“Momma, just killed a man. Put some pjs on his bed, made him wear them, now he’s dead.”
Brian Dolan makes no apologies for repurposing a Queen song in his crusade to save lives in hospitals around the world.
The Irish Professor of Nursing was recently voted one of the most influential people in the history of the UK National Health Service and is the creator of the #Last1000Days and #EndPJParalysis movements.
Presenting a masterclass at Bond University where he was a special guest last week, Dolan said 30 per cent of patients aged over 70 go home from hospital more disabled than when they arrived.
The reason in part is deconditioning. Patients who spend a week in bed lose 1.5kg of muscle, 20 per cent of the power in their quads, and 10 per cent of aerobic fitness.
“People go to hospital, get into their pyjamas and they are then paralysed in their pyjamas until they leave,” said Dolan.
“This is where End PJ Paralysis started and is about encouraging patients to get up, dressed and moving while in hospital.
“We have said for decades and decades, ‘Come to hospital, you’ll be safe’. And now we are going, ‘About that’…
“Instead of asking, ‘Is this patient safe to be discharged’, a better question may be, ‘Is this patient safe to be admitted?’”
Prof Dolan is not trying to demonise hospitals, but rather affect simple and effective social change that can be implemented by everyone from experienced practitioners to first-year clinical students.
There are 39 health services around Victoria involved in the program and the Gold Coast University Hospital has started running with it.
“This is about how do we look at the health system where we value patients’ time so they spend as little time as possible in the hospital,” said Dolan.
“Seventy per cent of the Australian health budget is spent on time - through payment of salaries and wages, which is the purchase of people’s time. Waiting is one of the biggest wastes in the healthcare system.
“The most important currency is patients’ time and a key question to ask is ‘If you had 1,000 days left to live, how many would you choose to spend in hospital?” The answer for most of us would be none or as few as possible.”
Professor Dolan’s top tips:
- If you’re in hospital go for a walk. If you have a test, walk, don’t get in the wheelchair.
- Meet your family in the canteen, rather than by your bed.
- Pimp your Zimmer. Having personalised Zimmer frames can reduce patient falls by 40-60 per cent. It helps mobilise patients, but also increases conversations which cuts loneliness. Your likelihood of an early death goes up 27 per cent if you are lonely.
- Encourage wards to have goals written on the floor every 10 metres, but have them aspirational like places on a map, not just numbers. Names and villages so people can say they got to Surfers Paradise today.
In addition to presenting a masterclass for staff of the Faculty of Health Sciences & Medicine, Prof Dolan was a VIP guest at the inaugural Bond University Sustainable Healthcare Awards, which were held in the Bond University Club on 22 November.