 8 Communication Necessary, but can be problematic “Sorry, No beds available for admission” Cultural norms Direct vs oblique Formal vs informal Verbal vs written Many providers do not send reports, much less details Sub-rosa communications Medical Staff to HN Staff The Good, the Bad and the Ugly MTF HN employees Risk/Benefit Ratio The Japanese Intern Use, Don’t Abuse
TRICARE Pacific 9 Managing Expectations Patient Limit patient surprises Patient Guides to HN Health Care What to expect with facility, wait times, visits etc. How to communicate with HN staff Nurse vs Doctor How to help yourself MTF HN employee assistance and tracking Travel assistance Communications assistance Records assistance Reports back to MTF provider and command Seek patient experience and address their concerns
TRICARE Pacific 10 Managing Expectations MTF Providers MTF Provider education Need to understand HN culture and medical capabilities Build knowledge and pass it along (Preferred Providers) Listen to MTF HN employees Listen to patient experiences MTF/HN Provider relationship building Engage HN counterparts before sending pts. How to communicate, receive reports, etc. Call/Message HN provider to set case expectations Provide relevant case information and expectation for care Make sure patient hand delivers all labs, films, etc. Provide follow up on cases Publish! Medical Quality Assurance and Review US standards vs HN standards? Role of the MTF Provider and MTF HN employee
TRICARE Pacific 11 Managing Expectations HN Providers Be clear on desired end state for patient experience The Mayo Clinic perception Find comfort level for communication Written or verbal Payment Make sure our patients understand their requirements Supplemental Funds, Payment at Discharge Just-In-Time hospital operations