Scenario: An elderly woman showed symptoms of near syncope and was admitted via ambulance to a small community hospital.

Scenario: An elderly woman showed symptoms of near syncope and was admitted via ambulance to a small community hospital. She experienced an inability to move on her own and almost lost consciousness while watching her grandson play basketball. Her symptoms occurred during a visit to her daughter’s home, which is approximately 150 miles from Liza’s home. When Liza was admitted to the hospital, her daughter explained the numerous types and dosages of medications her mother was taking. She also mentioned that Liza had not been taking her Coumadin as directed by her physician for the past week or so. Liza was admitted to the intensive care unit for evaluation. Over the course of hospitalization, Liza’s condition worsened. Approximately 18 hours after her admission, the nursing staff began performing nervous system checks on Liza and contacted the physician-on-call to obtain an order for a CT scan. The scan showed evidence of a cerebral infarction. Appropriate treatment for the infarction then was provided.

1. How might the student monitor the process he or she has experienced? What types of data would be useful? Describe variations and possible causes of variations in the care processes.

2. What worked and what did not work in the processes?

 
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