Last year we instituted a policy of not refusing any referrals or requests from private healthcare institutions and have since then been slowly cultivating a relationship of trust with these facilities and related organizations despite inadequacies in the relationship that have yet to be addressed. Our goal for this year is to raise the quality of our medical treatment to an even higher level than before based on this relationship to become the first-choice treatment center for patients. The most important thing in achieving the latter aim is to improve the skills and ethical training of every specialist on our staff who is directly involved in treating patients. We intend to do this through workshops and OJT. At the same time, accumulating know-how in hospital and organizational administration are a sine-qua-non for a public health center like ours. Medicine in Japan has long enjoyed a heavily protected status; as a consequence, almost no attention has been paid to accruing expertise in administration. This is especially true of public health institutions.
However, given the uncertain future of the medical sector in the face of dwindling funding, the way to secure a stable future for Matsuzawa Hospital is not to allow a troop of amateur administrators to run the hospital into the ground and then to let them fill the hole they have dug themselves into with more of tax payers’ money.
The second point in achieving the aim of improving our medical services is the need to promote transparency. Making the workings of our organization fully transparent to the public, forcing ourselves to carry out our duties under the strict and constant scrutiny of society is bound to have a salutary effect on the quality of care that we provide. As civil servants, we enjoy many protections under the law; but unless we can put ourselves into the shoes of the average member of society who is fully cognizant of the day-to-day realities of life, we will find it difficult to help psychiatric patients, who often lead a precarious existence due to unstable employment, to become successfully rehabilitated to life in the greater community. Such a goal as this cannot be achieved overnight, of course, but the system of appointing physicians and other experts, the system of allocating personnel, and so forth, need to brought into closer alignment with the expectations of society at large. Even if a single public health center alone were unable to accomplish this aim, achieving full transparency of administrative and professional practices could theoretically be done in a single day given the will to do so; along with information disclosure via the hospital’s website and public lectures, we might accept trainees from various educational institutions, strengthen our ties with other treatment facilities, encourage patients’ families to come to the wards to visit patients and get a better sense of life during hospitalization, and enable more volunteers to work within the hospital as effective ways of promoting greater transparency.
Third, while furthering our efforts to promote transparency, we need to have various methods of evaluating our own performance as healthcare workers. Matsuzawa Hospital issues the standard questionnaire of the Tokyo Metropolitan Hospital System every month to patients discharged within that month. In addition, from two years ago we have been issuing an annual questionnaire to all our inpatients to ask for feedback on our services. The responses of patients who still carry vivid memories of being constrained or isolated often cut us to the quick; but covering our ears, so to speak, against these painful replies with the thought that these practices were necessitated by the patients’ condition or treatment or some other such excuse does nothing to ameliorate the situation. I would like to raise a generation of healthcare workers who have enough compassion for their patients to remain stalwartly at their aside even when constraints or isolation are unavoidable and they must endure being yelled at, spat upon or rebuked.
Starting last year, in addition to issuing the patient questionnaires, we have begun asking an independent evaluation committee comprising medical, nursing, and legal experts to assess the conditions within our wards. Based on the results of their assessment, we are holding discussions with on-site personnel to address any matters of concern. Due to the costs involved, we have thus far been unable to expand this initiative to all the wards but performed a successful trial in the dementia ward last year and intend to expand it to the social rehabilitation ward this year, with the eventual aim of implementing it in all the wards.
Finally, to the end of achieving our goals, we appeal to the patients who come to us for treatment, their families, as well as the greater public, to shoulder their part of the responsibility of maintaining, indeed improving, the unparalleled national health insurance system we all enjoy. The preservation of the medical system is not the sole responsibility of healthcare providers; it falls to the entire citizen body as beneficiaries of national insurance to make prudent use of the services provided. Our goal at Matsuzawa Hospital is not to provide the best possible healthcare only to the first and limited contingent of patients to walk through our doors, but to do so, to the best of our ability, for as many Tokyoites as require our services.
I have laid out the three requirements for becoming the first-choice treatment center for patients. Our task now is to train the efforts of every part of our organization towards achieving this goal. To this end, as ever, I hope to have your understanding and cooperation.