2014.01.23
Some thoughts on the present and future of Matsuzawa Hospital on New Year’s Day 2014
2014 has dawned, and once again, all of us at Matsuzawa Hospital are renewing our resolve to do our utmost to help alleviate the suffering of our patients and answer the expectations of the taxpayers.
In April last year, Matsuzawa Hospital implemented a new policy of not turning away requests for help from other facilities, foremost among which are private healthcare centers. Thanks to the kind cooperation of the relevant parties, we were able to make a big step towards the full implementation of this policy in the four months from April to August last year. As a public healthcare facility, we have the extremely important task of supporting healthcare centers in the private sector as well and hope to maintain this stance firmly as we move toward realizing our own goals.
Starting now, Matsuzawa Hospital aims to revisit its fundamental tenets as a healthcare center to achieve yet greater improvements in its medical care. Naturally, such a project is too grand to achieve within the scope of a single year; hence, it is a goal which we will have to hold before us continually in future years as well. It is no easy task to assess the quality of medical care, especially psychiatric care. For the present, at any rate, we can start by lending an ear to the opinions of our patients and their families.
In psychiatric practice, there are times when the needs of the patients and those of their families do not coincide. For instance, families are only too grateful to have the patient committed when his or her psychiatric condition deteriorates to the point of becoming hazardous to life at home, but the patient can hardly be expected to feel the same way after being subjected to involuntary hospitalization without any self-awareness of being ill. The annual questionnaire that we ask our patients to fill out are replete with comments brimming with the anger and distress they feel at being forcibly hospitalized, then placed in isolation in protection rooms or strapped to a bed against their will. Even if the responses were to show that most of the patients were “Satisfied” or “Generally satisfied,” just one outcry from a single patient would force us to admit that our mission of providing the best medical care was far from achieved. Moreover, we might even suspect that among families who have expressed satisfaction with the care provided, there may be some who felt grateful to us for having taken a troublesome member off their hands and rescued them from a desperate situation, compelling them to be more generous in their evaluation due to feelings of indebtedness. Clinical work requires that we deal face-to-face with individuals. We can’t talk about the quality of clinical practice without also considering the need to address the particular needs of individual patients. Similarly, we need to listen with consideration to the complicated feelings often experienced by patients’ families. Our aim is to create a hospital that can do both.
Two things are crucially important in improving the standard of medical care. The first is to improve the skills of each staff member; the second is to strengthen the hospital’s organization as a whole. By staff member, I mean not only the physicians, nurses, co-medical staff, and other persons who come into direct contact with the patients, but also the workers who are responsible for facility maintenance or administration. To this end, I hope to enhance opportunities for professional development or support their efforts to publish their research at conferences or in academic journals. But improving the skills of our staff involves not only providing the kinds of assistance I have just described to those currently on the Matsuzawa Hospital staff, but also bringing in new personnel from time to time. In particular, where physicians are concerned, I would like to hire personnel with experience in a range of work environments, including university hospitals, general hospitals, private psychiatric institutions, and local clinics. When people with diverse experiences gather, multiple perspectives emerge, enabling each of us to position our work in the most appropriate way within the context of the hospital’s activities as a whole. For young physicians on staff at another healthcare facility, several years spent working at Matsuzawa Hospital would hardly be a waste of time, and physicians who are currently receiving their training at Matsuzawa Hospital have the career option of going on to work at other facilities and later returning here to join our staff.
While attempting to improve the skills of the staff individually, it is important simultaneously to establish the administration of Matsuzawa Hospital on a firmer footing and to reinvigorate its activities. For instance, a public hospital’s nursing department is organized in a way most suited to its needs while the administrative departments are likewise organized along their own lines, and so forth, but because these several groups find it difficult to cooperate organically, there is a great deal more inefficiency in a publicly run hospital than in a private one. This is one of the flaws of the so-called, vertical style of organization. In the case of Matsuzawa Hospital, over the course of a century since its foundation in 1919, it has been traditionally run more or less as an aggregation of various wards within a large tract of real estate, each operated by the most competent physician or head of nursing within it. In 2012 following the construction of a new hospital building, all the disparate wards were gathered under one roof, but the divisive mentality of earlier years seemed to persist among the medical staff. However, time has clearly brought about far-reaching changes; under the present, more straitened financial circumstances, our hospital’s ability to continue providing medical care has become increasingly challenging, and we can no longer administer the hospital along the idyllic lines of the past. A hospital with an annual intake of 3000 patients and a daily outpatient intake of over 400 must employ its human resources to the maximum extent to realize high quality medical care that will meet the needs of all the patients. Without a novel approach to administration unhampered by past practices and without awakening the people making up the hospital’s organization to their new role, the medical resources entrusted to us by the taxpayers will go to waste. A new wineskin needs fresh wine, so to speak. We must shed the vertical style of organization or the conditions which have carried over from the past and create a system in which the requisite directives are sent where they need to go in whatever direction, whether vertical, horizontal or indeed diagonal.
Once again, I appeal to everyone for their continued, kind support and unflagging encouragement as spurs to our renewed efforts in the psychiatric department to face the current whirlwinds of change. I also encourage you to pay us a visit if you are interested. Any help you provide in our effort to create a new system of psychiatric care will be much appreciated.