"They took such good care of me, they were so nice!"

An elderly woman with confusion, vomiting, weakness and malaise is taken to the ER, admitted for a three day hospital stay and discharged. She was given a patient experience survey with the response, "Oh, they took such good care of me, they were all so nice."

​My primary care physician had me on meds that caused my sodium to drop and he never checked it, and there was no care coordination with any of the other five doctors he kept referring me to.​

​The admitting attending-hospitalist should not have walked in and asked me why I was there or how much IV fluid I was given - she was supposed to have been fully briefed from the ER doctor and read the electronic medical record to tell me along with review of my plan of care and advanced directives with me.

​The admitting nurse should have introduced herself, read the record in front of her on the laptop, instead of asking a confused person the same questions already clearly uploaded. She should have known my life threatening primary diagnosis, she should have done a full physical and level of awareness assessment to establish a baseline upon admission to compare to as treatment was given instead of only touching her keyboard. She should have called in a case manager to coordinate advanced directives to be done and begin discharge planning of an elderly confused person with complications from lack of follow up by primary care physician, and to also contact that physician regarding the admission.

Numerous staff throughout the three days should have been doing level of consciousness (LOC)/awareness checks to note the increased confusion which can be caused by raising sodium too quickly; they should have contacted the primary physician for the last time labs were checked, and the discharge planning status was not supposed to be To Be Determined (TBD) two hours after the discharge order was written; planning should have been initiated the first day admitted. 
A hospitalist who had never seen me wrote the discharge summary incorrectly, changing it from the admission of low sodium (hyponatriumia) which i was treated for, to reflect symptoms for low potassium, with the discharge diagnosis of hypokalemia.

There is a difference between experience questions that do not reflect quality care delivered, and that of value care delivery along with engagement questions. There is a Population and Experience Officer in health systems and to contact them regarding poor care coordination, clinical quality assessments and poor engagement and listening of extended family members - while still in the hospital to ensure good care.